www.healthpolicy.ucla.edu

Research and Data Analysis

for Policy ImpactSteven P. Wallace, Ph.D.

Associate Director, UCLA Center for Health Policy ResearchProfessor & Chair, Department of Community Health Sciences

UCLA Fielding School of Public Health

In memory of E. Richard Brown

Based on his earlier presentations

Active in local, state & national policy

Founder UCLA CHPR & CHIS

Research and data analysis for policy impact

Data don’t change policy…but data may help stimulate and inform it.

Opportunities to make empirical evidence relevant in policy process

Audiences that may use empirical evidence for policyData and analysis for evidenced-based policyHow can researchers encourage use of their empirical

evidence? The strategy of the UCLA Center for Health Policy

Research The California Health Interview Survey

Research and data analysis for policy impact What is the policy outcome?

“Evidence-based health policy”

Health policy that is shaped by sound empirical evidence to improve health care access and quality and health outcomes

What does it take to get there?

Receptivity by policy actors

Data and evidence relevant to policy decisions

Easily accessed channels of communication

Formats that are accessible to policy audiences

Creating body of evidence that stakeholders and interest groups accept

Opportunities to make empirical evidence relevant in policy process

Problem Stream

Policy Stream

Political Stream

Data don’t change policy …but policy makers, advocates, and policy entrepreneurs can use data and research evidence to support policy change efforts

Data and evidence are relevant to: Identifying, describing, & analyzing problem (Kingdon’s “problem stream”) Developing or analyzing policy options (“policy stream”)

Apologies to John Kingdon, Agendas, Alternatives, and Public Policies

Evidence-based Health Policy

Our Goal

Audiences for policy-relevant data and research evidence

Audiences that may use data and research for policy Policy makers in government agencies and legislatures

Policy entrepreneurs

Foundations trying to shape policy outcomes

Advocates trying to influence policy process and outcomes

Not all audiences have equal technical and policy resources to affect political policy process Many advocates, especially for low-income populations, have limited

technical resources needed to access and analyze data

Even many local health departments have limited data analytic technical capacity

Many populations of color and smaller local jurisdictions find little data available on their group or area

How can researchers encourage policy audiences to use data and research evidence?

Academic health policy researchers’ audience is traditionally peers

Peers usually care about scientific rigor — originality of research question, conceptual framework, data and methods

Peers not usually concerned about policy relevance

What do policy audiences care about?

How can researchers encourage policy audiences to use data and research evidence?

Policy audiences care about policy issues and relevant actionable factors

Does it inform debate on the issues they care about?

Does it support their policy goals?

Does it identify policy relevant factors that will make a difference?

Credible role as a policy researcher

Researcher, not advocate

How can researchers encourage policy audiences to use data and research evidence?

How to reach policy audiences? Formats that are accessible to policy audiences

Publishing in peer-reviewed journals is key to academic career and provides credibility

Policy publications (reports, policy briefs, factsheets) are more accessible formats for policy audiences

Speak to both audiences – journal articles for academics and policy publications for policy makers and advocates

Easily accessed channels of communication and dissemination

Dissemination channels push policy findings directly to policy audiences vs. “if we build it, they will come”

UCLA Center for Health Policy Research’s strategy to promote use of its research and data in policy

development

1. Center faculty and researchers conduct studies on broad range of public health and health care policy issues

Center researchers interact with stakeholders who help researchers identify policy issues for research

Center researchers encouraged to include policy relevant conclusions in journal submissions

Center publications require policy discussion and conclusions

2. Scientifically credible data about diverse populations and geographic areas

The Center is home of California Health Interview Survey (CHIS)

Statewide and local population-based health data on adults, adolescents, and children

Omnibus survey Covers wide range of public health and health care topics

Extensive demographic and social information

Very large RDD survey of California population Survey conducted in 6 languages

Sample sizes ~50,000 households/ 2 years

Robust samples of counties and subcounty areas

UCLA Center for Health Policy Research strategy

2. Scientifically credible data about diverse populations and geographic areas

CHIS is designed to provide data that is used

To support policy analysis, development and advocacy at local level and statewide for public health and health care

To understand and measure health needs of California’s population and assess disparities in health and health care Capture ethnic, geographic, and social class diversity

Geocoded to link to external data on social and physical environment

More than 140 individuals from over 60 diverse organizations and agencies participate in formal advisory committees

UCLA Center for Health Policy Research strategy

strategy to promote use of research and data in policy

3. Direct-to-policy-audiences channels of communication and dissemination

Multiple channels and formats to maximize use of results by wide range of constituencies

Policy research reports ~ to meet needs of policy wonks, specialized policy makers, and focused policy advocates

Policy briefs ~ for those interested in policy issue but not deeply involved

Fact sheets ~ to interest people in policy issue even when they are not focused on it

Disseminate directly to broad policy audience and to larger public

Listservs and mailing lists

News media/ Press releases

Policy Brief

Press Release

Web page with updates

www.healthpolicy.ucla.edu/ElderIndex

Media (p.1, above the fold)

Immigration Resources

Migration Policy Institute http://www.migrationpolicy.org/

Pew Hispanic Center http://www.pewhispanic.org/

Health Initiative of the Americas http://hia.berkeley.edu/

Immigration Policy Center http://www.immigrationpolicy.org/issues/health

USC Center for the Study of Immigrant Integration http://csii.usc.edu/

International Organization for Migration http://www.iom.int/jahia/Jahia/lang/en/pid/1

