Collaboration Between Researchers and State

PolicymakersAHRQ Annual Meeting

September 16, 2009

Collaboration Between Researchers and State

PolicymakersAHRQ Annual Meeting

September 16, 2009

Robert F. St. Peter, M.D.President & CEO

Kansas Health Institute

Communicating withPolicy Makers

Communicating withPolicy Makers

Research competes for the attention of policy makers on two levels

Subject – health vs. all other public policy issues demanding attention

Influence – objective information is only one voice among many affecting decisions by public policy makers

Audience Identification & Research

Message Development

Tactics

Strategic Communication 101Strategic Communication 101

Kansas LegislatureKansas Legislature

Citizen legislature In session ~90 days every year Five “health” committees

Senate Public Health and Welfare Senate Financial Institutions and Insurance House Health and Human Services House Insurance Health Policy Oversight Committee

Two budget committees Leadership committee

Kansas Legislature (cont.)Kansas Legislature (cont.)

Limited support staff Legislative Research Department (staff of

36, including clerical) Committee staff (primarily clerical) Personal staff (clerical, shared) Agency testimony

It’s not Washington, DC out there! OMB, GAO, CRS, AHRQ, think tanks, etc.

Survey of KansasPolicy Makers (2003)

Survey of KansasPolicy Makers (2003)

State legislators 70% response rate (116/165)

County commissioners 80% response rate (268/334)

CATI-administered telephone survey Questions focused on

sources and methods of receiving information perceived information needs

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Television or radio reports

Party leadership

Other healthcare providers in your district

Your local health department

New spaper reports

Other scientif ic experts

Information from the Internet

Your ow n healthcare provider

University researchers

Individual citizens in your district

Other legislators

Lobbyists

Advocacy groups

The Kansas Department of Health and Environment

Your government support staff

Frequently Occasionally Never

Sources of Health Policy Information: KS LegislatorsSources of Health Policy

Information: KS Legislators

Information Sources for State Policy Makers, U.S.

Information Sources for State Policy Makers, U.S.

(scale from 1 to 5) Rating

Legislative staff 4.3

State agencies 4.1

Constituents 3.8

Non-profit organizations 3.5

Legislators 3.5

Advocates/lobbyists 3.3Sorian & Baugh, 2002

(scale from 1 to 10) KS Legislators

KS Commissioners

Talking one-on-one w/ informed ind. 8.7 8.8

Reading brief summary material 8.4 7.9

Receiving testimony at hearing 7.9 6.5

Forums/seminars lasting 1-3 hours 5.8 6.3

News media articles/reports 5.3 6.0

Reading in-depth articles or reports 4.8 5.7

Watching videotapes 4.7 5.3

Conferences lasting 1 day or longer 4.2 4.9

Listening to audio tapes 4.1 4.4

Preferred Ways to Receive Information

Preferred Ways to Receive Information

23%

50%

4%

18%

5% 1 page or less

2 or 3 pages

4 to 10 pages

As long asnecessary

Other

Length of Written InformationLength of Written Information

“Ideal length of written materials you read to help you make policy decisions” (KS Legislators)

2%

30%

61%

7%

Never

Sometimes

Usually

Always

Adequacy of Available InformationAdequacy of Available Information

“In making policy decisions, would you say you have enough reliable information on public health never, sometimes, usually, or always?” (KS Legislators)

Framework for Knowledge TransferFramework for Knowledge Transfer

What should be transferred to decision makers (the message)?

To whom should research knowledge be transferred (the target audience)?

By whom should it be transferred (the messenger)?

How should it be transferred (communications infrastructure)?

With what effect should it be transferred (evaluation)?

Lavis, et. al., 2003

What Should Be Transferred?What Should Be Transferred?

Transfer actionable messages from a body of research knowledge, not simply a single research report or findings from a single study

Research in the form of “ideas,” not “data,” is most influential

Decision makers rarely use a regression coefficient to solve a particular problem

Over long periods of time, “ideas” enlighten decision makers about a particular issue and how to handle it

Lavis, et. al., 2003

Focus on “interactive engagement” Interpersonal Exchange of ideas Iterative

“The research literature on which processes are best at transferring knowledge suggest that passive processes are ineffective and that interactive engagement may be most effective…. The hall mark of these interventions is interaction: interaction between the [subject] and an ‘expert’ … or interaction between the [subject] and someone to whom he or she routinely turns for guidance.”

Lavis et al., 2003

How Should ItBe Transferred?How Should It

Be Transferred?

How Should ItBe Transferred? (cont.)

How Should ItBe Transferred? (cont.)

Focus on process not events Long-term Continuous Outcome oriented

“ Over long periods of time, two-way ‘exchange’ processes that give equal importance to what researchers can learn from decision makers and what decision makers can learn from researchers can produce cultural shifts. Such cultural shifts can facilitate the ongoing use of research knowledge in decision making, not just one-off uses.”

Lavis, et al., 2003

Evolution of KHI Communication Activities

Evolution of KHI Communication Activities

Briefs and reports Legislative testimony Legislative brown bags and forums Study groups for legislature KHI News Service Legislative Health Caucus Legislative Health Academy

Kansas Legislative Health AcademyKansas Legislative Health Academy

Launch in Fall 2009 12-15 legislators

Selected with input from legislative leadership Substantial commitment of time

3-day retreat, three 2-day sessions At least one year

Payment of per diem and expenses Support from legislative leadership Certificate upon completion Curriculum integrates

System dynamics Values framework Leadership skills

Considerations withActive EngagementConsiderations withActive Engagement

Restrictions based on tax status Governmental ethics/open meetings Comfort with shared control Potential for introduction of bias Maintaining credibility while in mix Resources to sustain engagement Determining effectiveness

Information for policy makers. Health for Kansans.Information for policy makers. Health for Kansans.

Kansas Health InstituteKansas Health Institute