Upload
ella-mcdowell
View
215
Download
0
Embed Size (px)
Citation preview
www.healthpolicy.ucla.edu
Putting Data and Information into Hands of Those Who Can Use It: Dissemination and Impact
of the California Health Interview Survey
E. Richard Brown, PhD,David Grant, PhD, May H. Jawad, PhD,
D. Imelda Padilla-Frausto, MPHUCLA Center for Health Policy Research
Nancy Breen, PhD, National Cancer Institute
Barry Portnoy, PhD, Office of Disease Prevention, National Institutes of Health
AcademyHealth Annual Research MeetingJune 7, 2008
2
Translating research into policy to improve health
Intended outcome
Promote development of “evidence-based health policy” to improve effectiveness of health policy
First step
Putting usable data, research analysis and information into hands of policy makers and advocates
Requires strategic approach to data and dissemination
Make research findings and data accessible to policy makers and advocates
Democratize access to analysis and application of data for policy makers and advocates with less technical capacity
This presentation
Conceptual framework
Dissemination intervention
Results of study assessing use and impact
3
Conceptual model: 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”)
John Kingdon, Agendas, Alternatives, and Public Policies
Evidence-based Health
Policy
Our Goal
4
Audiences for policy-relevant data and research evidence
Policy makers in government agencies and legislatures
Policy entrepreneurs (or champions) in and out of government
Advocates trying to influence policy process and outcomes
News media/journalists
5
Audiences for policy-relevant data and research evidence
Researchers and government agencies often ignore substantive, resource and access constraints
Policy makers and their staff: Limited technical resources or time to access and analyze data
Advocates, especially for low-income populations: Limited technical resources needed to access and analyze data
Local health departments: Many have limited technical capacity for data analysis
Populations of color and smaller local jurisdictions: Many find little data available on their group or geographic area
Journalists working for print or broadcast media: Most have no expertise to conduct analyses and little time to search for data
6
UCLA Center for Health Policy Research’s strategy to democratize access to research data and analysis
The Center has developed strategy to democratize access to research data and analysis
1. Develop population-based data to provide information about diverse populations and geographic areas — with input from data stakeholders
2. Encourage policy-focused research and provide relevant data
3. Develop direct-to-policy-audiences channels of communication and dissemination that respond to each level of technical capacity
4. Provide free access to these data and easy-to-use analytic tools
5. Help advocates and local health departments enhance their capacity to effectively use data and research
These have proved effective in reaching policy audiences and impacting public policy
7
The Center also is home of California Health Interview Survey (CHIS)
California’s assessment tool designed to meet statewide and local needs for population-based health data on adults, adolescents, and children
Omnibus survey covers wide range of public health and health care topics plus extensive demographic and social information
Very large biennial RDD survey of California population
Sample sizes: 56,000 households in 2001, 42,000 in 2003, 45,000 in 2005, and over 50,000 in 2007
Statistically adequate samples for most counties
Survey conducted in 6 languages
Statistically adequate samples for key ethnic groups and Asian & Latino subgroups
Develop population-based data to provide information about diverse populations and geographic areas
www.chis.ucla.edu
8
Develop population-based data…with input from data stakeholders
CHIS developed and conducted through extensive participatory process
Formal participatory approach to develop each 2-year cycle
Involves diverse constituency organizations and stakeholder agencies in formal advisory process
In planning CHIS surveys to enhance their relevance to communities surveyed and measure factors related to community needs
In using CHIS data and results and enhancing community knowledge and skills
Contrast to other large-scale health surveys, which include limited, if any, participatory approaches
9
Extensive dissemination to maximize use of CHIS data and results
Policy makers, advocates, media, analysts, and researchers
CHIS invests more than 1 in 5 project dollars in dissemination in every two-year cycle
Web marketing use by most audiences to access CHIS
Center policy research publications based on CHIS data targeted to key audiences
Easy-to-use web-based free query system to democratize access to data and analysis
Electronic data files — public-use, special-use, and confidential — for analysis by independent researchers
Workshops to disseminate knowledge about CHIS and encourage use
Develop channels of communication and dissemination responsive to audiences’ technical and analytic capacity
www.chis.ucla.edu
10
CHIS Impact Study: Study goals
Developed study to understand how organizations and agencies access and use CHIS data and what impact CHIS data may have in their work
Found that diverse audience of CHIS users include:
State and national policy makers
Advocacy organizations
Philanthropic health foundations
Private hospitals and health care organizations
State and county public health agencies and federal agencies
11
CHIS Impact Study: Study approach Two-stage design
Phase 1 — qualitative study — in collaboration with (and funding from) National Cancer Institute and National Institutes of Health: Completed
