collaboration between researchers and state policymakers: models for achieving evidence-informed...

Collaboration Between Researchers Collaboration Between Researchers and State Policymakers: Models for and State Policymakers: Models for Achieving Evidence-Informed PolicyAchieving Evidence-Informed Policy

Andrew Coburn, Ph.DAndrew Coburn, Ph.D

Muskie School of Public ServiceMuskie School of Public ServiceUniversity of Southern MaineUniversity of Southern Maine

AHRQ Annual MeetingBethesda, MD

September 16, 2009

“….Researchers Are From Mars; Policy Makers Are From Venus”

P. Feldman et al. (2001) Gerontologist 41:312-321

One perspective…….

Muskie School of Public Service

UNIVERSITY OF SOUTHERN MAINE

How Can We Expand The Use Of Health Services Research In State

Health Policy?

Evidence-Informed Decision Evidence-Informed Decision MakingMaking

The systematic application of the best The systematic application of the best available evidence to the evaluation of available evidence to the evaluation of options and to decision-making in options and to decision-making in clinical, management, and policy clinical, management, and policy settings.*settings.*

**Canadian Health Services Research Foundation. (2001) Health Services Canadian Health Services Research Foundation. (2001) Health Services Research and Evidence-Based Decision-Making. OttawaResearch and Evidence-Based Decision-Making. Ottawa



Policy Design

Policy Implementation

Identify problems

Review evidence and solution options

Assess stakeholder interests and concerns

Assess risks and costs to implementation

Prospects for successful outcomes

Track Implementation

Evaluation against objectives

Disseminate bestpractices

Assess policy effectiveness

Assess lessonslearned



The Key Stages of EIDM

Defining questions and hypotheses

Knowledge summary/synthesis

Casual model based on theory

Analysis and evaluation of findings

Communication ofresults

Dissemination/knowledge transfer

Re-assessment of Question/problem



Key Stages in the Research Process

Models for Linking Research to Models for Linking Research to Policy Decision MakingPolicy Decision Making

““Researcher-Push”:Researcher-Push”: Dissemination, translation, Dissemination, translation, KT, research synthesis, KT, research synthesis, ““User-Pull”:User-Pull”: Commissioned research, rapid Commissioned research, rapid response units, data and trends analysis, response units, data and trends analysis, research synthesisresearch synthesis““Researcher-User Exchange”:Researcher-User Exchange”: research-policy research-policy networks, informal policy-researcher exchange, networks, informal policy-researcher exchange, “embedded” researcher“embedded” researcher““Organizational Excellence”:Organizational Excellence”: organizational organizational strategy using multiple, integrated approaches to strategy using multiple, integrated approaches to linking and using evidence. linking and using evidence.



Source: J. Lomas Improving Research Dissemination and Uptake in the Health Sector: Beyond the Sound of One Hand Clapping , 1997

Factors Influencing the Policy Process

The Use of Evidence in Policy The Use of Evidence in Policy Decision MakingDecision Making

Emphasis has been on promoting greater Emphasis has been on promoting greater access to research through dissemination access to research through dissemination and knowledge transfer. and knowledge transfer. Follows tendency to view research and Follows tendency to view research and policy as policy as productsproducts versus versus processesprocesses. .



The Use of Evidence in Policy The Use of Evidence in Policy Decision Making Decision Making

InstrumentalInstrumental versus versus conceptual conceptual uses of uses of evidence: tendency is to focus on how evidence: tendency is to focus on how evidence influences specific decisions, evidence influences specific decisions, underplaying the role of evidence in underplaying the role of evidence in influencing general knowledge, thinking, influencing general knowledge, thinking, and culture. and culture.



What Facilitates Research Use In What Facilitates Research Use In Policy Decision-making?Policy Decision-making?

Benefits of using evidence are understood; Benefits of using evidence are understood; Users are partners in generating evidence;Users are partners in generating evidence;Evidence is relevant, timely, and Evidence is relevant, timely, and methodologically uncontested;methodologically uncontested;Results support political ideologies, are Results support political ideologies, are convenient and uncontentious;convenient and uncontentious;Results have high degree of certainty (error and Results have high degree of certainty (error and risk), are robust in implementation, and involve risk), are robust in implementation, and involve low costs.low costs.

Davies, Nutley, Smith, Davies, Nutley, Smith, What Works? Evidence What Works? Evidence basedbased policy and practice in public servicespolicy and practice in public services (2000) (2000)



Final ThoughtsFinal Thoughts

State capacity for EIDM is limited: how can State capacity for EIDM is limited: how can we accelerate move to “rapid learning” in we accelerate move to “rapid learning” in Medicaid and other state health policy?Medicaid and other state health policy?Importance of using multiple strategiesImportance of using multiple strategiesCan we demonstrate results?Can we demonstrate results?



collaboration between researchers and state policymakers: models for achieving evidence-informed...

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