Use of research evidence in U.S. federal policymaking: A reflexive report on intra-stage mixed methods.

The policymaking process is largely opaque, especially regarding the actual writing of the policy. To attempt to better understand this complex process, we utilized mixed methods in our evaluation of an intervention. However, the process of mixing methods can be messy, and thus may require recalibration during the evaluation itself. Yet, in comparison to reporting results, relatively little attention is paid to the effects of mixing methods on the evaluation process. In this article, we take a reflexive approach to reporting a mixed methods evaluation of an intervention on the use of research evidence in U.S. federal policymaking. We focus on the research process in a qualitative coding team, and the effects of mixing methods on that process. Additionally, we report in general terms how to interpret multinomial logistic regressions, an underused analysis type applicable to many evaluations. Thus, this reflexive piece contributes (1) findings from evaluation of the intervention on the policymaking process, (2) an example of mixing methods leading to unexpected findings and future directions, (3) a report about the evaluation process itself, and (4) a tutorial for those new to multinomial logistic regressions.

Women and Treatment for Opioid Use Disorder: Contributors to Treatment Success From the Perspectives of Women in Recovery, Women With Past Attempts in Drug Treatment, and Health and Criminal Justice Professionals.

Introduction: The disproportionate incidence of opioid use disorder (OUD) and the alarming increases in opioid-related overdose deaths among women highlight a clear need for the expansion of effective harm reduction and treatment practices. Research supports medications for opioid use disorders (MOUD) as an effective intervention; however, with low rates of utilization of such, there is a need to identify factors that facilitate MOUD treatment uptake and retention for women. Thus, the current study examines contributors to treatment success through the triangulation of perspectives from affected women as well as health and criminal justice professionals. Methods: Interviews (N = 42) were conducted from May to July 2022 with women in recovery who previously used or currently use MOUD (N = 10), women who currently use opioids who terminated a MOUD program previously (N = 10), SUD treatment professionals (N = 12), and criminal justice professionals who work with women who use opioids (N = 10). Interviews for all participants centered around their backgrounds, perceived barriers and facilitators to MOUD treatment, and issues specific to women in treatment for substance use disorder. We used a thematic qualitative data analysis process to analyze transcripts. Results: Participants highlighted contributors to treatment success from 3 domains: (1) internal processes (including promoting self-efficacy and setting realistic goals), (2) access to resources (including material resources, such as food and shelter, educational resources and social support), and (3) treatment structure (such as treatment type and protocol). Conclusion: Internal processes, access to resources, and treatment structure contribute to MOUD treatment success for women with OUD. Structured support where experiences are shared, and realistic goals are set, may promote feelings of acceptance and empowerment, thereby bolstering chances of treatment success. Additionally, the court system can promote evidence-based and trauma-informed substance use treatment and provide accessible educational resources related to substance use to extend these benefits to more women.

Shifting the paradigm of research-to-policy impact: Infrastructure for improving researcher engagement and collective action.

The body of scientific knowledge accumulated by the scholarly disciplines such as Developmental Psychopathology can achieve meaningful public impact if wielded and used in policy decision-making. Scientific study of how policymakers use research evidence underscores the need for researchers' policy engagement; however, barriers in the academy create conditions in which there is a need for infrastructure that increases the feasibility of researchers' partnership with policymakers. This need led to the development of the Research-to-Policy Collaboration model, a systematic approach for developing "boundary spanning" infrastructure, which has been experimentally tested and shown to improve policymakers' use of research evidence and bolster researchers' policy skills and engagement. This paper presents original research regarding the optimization of the RPC model, which sought to better serve and engage scholars across the globe. Trial findings shed light on ways to improve conditions that make good use of researchers' time for policy engagement via a virtual platform and enhanced e-communications. Future directions, implications, and practical guidelines for how scientists can engage in the political process and improve the impact of a collective discipline are also discussed.

Predictors of problematic adult alcohol, cannabis, and other substance use: A longitudinal study of two samples.

This study examined whether a key set of adolescent and early adulthood risk factors predicts problematic alcohol, cannabis, and other substance use in established adulthood. Two independent samples from the Child Development Project (CDP; n = 585; 48% girls; 81% White, 17% Black, 2% other race/ethnicity) and Fast Track (FT; n = 463; 45% girls; 52% White, 43% Black, 5% other race/ethnicity) were recruited in childhood and followed through age 34 (CDP) or 32 (FT). Predictors of substance use were assessed in adolescence based on adolescent and parent reports and in early adulthood based on adult self-reports. Adults reported their own problematic substance use in established adulthood. In both samples, more risk factors from adolescence and early adulthood predicted problematic alcohol use in established adulthood (compared to problematic cannabis use and other substance use). Externalizing behaviors and prior substance use in early adulthood were consistent predictors of problematic alcohol and cannabis misuse in established adulthood across samples; other predictors were specific to the sample and type of substance misuse. Prevention efforts might benefit from tailoring to address risk factors for specific substances, but prioritizing prevention of externalizing behaviors holds promise for preventing both alcohol and cannabis misuse in established adulthood.

