Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care Proceedings of a Workshop Series (2022) / Chapter Skim
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12 Workshop 4, Session 2: Informing Evidence-Based Policy Making
12 Workshop 4, Session 2: Informing Evidence-Based Policy Making
Pages 107-122
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From page 107... ...
• Formative audience research can inform effective design of dissemination materials and the channels and sources through which to distribute them. (Purtle)
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From page 108... ...
Tipirneni noted that as a primary care provider herself, she wondered how the department would be able to ensure and monitor access to primary care providers for patients with Medicaid within those time frames. Tipirneni considered several methods when she was developing a rigorous study to answer a policy-relevant question that examined both appointment availability and wait times for patients who had Medicaid coverage: • Conduct a secondary data analysis using federal or state surveys that monitor access to appointments or access to primary care practitioners.
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From page 109... ...
For stakeholders in the state's Medicaid program -- the audience she most wanted to inform -- the team prepared an issue brief that she updated regularly as the team collected additional data. The issue brief focused on the information stakeholders prioritized: appointment availability and the regions in the state that had better access and worse access.
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From page 110... ...
Those suggestions included • reading the policy or piece of legislation prior to generating research questions to address that legislation or policy; • engaging with policy stakeholders early and often during the research process; • considering a variety of methods, including secondary data analysis and primary data collection; • framing research as an iterative process that involves developing questions and methods in collaboration with both researchers and policy stakeholders; • writing issue briefs, not just academic papers, to translate research findings for policy stakeholders; and • developing relationships with policy makers and maintain them over time to truly have an impact on policy. CHANGING ACCESS TO CARE FOR UNDOCUMENTED IMMIGRANTS WITH DATA Lilia Cervantes is director of immigrant health and an associate professor in the Department of Medicine at the University of Colorado Anschutz Medical Campus.
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From page 111... ...
citizens can receive Medicare-covered kidney replacement therapy, including dialysis and kidney transplantation, because of the 1972 Medicare end-stage renal disease entitlement program.1 However, the availability of kidney replacement therapy varies by state for undocumented immigrants, who are excluded from Medicare, most Medicaid programs, and provisions of the Affordable Care Act. In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act,2 which prohibits refusal of care in an emergency situation regardless of immigration or insurance status.
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From page 112... ...
Presented by Lilia Cervantes on July 6, 2022, at Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care: A Workshop Series (Cervantes et al., 2019)
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From page 113... ...
Cervantes and her colleagues provided policy stakeholders with research evidence to support policy change. Colorado's Medicaid agency decided in February 2019 to expand access to standard dialysis by including it as a service under the Emergency Medicaid Program.
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From page 114... ...
Dissemination research, he explained, is a branch within the broader field of implementation science that is concerned with packaging and communicating research evidence to different audiences. According to the National Institutes of Health definition, "dissemination research is the scientific study of targeted distribution of information and intervention materials to a specific public health or clinical practice audience.
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From page 115... ...
"We contend that by doing research about the dissemination of research evidence, we can improve how evidence spreads, and we can change knowledge and attitudes in policy makers in ways that we want to see," said Purtle. He added the caveat that while dissemination research can improve how evidence spreads, it does not guarantee that evidence will consistently inform policy because of the nature of the policy making process, The first phase for dissemination is to conduct formative audience research.
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From page 116... ...
Formative audience research also aims to determine policy makers' attitudes about a specific evidence-supported policy. When Purtle's team surveyed legislators' attitudes related to state behavioral health parity laws, they found that nearly three-quarters of the legislators believed the evidence that parity laws increase access to behavioral health (Purtle et al., 2019b)
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From page 117... ...
Presented by Jonathan Purtle on July 6, 2022, at Accelerating the Use of Findings from Patient-Centered Outcomes Research in Clinical Practice to Improve Health and Health Care: A Workshop Series (data from Purtle et al., 2019a)
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From page 118... ...
The research team then tracked engagement with the evidence by email views and the rate at which legislators clicked links in the email to view the policy briefs. All the emails concluded with an offer for expert consultation for more information, which they tracked as an outcome.
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From page 119... ...
He also includes his phone number in emails and policy briefs that he sends to legislators, which often results in phone calls from the legislator or staff member. Supporting Translating Research to Policy An audience member then asked speakers to discuss their ideas for how AHRQ or other funders can support infrastructure development at research institutions and provide incentives to support researchers who want to engage in the policy space.
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From page 120... ...
She said such a curriculum would include how to put a policy brief together and how to think about research questions that can lead to policy change. Speakers' Advice for Researchers Hughes asked the panelists what advice they would give to a colleague considering engaging in policy-related work.
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From page 121... ...
Speakers had several suggestions for best approaches to disseminating research evidence to policy makers including5 • Knowing the audience, including those who hold different opinions • Selecting communication materials that are most effective and useful for each audience • Avoiding language that could alienate policy makers of one political party • Incorporating narrative evidence to provide context to quantitative data • Understanding the baseline awareness of the evidence and attitudes toward interventions among policy makers • Conducting audience segmentation to better understand knowledge, attitudes, and behaviors that will inform and allow for tailoring communications and dissemination plans 5 These points were made by the individual workshop speakers/participants identified above. They are not intended to reflect a consensus among workshop participants.
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