Translating Medical Effectiveness Research into Policy: Lessons from the California Health Benefits Review Program

Abstract

Methods: This article is based on the authors' experience reviewing benefit mandate bills for CHBRP and findings from evaluations of the program. General observations are illustrated with examples from CHBRP's reports. Information about efforts to incorporate evidence into health policymaking in other states and nations was obtained through a review of published literature.Findings: CHBRP produces reports that California legislators, legislative staff, and other major stakeholders value and use routinely in deliberations about benefit mandate bills. Where available, the program relies on previously published meta-analyses and systematic reviews to streamline the review of the medical literature. Faculty and staff responsible for the medical effectiveness sections of CHBRP's reports have learned four major lessons over the course of the program's six-year history: the need to (1) recognize the limitations of the medical literature, (2) anticipate the need to inform legislators about the complexity of evidence, (3) have realistic expectations regarding the impact of medical effectiveness reviews, and (4) understand the consequences of the reactive nature of mandated benefit reviews.

Strategies for effective dissemination of research to United States policymakers: a systematic review

“…Two studies (about 7%) did not specific the geographic region or state in which the study took place [43,44]. Of the remaining studies, four examined policymaking in the Northeastern United States [45][46][47][48], four in the Western US [49][50][51][52], and one in the South [53]. The geographic regional groups used similar channels to disseminate evidence to policymakers including publications and presentations.…”

“…Included studies examined a variety of channels with many including multiple channels. Print materials was the most commonly used channel, including reports (n = 10) [27,30,33,41,46,50,53,55,57,58] and policy briefs (n = 3) [31,34,38]. Researchers examined in-person meetings and communications as a channel to disseminate research (n = 9) [30,32,33,39,44,48,53,56,57].…”

“…• Research use 'champions' engage with community stakeholders and policymakers [45] • Intermediary organizations connect "research supply" to "research demand" [53] • External brokers play a role both in connecting policymakers to research and in conceptualizing and developing policy [39,43] • Intermediary individuals or organizations may select or spin research to make their point [45,52,53] • Policymakers may have a list of preferred evidence brokers [53] • Basing policy on evidence requires identified 'best evidence', which may reflect bias and favoritism [29] Context matters • Integrate research evidence into broader sociopolitical context [45] • Research must be locally, contextually relevant [54,55,57] • Specify which government office(s) are responsible [47] • Federally imposed policies (e.g., education) often override local expertise around context and population [29] • Ideology, whether personal or regional, may create a barrier between researchers and policymakers [27,41,44,50,[54][55][56] Make research products timely, relevant, and accessible…”

“…Purtle et al [55] concur, reporting that some county health officials were wary of the potential to spin research findings to make a case for certain programs over others and noted the need to avoid the challenge of distorting evidence. Two studies recommend positional neutrality as a researcher's best approach to handling potential ideological differences, suggesting that presenting research findings as simple fact, rather than making specific recommendations for action, may help avoid conflict and also help researchers gain credibility across the ideological spectrum [27,50].…”

La investigación traslacional y su aporte para la toma de decisiones en políticas de salud

“…Si bien se reconoce el creciente interés internacional, la IT hoy en día enfrenta importantes desafíos (49)(50)(51)(52)(53) . El primero de ellos es la necesidad de avanzar en su definición conceptual y, en algunos casos, la poca división entre sus distintas etapas, en especial T2 y T3.…”