Center for Immigration Studies (anti-immigration) http://www.cis.org/

UCLA Center for Health Policy Research strategy

4. Easy and free access to CHIS data and analytic tools

Web site is portal to all information about CHIS

CHIS questionnaires and topics

CHIS public-use data files to download, information on how to access CHIS confidential data files

CHIS methodology reports

Easy-to-use online data query system

Free access to statewide and local data through fast, user-friendly Web-based data query system

User defined analyses of CHIS data from all surveys

More than 27,000 registered users

Ran more than 94,415 queries in last 12 months, an average of 258 per day

UCLA Center for Health Policy Research strategy

5. Help advocates and local health agencies enhance capacity to use data and research

Center’s public service program: Health DATA — “Turning Knowledge into Action”

Created to build capacity of advocates and agencies to use health research data to address their communities’ health policy issues

Conducts training workshops to help staff and volunteers learn:

How to access health research data

Questions to ask about data quality and validity, and

How to apply research data in their programs and policy work

First steps in helping change public policy through research

Decide what research will have desired impact on policy process

Research to help set policy agenda

Studies that get policy-makers and leaders to pay serious attention to an issue and take action on it

Focus people on particular aspect of problem — a population group, particular disparity, particular set of factors that contribute to problem

First steps in helping change public policy through research

Decide what research will have desired impact on policy process Research to help frame issue and shape policy debate

Results of policy research can be used to argue for one policy versus another

Framing it as “social issue” vs. “personal problem”

If framing and public debate are ideological, evidence-based arguments carry little weight

Research to help specify policy goals that will address the policy issue

Policy-related research can inform policy makers and advocates about relative effectiveness of different policy options

First steps in helping change public policy through research

Research to focus attention on implementation of the policy decision

Policy-related research can help illuminate whether policy is being adequately implemented

Determine if consequences of policy are what was intended

Recommendation changes to improve implementation or original policy

Give your results more impact

Journal articles follow form required by particular journal and by academic convention

Policy publications can speak directly to policy audiences

Make it relevant

Make it brief

Make it sing!

Make it relevant

Make it community specific

Make it comparative

Give your results more impact – Make it relevant by making it community specific

“Localizing” data – most people, especially elected officials, are particularly interested in their own communities

CHIS provides data and rates at county-level or more granular geographic level

CHIS provides data and rates at granular population levels (by age and gender, race and ethnicity, national origin, immigration status, income, education, sexual orientation, etc.)

No CHIS data?

Take national data and “extrapolate” it to local area

Take data from similar population and apply it to yours

Give your results more impact – Make it relevant by making it comparative

Across time

Measure and analyze change over time

CHIS provides data from 5 survey cycles to track change over time

Across space

Comparing rural areas with urban areas

CHIS oversamples rural areas and has large urban, suburban and rural samples

Comparing one county with another

CHIS has defined samples for 41 individual counties and some subcounty areas

Give your results more impact – Make it relevant by making it comparative

Compare to benchmark

Compare group’s rate with guidelines or target rate such as Healthy People 2020

CHIS includes many health indicators that match up well with Healthy People 2010 and 2020

Comparing immigrants with native born from same ethnic group, high vs low education immigrants

CHIS includes a great deal of social-demographic information about each respondent and large enough samples to enable analyses for many subgroups

Give your results more impact – Make it relevant by making it sing!

Keep the data presentation simple!

Tell a story with your data

The narrative should describe: the problem

the data, and

the conclusions

The narrative should lead directly to the policy conclusion

Use charts and graphs

Bars compare totals or rates across groups

Lines demonstrate trends

Pies show parts of a whole (distributions)

Tables display precise data

Give your results more impact – Make it relevant by making it sing!

Keep it simple

Make comparisons “intuitive”

If something is increasing, show it going up!

Make comparisons stand out

Show greatest proportional differences

Don’t put too much in a slide

Make just 1 to 3 points per slide (not like mine!)

Give your results more impact – Disseminating research results to policy audiences

Discuss policy implications in reports, articles, and public meetings

Identify how specific public policies (or absence of policies) affect outcomes

Such as morbidity and mortality, health status and conditions, and access to health services

Poor access to fresh produce in community linked to lower consumption of fruits and vegetables

Living near freeways linked to higher rates of asthma

Identify specific public policies needed to address problem

Give your results more impact – Disseminating research results to policy audiences

Share results with affected communities and populations, especially those that participated in research

“Giving back” to community

Informs and educates

Engages them in addressing the issue

Getting community’s input on interpretation of results

Improves accuracy and relevance of study conclusions and recommendations

Give your results more impact – Disseminating research results to policy audiences

Disseminate to policy makers

Create and send brief, readable summary of research and results with recommendations (e.g., policy brief)

Make issues concrete and personal

Bring study findings to attention of groups that can influence policy makers

Reach public and policy makers through news media

Increase credibility and reach policy analysts by publishing in journals

Conclusion: Research can help change public policy to improve public health

Data needs to be part of larger policy process with clear policy goals and strategy

Use creative and appropriate data methods

To get data (data collection or use CHIS or other good data)

To make data relevant (analysis)

To make it understood and interesting to target audiences (presentation): Make it sing!

Disseminate research findings

Include explicit policy discussions

To communities that are affected and participated

To policy makers