Trends and Opportunities for Bridging Prevention Science and US Federal Policy.

Prevention science sheds light on complex social policy problems, yet its social impact cannot reach full potential without the uptake of research evidence by policymakers. This mixed-methods study examined the US federal legislation pertaining to justice-involved youth to reveal opportunities for strengthening the use of prevention science in legislation. The results indicated that research language, particularly references to the type of study (e.g., longitudinal) or methodology (e.g., data mining), within bills predicted bill progression out of committee and enactment. Rigorous scientific methods may either lend credence to a bill during its progression in the legislative process or may be infused in language during mark-up and negotiation of bills that successfully progress in Congress. In-depth bill coding illustrated the ways that research has been used in legislation to define problems, reinforce effective practice, generate knowledge through research and evaluation, and disseminate findings. A prominent implication of these findings is that policies could be used to improve data monitoring and evaluation capacity in ways that enhance the implementation of evidence-based interventions. The comprehensive use of research in legislation increases the likelihood that policies reach their intended outcomes and benefit those they are designed to serve.

Development of individuals' own and perceptions of peers' substance use from early adolescence to adulthood.

This study evaluated how individuals' own substance use and their perception of peers' substance use predict each other across development from early adolescence to middle adulthood. Participants were from two longitudinal studies: Fast Track (FT; N = 463) and Child Development Project (CDP; N = 585). Participants reported on their own and peers' substance use during early and middle adolescence and early adulthood, and their own substance use in middle adulthood. From adolescence to early adulthood, individuals' reports of their own substance use in a given developmental period predicted reports of their peers' substance use in the next developmental period more than peers' substance use in a given developmental period predicted individuals' own substance use in the next. In the higher-risk FT sample, individuals' own substance use in early adulthood predicted alcohol, cannabis, and other substance use in middle adulthood, and peers' substance use in early adulthood predicted cannabis use in middle adulthood. In the lower-risk CDP sample, participants' own substance use in early adulthood predicted only their own cannabis use in middle adulthood, whereas peers' substance use in early adulthood predicted participants' alcohol, cannabis, opioid, and other substance use in middle adulthood. The findings suggest that peer substance use in early adulthood may indicate a greater propensity for subsequent substance use in lower-risk groups, whereas those in higher-risk groups may remain more stable in substance use, with less variability explained by peer contexts.

Early Physical Abuse and Adult Outcomes.

BACKGROUND: Because most physical abuse goes unreported and researchers largely rely on retrospective reports of childhood abuse or prospective samples with substantiated maltreatment, long-term outcomes of physical abuse in US community samples are unknown. We hypothesized that early childhood physical abuse would prospectively predict adult outcomes in education and economic stability, physical health, mental health, substance use, and criminal behavior. METHODS: Researchers in two multisite studies recruited children at kindergarten entry and followed them into adulthood. Parents completed interviews about responses to the child's problem behaviors during the kindergarten interview. Interviewers rated the probability that the child was physically abused in the first 5 years of life. Adult outcomes were measured by using 23 indicators of education and economic stability, physical health, mental health, substance use, and criminal convictions reported by participants and their peers and in school and court records. RESULTS: Controlling for potential confounds, relative to participants who were not physically abused, adults who had been abused were more likely to have received special education services, repeated a grade, be receiving government assistance, score in the clinical range on externalizing or internalizing disorders, and have been convicted of a crime in the past year (3.20, 2.14, 2.00, 2.42, 2.10, and 2.61 times more likely, respectively) and reported levels of physical health that were 0.10 SDs lower. No differences were found in substance use. CONCLUSIONS: Unreported physical abuse in community samples has long-term detrimental effects into adulthood. Pediatricians should talk with parents about using only nonviolent discipline and support early interventions to prevent child abuse.

Behavioral health policy for improving population health and wellbeing: opportunities for investment in evidence-based policymaking.

The high cost of behavioral health problems across the population continues to highlight the need to integrate high-quality behavioral interventions across a variety of service settings. To successfully achieve such a system-wide transformation will require supporting federal policies that invest in sustainable high-quality services. To support these efforts we provide a mixed-method study of all federal mental health legislation over the last three decades. Results indicate that mental and behavioral health policies have grown. Further, specific characteristics that comprise bills that are successfully enacted into law are identified. Finally, opportunities for the field to engage with policymakers to support widespread integration of behavioral health services are offered.

