Law & Ethics in Public Health Unit 1

Vol.:(0123456789)1 3

Maternal and Child Health Journal (2019) 23:733–738 https://doi.org/10.1007/s10995-018-02708-x

F R O M T H E F I E L D

Leveraging Public Health Research to Inform State Legislative Policy that Promotes Health for Children and Families

Emily J. Tomayko1  · Bethany Godlewski2 · Sally Bowman3 · Richard A. Settersten Jr.2 · Roberta B. Weber5 · Gloria Krahn4

Published online: 7 January 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019

Abstract Purpose Engagement in policy is an essential public health service, with state legislatures serving as important arenas for activity on issues affecting children and families. However, a gap in communication often exists between policymakers and public health researchers who have the research knowledge to inform policy issues. We describe one tool for researchers to better leverage public health research to inform state legislative policymaking on issues of relevance to children and families. Description The Oregon Family Impact Seminar (OFIS), adapted from the Policy Institute for Family Impact Seminars, applies a systematic process to bring a synthesis of research findings on public health issues to state legislators using a six- step process: (1) identify candidate topics, (2) recruit legislative champions, (3) select the topic, (4) identify and prepare speakers, (5) host the presentations, and (6) develop and disseminate a research brief as a follow-up contact. Assessment Use of this model in Oregon has produced policy impact; for example, the 2015 presentation, “Two-Generation Approaches to Reduce Poverty,” prompted ongoing dialogue culminating in a new statute to increase Earned Income Tax Credit for parents with young children. This approach also has strengthened relationships among researchers and legislators, which serves to streamline the OFIS process. Conclusion This model is an effective vehicle for leveraging public health research findings to inform state-level policy. This model also serves to connect researchers with opportunities to engage with policymakers to address significant public health problems, particularly those addressing social, economic, and environmental determinants of health for children and families.

Keywords Policymaking · Evidence-based policymaking · Translation of research to practice/policy · Child health · Health policy · Health promotion · Social determinants · Communication

* Emily J. Tomayko [email protected]

Bethany Godlewski [email protected]

Sally Bowman [email protected]

Richard A. Settersten Jr. [email protected]

Roberta B. Weber [email protected]

Gloria Krahn [email protected]

1 Nutrition, College of Public Health and Human Sciences, Oregon State University, 101 Milam Hall, 2520 SW Campus Way, Corvallis, OR 97331, USA

2 Human Development and Family Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

3 Extension Family and Community Health, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

4 Family Policy Program, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

5 Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

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Significance

What is already known on this subject? State legislatures represent a significant arena for policy decisions that affect children and families. However, a communication gap often exists between state legislators and academic researchers with expertise to provide evidence to inform critical policy decisions.

What this study adds? We present a model for facili- tating engagement between policymakers and researchers to promote health and well-being for children and fami- lies. We outline the steps of the process, discuss lessons learned, and highlight impacts observed by use of this model to date. These details could facilitate replication of this process in other states.

Purpose

Engagement in policy is an essential public health ser- vice (CDC 2014), with state legislatures serving as important arenas for local and timely activity on issues that affect children and families. Many state legislators are interested in and influenced by research findings that inform their policy decisions, and researchers have noted the benefits of engaging with state-level policymakers to transmit research knowledge and affect family health (Morshed et  al. 2017). However, identifying and using relevant research in an unbiased and timely manner can be challenging for legislators (Brownson et al. 2009). At the same time, many academic researchers do not have ready access to legislative audiences or lack the training to effectively engage policymakers. Family policy experts attribute this gap in communication between research- ers and legislators to the existence of “community dis- sonance,” whereby each group inhabits disparate “com- munities” with different cultures, institutional processes, methods of communication, and timelines for achieving key objectives (Bogenschneider and Corbett 2010). Col- laborative forums that bring together research experts and legislators for mutually respectful discussion can repre- sent an effective approach to bridge these distinct insti- tutional cultures (“Kellogg Commission” 1999; Nutley et al. 2007). We describe one model for leveraging public health research to inform state legislative policymaking, The Oregon Family Impact Seminar (OFIS). Oregon is a state affiliate of the national Policy Institute for Family Impact Seminars (PINFIS), which uses validated methods of conveying research information to state legislators on the impact of a broad array of policies on families (Bogen- schneider 1995, 2000; Bogenschneider et al. 2012b; Mayer

and Hutchins 1998; Wilcox et al. 2005; Wise et al. 2014). State-level Family Impact Seminars (FIS) began in 1993 and are currently utilized by 24 states and the District of Columbia. Past topics have included health care and fam- ily stability, teenage pregnancy, safe sleep practices for children, adverse childhood experiences and health, birth outcome disparities, and child mental health. In Oregon, OFIS has been an effective tool for systematically applying the PINFIS process and bringing to our state’s legislators a synthesis of research findings on family-relevant issues. The purpose of this paper is to detail the OFIS process, lessons learned, and resulting impacts of its application as an example of an effective state-affiliate FIS program.

