Epidemiology: Policy Development Process

Who are stakeholders?

Individuals or organizations invested in a program’s outcomes

What are the steps involved for Step 1 - Problem Identification?

• identify the root cause via research, environmental scans, conversations with stakeholders

Identify the effect on human health (Step 1 - Problem Identification)

• What are the outcomes and impacts?

• Who is affected?

• How big is the problem?

• What contributes to the problem?

• When and where is the problem likely to occur?

• What is currently known?

• Are there gaps?

Who should be included in Step 2 - Policy Analysis

• Partners and Specialists

• Those Affected by the Policy

• People Who Administer Resources

What are the steps involved for Step 2 - Policy Analysis?

1. select multiple policy options via research, environmental scans, surveys of others

2. consider health impact, cost of implementation, feasibility

3. rank options based on steps above. identify trade offs and figure out best option

Who should be include in Step 3 - Strategy & POlicy Development?

• People who can help design & develop the policy 

What are the steps involved for Step 3 - Strategy & Policy Development?

1. Develop enactment strategy - use stakeholders with previous experience to assist where to start process

2. develop/draft the policy, look for pre-existing language in other policies

Who should be included in Step 4 - Policy Enactment?

• Federal and state government agencies

• Legislators 

• Public officials and administrators

• Local and state board members

• Both, people that are supportive and people that have concerns

What are the steps involved for Step 4 - Policy Enactment?

1. Process may require multiple tries

2. enactment is complete when it’s authorized by vote or passage of a bill

What are the steps involved in Step 5 - Policy Implementation?

An enacted policy will not automatically be successful, additional steps are necessary

1. Educate people/organizations affected by the policy

   1. Identify/coordinate resources/support

2. Change pre-existing admin systems

   1. Ensure current policy(s) do not conflict with new policy

   2. Identify individual(s) that will lead implementation

   3. Identify roles/responsibilities or partners/stakeholders

   4. Identify opportunities for collaboration

3. Monitor/enforce the policy

   1. Plan for policy, programmatic, and fiscal sustainability

   2. Keep the desired outcomes in mind

What are the steps involved for evaluation?

• Continued evaluation to prove that the policy is efficient & effective

  • important to validate funding

• Success or failure of a policy could influence other jurisdictions’ considerations of similar policies

• Data driven: qualitative vs quantitative; a mixture of methods

• Provide public accountability and transparency (trust and credibility)

What are the 3 types of evaluation?

1. Performance Monitoring- ongoing evaluation of how the process is performing

2. Outcome Evaluation- Is the program meeting its goals?

3. Cost-Benefit Evaluation- Ensuring the benefit(s) of the program outweighs the cost of implementation

What are the indicators used in evaluations?

• Status change: Improvement of a population’s health care status

• Environmental changes: Factors in environmental variables that have changed

• Change in knowledge: A population’s acquisition of new knowledge that enables them to make educated decisions

• Change in behavior: Population’s adoption of new behaviors/amending existing ones 

• Affective change: Population’s change in feelings/outlook about a particular issue or behavior

What are some challenges in evaluation?

All of these changes are going to occur when a program is rolled out but what percentage of those changes can be directly attributed to the program vs which would have naturally occurred anyway?