The role of psychology in evidence-based policymaking: Mapping opportunities for strategic investment in poverty reduction.

Increasing efforts are being undertaken to understand how to improve the use of research evidence in policy settings. In particular, growing efforts to understand the use of research in legislative contexts. Although high-profile examples of psychology's contributions to public policy exist-particularly around antipoverty legislation-little systematic review has quantified how the field has informed federal policy across time. Recognizing the importance of exploring psychology's use in policymaking, we provide an overview of psychology's presence in federal antipoverty legislation over the last 2 decades by reviewing the over 6,000 antipoverty bills introduced to the U.S. Congress since 1993 for mentions of psychology. Further, to explore how psychology's contributions are related to policymakers' attributions about the causes of poverty, their public statements and voting behavior is considered. Key gaps in our scientific knowledge for informing poverty-related policy are identified. Opportunities to enhance the relevance of psychology in poverty reduction efforts, including the evidence-based policy movement, are described. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

At what cost? Examining the cost effectiveness of a universal social-emotional learning program.

Although implementation of universal social-emotional learning programs is becoming more common in schools, few studies have examined the cost-effectiveness of such programs. As such, the purpose of this article is two fold. First, we provide an overview of cost-effectiveness methods for school-based programs, and second, we share results of a cost-effectiveness analysis (CEA) of a universal social-emotional learning (SEL) program, the Social Skills Improvement System-Classwide Intervention Program (SSIS-CIP; Elliott & Gresham, 2007). Specifically, we compared the cost-effectiveness of SSIS-CIP implementation across first- and second-grade classrooms, and results indicated that second grade is the more cost-effective option for implementing the SSIS-CIP. Several considerations are discussed regarding cost-effectiveness analysis of universal SEL programs as well as the importance of using CEA results to inform programming decisions. (PsycINFO Database Record

Translating Prevention Research for Evidence-Based Policymaking: Results from the Research-to-Policy Collaboration Pilot.

The importance of basing public policy on sound scientific evidence is increasingly being recognized, yet many barriers continue to slow the translation of prevention research into legislative action. This work reports on the feasibility of a model for overcoming these barriers-known as the Research-to-Policy Collaboration (RPC). The RPC employs strategic legislative needs assessments and a rapid response researcher network to accelerate the translation of research findings into usable knowledge for policymakers. Evaluation findings revealed that this model can successfully mobilize prevention scientists, engage legislative offices, connect policymakers and experts in prevention, and elicit congressional requests for evidence on effective prevention strategies. On average, the RPC model costs $3510 to implement per legislative office. The RPC can elicit requests for evidence at an average cost of $444 per request. The implications of this work, opportunities for optimizing project elements, and plans for future work are discussed. Ultimately, this project signals that the use of scientific knowledge of prevention in policymaking can be greatly augmented through strategic investment in translational efforts.

Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed.

A Framework for Valuing Investments in a Nurturing Society: Opportunities for Prevention Research.

Investing in strategies that aim to build a more nurturing society offers tremendous opportunities for the field of prevention science. Yet, scientists struggle to consistently take their research beyond effectiveness evaluations and actually value the impact of preventive strategies. Ultimately, it is clear that convincing policymakers to make meaningful investments in children and youth will require estimates of the fiscal impact of such strategies across public service systems. The framework offered here values such investments. First, we review current public spending on children and families. Then, we describe how to quantify and monetize the impact of preventive interventions. This includes a new measurement strategy for assessing multisystem service utilization and a price list for key service provision from public education, social services, criminal justice, health care and tax systems.

Early Social-Emotional Functioning and Public Health: The Relationship Between Kindergarten Social Competence and Future Wellness.

OBJECTIVES: We examined whether kindergarten teachers' ratings of children's prosocial skills, an indicator of noncognitive ability at school entry, predict key adolescent and adult outcomes. Our goal was to determine unique associations over and above other important child, family, and contextual characteristics. METHODS: Data came from the Fast Track study of low-socioeconomic status neighborhoods in 3 cities and 1 rural setting. We assessed associations between measured outcomes in kindergarten and outcomes 13 to 19 years later (1991-2000). Models included numerous control variables representing characteristics of the child, family, and context, enabling us to explore the unique contributions among predictors. RESULTS: We found statistically significant associations between measured social-emotional skills in kindergarten and key young adult outcomes across multiple domains of education, employment, criminal activity, substance use, and mental health. CONCLUSIONS: A kindergarten measure of social-emotional skills may be useful for assessing whether children are at risk for deficits in noncognitive skills later in life and, thus, help identify those in need of early intervention. These results demonstrate the relevance of noncognitive skills in development for personal and public health outcomes.