Description

The OFIS series is intended to facilitate learning among stakeholders about challenges facing families in a nonpar- tisan, solution-oriented way. The primary seminar targets legislators; in Oregon, a second seminar engages state agency leaders, research and social service organization directors, and program officers of philanthropic founda- tions. This additional seminar seeks to engage profession- als working closely with children and families to acknowl- edge the importance of their activities for creating positive solutions for families. OFIS is coordinated through two Oregon State University (OSU) units: the Hallie Ford Center (HFC) for Healthy Children and Families and the Family and Community Health program of Extension Ser- vices. These units jointly convene a planning committee, and the HFC provides administrative support to sched- ule planning meetings, develop print materials, and make logistical arrangements for the seminars. Funding is pro- vided through internal operating budgets of the HFC. We estimate the total cost to be between $8,000–10,000 for the two sessions (legislative and agency head) combined, depending on the number of speakers, the distance they are traveling, and anticipated attendance. This cost esti- mate includes a modest speaker honorarium ($500 each); speaker travel, accommodations, and meals; accommoda- tions for members of the OFIS team; space rental near the capitol; and catering and incidentals. All planning time of faculty and students is considered an in-kind contribution.

We follow a six-step process (Fig. 1): (1) identify can- didate topics, (2) recruit legislative champions, (3) select the topic, (4) identify and prepare speakers, (5) host the presentations, and (6) develop and disseminate a research brief and follow up. Throughout the process, we inform and involve our university’s government relations office to ensure all activities align with university-level policies and guidance.

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Step 1. Identify Candidate Topics

Step 1 begins with forming a small interdisciplinary com- mittee of faculty and students (around 8 people) with interest and expertise in family well-being, health promotion, and public health. For OFIS, this group includes representation from OSU’s land grant Extension service and the Hallie Ford Center, a research center in OSU’s College of Public Health and Human Sciences focused on promoting healthy children and families. A core group participates each year to capitalize on experience and relationships from prior years, with new members invited depending on anticipated top- ics. This committee begins to meet regularly approximately 10 months in advance of the intended seminar date. During planning, the committee generates a list of policy topics with bipartisan and bicameral interest and with momentum for legislative action. We monitor policy events in other states through monthly PINFIS conference calls and contact the state Legislative and Policy Research Office to inquire about emerging issues that could inform OFIS topic selection. Pri- ority topics considered in recent years have included child- hood obesity, opioid use and abuse, mental health, multi- generational poverty, early brain development, foster care, food insecurity and safety, housing and homelessness, and immigration. Selecting and refining the topic often repre- sents the most time-consuming part of the process.

Step 2: Recruit Legislative Champions

Using the short list of topics generated in Step 1, we stra- tegically seek the input of a broader group of legislative contacts who are current chairs or members of relevant com- mittees, and we draw upon existing relationships of OSU’s government relations office or individual faculty to solicit the advice of legislators or their staff by phone, email, or in-person visits. The planning committee recruits “legisla- tive champions” within each of four cells in a 2 × 2 matrix that crosses the categories of House/Senate with Republican/ Democrat. These legislators provide input on the topic list, recommend other stakeholders to approach, and advise on optimal scheduling of seminars to maximize participation. These connections largely occur through personal, one-on- one communication, and they ensure that the seminar will be of interest to a broad group of legislators.

Step 3: Select the Topic and Date

Step 3 involves refining the topic list to best align with what we understand to be the current interests of the legislature based on Step 2. After selecting a single topic, we then begin to deliberate the specific ways in which academic research can inform policy angles and actions, and especially their impact on families. For example, the broad topic of “housing Fig

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and homelessness” was refined to the more specific topic of “How housing policies affect child and family outcomes.” Next, the OFIS  committee plans the events. In previous years, we have hosted breakfasts and early evening recep- tions. If a legislative committee chair expresses interest in having our speakers present their research during a commit- tee meeting, the legislative scheduler has helped in facilitat- ing that communication. This approach results in testimony for the legislators who can best utilize this information in their committee work. We consult with our legislative cham- pions to negotiate a date and time that best aligns with the legislative activities at the State Capitol, brings the poten- tial to present at a committee hearing, and maximizes the availability of speakers (Steps 3 and 4 are often undertaken concurrently).