Phase 2 — quantitative study — in collaboration with (and funding from) The California Endowment: Will begin in June
Methods: Phase 1
Sample drawn from lists of CHIS data users (Center listserve, AskCHIS users, public-use data files users) and others known to Center staff
29 diverse organizations interviewed
State and local government legislative and agencies
Nonprofit organizations
Commercial organizations in health care
7 of these organizations selected for in-depth studies
12
Health policy analysis and development
California Governor Schwarzenegger’s office used CHIS data to support development of his proposal for health care reform
Used CHIS data to estimate number of people who would be affected by his proposal and develop a fiscal analysis of various policy options
Governor’s staff requested the Center to conduct multiple data analyses
California State Senate Health Committee used CHIS data to assess coverage effects of each proposal for expanding health coverage
13
Health policy advocacy
CHIS data used by virtually all stakeholders involved in California’s health care reform process
To analyze Governor’s health care reform proposal, develop amendments to his proposal or develop alternative proposals
Most organizations accessed CHIS data through several means Including AskCHIS, public-use data files, and special requests to
UCLA Center for Health Policy Research for data analysis
Created common data base to define the problem and to craft and assess policy proposals
California Food Policy Advocates collaborated with Center on research brief on food insecurity
Article in LA Times about study findings prompted Assemblyman to introduce bill to increase participation in food stamp program; bill passed
California Food Policy Advocates considered CHIS data and research study the centerpiece of their successful advocacy effort
14
Grant making
The California Endowment uses CHIS data in developing specific initiatives and programs within each program area
Program officers and associates use CHIS data in assessments of grant proposals and to supplement proposals with information relevant to program need within community or region of focus
The data are used during internal grant review processes to establish need, set context for programs and justify investment of foundation funds
15
Funding development
Los Angeles Regional Food Bank (LARFB)
Collects food and distributes it to sites throughout LA County
Obtains food resources through fundraising and resource acquisition as well as advocacy at the federal, state, and local levels
LARFB uses CHIS data to demonstrate need for additional resources
CHIS data are used with administrative data to demonstrate need for resources at local level and to advocate policy changes in food stamp, school breakfast and school lunch programs
CHIS data are also used to inform implementation of those programs
LARFB uses numerous sources of data in its planning, but CHIS is only source of local level data on population needs
LARFB benefits from CHIS providing data for county service planning areas and health districts with adequate sample sizes
LARFB considers CHIS credible, reliable source of information on hunger and food insecurity
16
Program and service planning
Many counties have used CHIS data to develop public-private partnerships to provide health insurance for uninsured children
CHIS data to estimate number of uninsured children in county who are not eligible for California’s Medicaid and SCHIP programs
CHIS data to develop budget for “Healthy Kids” programs and seek funding for them
CHIS data used to develop justifications for funding
The California Diabetes Program in California Dept. of Public Health
Uses CHIS data to measure county-level prevalence of diabetes and receipt of services essential to diabetes disease management (A1C tests, dilated eye and foot exams, and pneumococcal vaccine)
CHIS was only source of local health data relevant to this effort to demonstrate risk factors & burden related to diabetes at county level
17
CHIS Impact Study: Results summary
Multiple ways CHIS data were accessed
Most data users access CHIS data through AskCHIS online query system
Center reports and briefs, public-use files, confidential data files and requests for special data analyses by Center researchers also important
CHIS data were used by stakeholders for variety of purposes:
Health policy analysis and development
Health policy advocacy
Grant making
Funding development
Service and program planning
18
Key factors reported by stakeholders as important in their decisions to select CHIS data and ability to obtain and use it
Breadth of information makes CHIS useful for wide range of health issues
Availability of comparable CHIS data for both state and local-level data
CHIS sample supports analyses for many racial-ethnic and other population groups
CHIS data quality important to providing credible evidence for identifying and defining problems, and for planning and assessment
Data accessibility through multiple channels and methods critical to meeting the needs of extremely diverse data audience
Technical support, training and guidance to assist for data users
CHIS Impact Study: Conclusions
19
Comprehensive topics and comparable state and local population-based health data provide useful data source for policy development, advocacy, and program planning
Substantial investment in dissemination and communication — specially providing free and highly accessible data and analysis — foster widespread use of CHIS data by many types of public agencies and private organizations
Conclusions
www.chis.ucla.edu