Background and Purpose
Preventing obesity is an urgent public health challenge that demands innovative policy approaches. Critically missing in current obesity prevention efforts is a quick and efficient system for translating the best available evidence from research to policy. to date, little is known about how research evidence on physical activity and the environmental determinants of obesity has been used to influence the policymaking process. We convened a faculty-community collaborative to analyze the process of childhood obesity policymaking in Minnesota, with the objective of developing a system for communicating timely and relevant evidence to policymakers. This abstract describes the extent to which research evidence and other persuasive information was used in policy-relevant documents (e.g., bills, hearing testimony, fact sheets) presented during legislative discussions regarding Complete Streets policies, school siting guidelines, joint-use of school recreational facilities, and physical education standards in Minnesota between 2007 and 2011.
Objectives
The objectives of this research are the following: 1. To identify the frequency with which policy discussions on active living environments reference research evidence; 2. To identify the frequency with which policy discussions on active living environments reference non-research-based information, such as anecdotes, political appeals, and cost concerns; 3. To generate hypotheses for future research examining the barriers of and facilitators to using research evidence to achieve policy impact.
Methods
To identify policy-relevant documents for the sample, a timeline identifying Minnesota state-level obesity policymaking events from 2007 to 2011 was developed based on study team experience (including researchers, an advocate, a public health lawyer, and a university-policy community liaison) and supplemented with informational interviews (n=11) with lobbyists, advocates, legislative staff, and agency staff at the Minnesota Departments of Health and Education. We used the Minnesota Legislative Library and Minnesota State Legislature archives to search for and collect all committee meeting materials related to each policymaking event, including bills, factsheets, reports, legislative research, and all testimony available in audio or visual format. The searches resulted in a sampling frame of 243 documents; a 50% random sample of testimony yielded a total of 154 documents for analysis. After eliminating duplicates (n=10) and restricting to those documents related to physical activity or community planning, the total sample size was 83 documents. We developed a structured coding instrument with 66 items to collect data on descriptive information about each document (e.g., length, author) and to characterize the types of evidence (e.g., source, purpose, format) and alternatives to research evidence (e.g., use of anecdotes, appeals to political principles) present in the policy documents. The coding instrument was piloted to assure inter-rater reliability, and two coders coded all documents. We calculated frequencies of variables and statistical measures of associations using STATA 11.
Results
The sample consisted of testimony (n=44; 54%;), fact sheets (7; 9%), policy briefs (2; 1%), bills (13; 16%), and other policy-relevant documents (17; 21%, e.g., legislative research briefs, letters to stakeholders). Examining the non-bill documents, we found that 36% included at least one reference to research evidence, especially evidence describing the health and non-health related consequences of obesity (68%), the impact of policies or programs (64%), and the magnitude of obesity among adults and children (48%). Evidence about children was common (48%), while no documents presented any evidence about groups defined by race, ethnicity, geography, or socioeconomic status. Half of the evidence presented concerned Minnesota specifically. in contrast to the relatively infrequent presentation of research evidence, 89% of all documents included non research-based persuasive information, with presentation of expert beliefs (50%), public or constituent opinion (40%), cost or financial impact (32%), appeals to political principles (31%) or anecdotes/stories about communities (13%) particularly common. More research evidence was presented in policy discussions in 2011 (57% of documents) than in 2007 (31%), and written materials (e.g., fact sheets) more often presented research evidence than did stakeholders in oral testimony. Specific sources of research evidence were infrequently presented, with policy communications either not referencing a source (61% of documents) or referencing a generic “study” (44%) compared to citing a specific peer-reviewed journal article (9%) or specific data sources (e.g., CDC’s NHANES) (9%).
Conclusions
Despite an abundance of research evidence on active living environments, only about one-third of policy-relevant documents and oral testimony cited any such evidence in legislative discussion around physical activity-promoting bills under consideration in Minnesota in the previous five years. Furthermore, none of the documents mentioned evidence related to socioeconomic, racial, or geographic disparities. Innovative models of translation and dissemination are needed to facilitate more use of research evidence in legislative decision-making, as are more investigations of the barriers, facilitators, and impact of using research evidence as a persuasive tool in the policy process.
Support / Funding Source
The preliminary stage of this project was funded by the University of Minnesota’s Healthy Foods, Healthy Lives Institute. The National Institute of Child Health and Human Development is funding additional stages of the project through Grant NIH/1R03-HDO71.