Step 4: Identify and Prepare Speakers

After finalizing the topic, Step 4 involves reviewing the sci- entific literature, including conducting an abbreviated litera- ture search and reading key publications on the topic. Typi- cally, at least two members of the planning committee also have expert knowledge of the topic and can lead the group through this process. Professional networks are consulted to identify highly-respected experts who have broad and deep experience in their fields. We underscore the importance of selecting speakers who are not only the preeminent leaders in the field but also have significant knowledge of federal and state policies, along with the experience and ability to communicate with a legislative audience. Speaker suitabil- ity is confirmed by reviewing their publications and past recorded presentations and by conferring with others within professional networks. If the topic has been addressed in a FIS by another state-level PINFIS affiliate, we consult with that state about the speaker options they considered, the choices they made, and the effectiveness of those speakers for their purposes.

The goal is to recruit and secure two to three experts who have distinct but complementary perspectives on the selected topic. This approach involves an assessment of their disci- pline (e.g., economics, social sciences) and the type of data they are likely to present (e.g., large quantitative data sets addressing national or state trends; experimental or quasi- experimental intervention projects; small qualitative data sets that reveal the impact of policies on the lives of children and families or suggest mechanisms that may explain larger effects). Often one speaker will have an economic perspec- tive to address budgetary concerns and another speaker will address social, psychological, and/or health impacts. Pres- entations generally encompass a broad depiction of the field that extends beyond each researcher’s work, yet provides suf- ficient detail so that legislators can understand how policies or programs could be implemented in their state or district.

The speakers are selected, contacted by phone/email, and confirmed. The committee then engages them on logistics, which allows everyone to get acquainted and to jointly plan the scope of their presentations. We provide speakers with a briefing document about the state context—for example, demographic, legislative, or political information pertinent to state-level discussion of the topic. This step is critical because our top choices for speakers are typically not from our state. We coach speakers on effective communication strategies for legislative audiences (e.g., how to avoid sci- entific jargon; how to provide direct, concise answers) and the importance of avoiding “political agendas” during their presentation and the discussion. Speakers are specifically coached not to give their personal opinion, including in response to questions; instead, they are advised to provide information about outcomes when different policies have been implemented. Speakers are asked to share drafts of their presentation slides and text in advance of the events. We then hold joint conference calls to provide feedback and to refine the scope of the presentations to maximize the indi- vidual contributions and the synergy among them. When disagreements arise regarding presentation or interpretation of data, these issues are discussed to reach agreement on how to present the findings. If possible, we begin drafting a ‘white paper’ at this point (discussed below) so that speakers gain insight into how their presentations will be summarized in the document that will be released at the time of the semi- nar or shortly thereafter.

Concurrently, invitations are sent to legislators to inform them of the upcoming OFIS event and to other stakeholders for the ancillary seminar. A professionally-designed flyer is created by our College’s news and communication team. We also create a general invitation letter, which outlines the purposes of the OFIS, the significance of the chosen topic, and details of the event. We send those documents electroni- cally to all state legislators. In addition, we send personal- ized invitations to legislators serving on committees whose purview includes the topic and to our small group of legisla- tive champions. We ask them to encourage their colleagues to attend the seminar. Finally, we distribute a printed copy of the flyer to legislators’ mailboxes in the Capitol building.

Step 5: Host the Presentations

The primary seminar typically has been a 1.5-h session with legislators. Refreshments and light food options are provided to encourage attendance by legislators and staff- ers. The formal session begins with synthesized research presentations by the researchers, followed by an in-depth facilitated discussion with legislators. All sessions are held in or adjacent to the legislative Capitol building to increase participation. The featured speakers and OFIS committee members remain available before and after the formal events

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for further networking and discussion. In negotiating OFIS events, we are alert to opportunities to elevate and amplify our reach. For example, early discussions around the 2016 topic “Childhood Obesity: School and Community Solu- tions” resulted in an invitation to our speakers to testify before the Senate Committee on Health Care. This opportu- nity allowed us to address this topic to a significantly larger audience with authority for this topic. Because legislative schedules are both full and unpredictable, we are flexible in responding to unanticipated opportunities or last-minute scheduling conflicts.

We host a second, by-invitation session on the same or next day for a variety of other state leaders: heads of state agencies, chairs and selected members of task forces assembled by the Governor or business councils, directors of research and social service organizations, and program offic- ers of philanthropic foundations. For this session, we con- tinue to avoid endorsing advocacy positions. We rent space in or near the Capitol building for this session, which has traditionally been slightly longer (2 h) and included more participants. Similar to the legislative session, this session is catered with refreshments and light fare.

Step 6: Develop and Disseminate a Research Brief and Follow‑Up

Following the seminars, all session participants are asked to complete a simple evaluation form that identifies what was most informative, how they might use the information, and suggestions for future topics. We finalize the brief ‘white paper’ (typically around 15 pages, inclusive of the cover, resources, and references) that provides tailored information on the state context, synthesizes research evidence, and high- lights policy implications and potential solutions relating to the topic. To draft the white paper, we draw heavily from the speaker presentations and our notetaking at the events. The paper is edited by the committee and the speakers for brevity, clarity, and accuracy. Because the white paper and event invitations are largely circulated in electronic form, production costs are minimal.

Following the OFIS events, we distribute the white paper to all legislators and to those who were invited to the ses- sion for other state leaders. This document serves as both a resource and as a natural opportunity for the OFIS commit- tee to follow-up with the legislative champions, the legisla- tors in attendance, and those who expressed interest but were unable to attend the events. In addition, we send individual thank-you emails to participants and invite further ques- tions and feedback. These follow-up activities function as an important mechanism for cultivating our relationships with policymakers and encouraging ongoing discussion of these important family health issues. Moreover, the feedback

solicited during Step 6 ensures the format and information continue to be relevant to the intended audience.

Assessment

Lessons Learned

Building relationships with legislators requires sizable investments of time and effort, but the payoff can be equally great. In-person meetings and personal connections are vital to the success of the seminars and the uptake of information, and we have found email to be less successful for initial con- tacts. In addition, significant time is required to select a rel- evant topic with bipartisan interest. The planning committee has learned to use more unbiased language in all communi- cations (e.g., email, phone call, in person). Frequent discus- sions relate to “how would this information be understood by Republican Representative X, or Democratic Senator Y?” For researchers to have bipartisan credibility, they need to be highly knowledgeable about research on the topic, be able to hone a message to its core, and present findings in an unambiguous and unbiased way. The OFIS committee con- tinues to learn how to provide adequate coaching to ensure that all speakers understand the political context of their audiences and deliver consistent, concise information. This approach requires a balance between respecting the expertise of the speakers while moderating any tendencies to offer opinion without supporting data. Notably, legislators may ask speakers to take or endorse a position on a particular policy; coaching equips speakers with appropriate strategies for responding. The committee also continues to understand the importance of evaluating this process. OFIS staff collect basic evaluation data from participants; future evaluation could include impact analysis to examine over a period of time the extent to which policies related to the chosen topic do or do not support families (Bogenschneider et al. 2012a).

Impact

Use of this model in Oregon has produced policy impact and strengthened relationships between researchers and legisla- tors. The 2015 presentation, “Two-Generation Approaches to Reduce Poverty,” prompted ongoing dialogue that cul- minated in a new statute to increase the Earned Income Tax Credit value for parents with children under 3 years of age (Chap. 98, [2016 Laws]: effective 9/2/2016). The 2016 presentation “Childhood Obesity: School and Community Solutions,” resulted in a news release from the Senate Presi- dent’s office regarding research evidence to support upcom- ing implementation of a House Bill (Oregon HB3141) that requires K-8 students to receive at least 150 min of physical education each week. Moreover, our efforts have influenced

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the policy process, as evidenced by the invitation of the featured researchers to present during committee hearings, which allowed legislators to engage with experts early in the policy process while key outcomes were still under discus- sion. Implementation of the OFIS in Oregon has increased the interest and confidence of faculty and students to engage in policy dialogue, and our OFIS planning committee has continued to grow and diversify. Moreover, the number and depth of relationships between policymakers and members of the planning committee has grown as the committee has expanded. These relationships have strengthened and streamlined the OFIS process described in this paper.

Conclusions

The Family Impact Seminar is a powerful tool for informing state legislators about current research on selected topics affecting children and families. State affiliate groups such as ours can be invaluable allies for addressing key family health issues at the state level, where there is often significant opportunity for impact. Moreover, these state-level efforts significantly align with federal-level efforts to bolster the use of evidence-based policymaking (Abraham et al. 2017). Even in states without an FIS, these methods and resources can be useful for facilitating connections with legislatures. The Family Impact Seminar represents an effective vehicle for leveraging public health research findings to inform state legislative and administrative policymaking and for con- necting researchers with opportunities to “think forward” alongside policymakers to address significant problems for children and families (Farley 2016).

Acknowledgements This work was funded by the internal operating budget of the Oregon State University Hallie Ford Center for Healthy Children and Families. We gratefully acknowledge all stakeholders in and past participants of the Oregon Family Impact Seminar series.

References

Abraham, K. G., Haskins, R., Glied, S., Groves, R. M., Hahn, R., Hoy- nes, H.,… Wallin, K. R. (2017). The Promise of evidence-based policymaking: Report of the commission on evidence-based poli- cymaking. Retrieved 9 September, 2018, from https ://www.cep. gov/conte nt/dam/cep/repor t/cep-final -repor t.pdf.

Bogenschneider, K. (1995). Roles for professionals in building fam- ily policy: A case study of state family impact seminars. Family Relations, National Council on Family Relations, 44(1), 5–12.

Bogenschneider, K. (2000). Has family policy come of age? A decade review of the state of U.S. family policy in the 1990s. Journal of Marriage and Family, 62(4), 1136–1159. https ://doi.org/10.111 1/j.1741-3737.2000.01136 .x.

Bogenschneider, K., & Corbett, T. (2010). Evidence-based policy- making: Insights from policy-minded researchers and research- minded policymakers. New York: Taylor & Francis Group.

Bogenschneider, K., Little, O. M., Ooms, T., Benning, S., & Cadigan, K. (2012a). The family impact handbook: How to view policy & practice through the family impact lens. The Family Impact Institute. Retrieved 9 September 9, 2018, from https ://www.purdu e.edu/hhs/hdfs/fii/wpcon tent/uploa ds/2015/06/fi_handb ook_0712. pdf.

Bogenschneider, K., Little, O. M., Ooms, T., Benning, S., Cadigan, K., & Corbett, T. (2012b). The family impact lens: A family- focused, evidence-informed approach to policy and prac- tice. Family Relations, 61(3), 514–531. https ://doi.org/10.111 1/j.1741-3729.2012.00704 .x.

Brownson, R. C., Chriqui, J. F., & Stamatakis, K. A. (2009). Under- standing evidence-based public health policy. American Journal of Public Health, 99(9), 1576–1583. https ://doi.org/10.2105/ AJPH.2008.15622 4.

CDC. (2014). Centers for Disease Control and Prevention. The 10 Essential Public Health Services. Retrieved 21 August, 2018, from https ://www.cdc.gov/nphps p/essen tials ervic es.html .

Farley, T. A. (2016). Asking the right questions: Research of con- sequence to solve problems of significance. American Journal of Public Health, 106(10), 1778–1779. https ://doi.org/10.2105/ AJPH.2016.30341 6.

Kellogg Commission. (1999). Returning to our roots: The engaged institution. Third Report. National Association of State Universi- ties and Land-Grant Colleges. Retrieved 21 August, 2018, from http://www.aplu.org/libra ry/retur ning-to-our-roots -the-engag ed- insti tutio n/file .

Mayer, R., & Hutchins, V. L. (1998). District of columbia family policy seminar: A tool for devolution. Maternal and Child Health Jour- nal, 2(1), 59–62.

Morshed, A. B., Dodson, E. A., Tabak, R. G., & Brownson, R. C. (2017). Comparison of research framing preferences and infor- mation use of state legislators and advocates involved in cancer control, United States, 2012–2013. Preventing Chronic Disease, 14, E10. https ://doi.org/10.5888/pcd14 .16029 2.

Nutley, S., Walter, I., & Davies, H. (2007). Using evidence: How research can inform public services. Bristol: Policy Press.

Wilcox, B. L., Weisz, P. V., & Miller, M. K. (2005). Practical guide- lines for educating policymakers: The family impact seminar as an approach to advancing the interests of children and families in the policy arena. Journal of Clinical Child & Adolescent Psychology, 34(4), 638–645. https ://doi.org/10.1207/s1537 4424j ccp34 04_6.

Wise, D., Brandon, D., & Tucker, A. (2014). Strengthening families: Making the connection to early childhood policy. National Coun- cil on Family Relations Report.

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