State legislators' work on public health-related issues: what influences priorities?

CONTEXT: Policies are an effective way to influence population health and prevent disease. Unfortunately, public health research is often not well translated for policy audiences. Furthermore, researchers seeking to influence policy face an incomplete understanding of what influences legislators' decisions regarding which issues will receive their limited time and focus. OBJECTIVE: The objective of this analysis was to examine various factors that may influence state legislators' decisions about which health issues they address. DESIGN: Cross-sectional analysis of data collected from a randomized trial. SETTING: State legislatures. PARTICIPANTS: State-level legislators. MAIN OUTCOME MEASURE(S): Measures included a rating of the influence of various factors on health policy priorities. A 7-point scale was used to measure political ideology on social and fiscal issues. Standard demographic questions were included on age, gender, and level of education. RESULTS: Seventy-five legislators completed surveys. Sixty-three percent were aged 55 years or older, and 76% male. When they were asked to rate factors according to importance in determining what health issues to work on, the top-rated factor was constituents' needs or opinions followed by evidence of scientific effectiveness. Ratings were also examined by subgroups. CONCLUSIONS: These findings point to several important applications for public health practitioners and researchers. Because legislators value constituents' opinions, it is critical to inform and educate constituents about public health issues as well as policy options that may be effective in addressing problems. The results also highlight the importance of public health researchers and practitioners improving dissemination efforts to ensure that evidence-based scientific information is shared with policymakers in an effective and timely manner.

Methods of generating state revenue for breast cancer prevention and early detection: an analysis of pink dollars.

OBJECTIVE: We assessed income tax check-offs, specialty license plates, and lottery tickets as ways states raise funds for the early detection and prevention of breast cancer. METHODS: We conducted an inventory of state legislation allowing these revenue-generating methods, and collected and compared information on each initiative. We conducted logistic regression analyses to compare these methods with state breast cancer mortality rates. RESULTS: Eighteen states had programs for contributions through an income tax check-off. Revenue for tax check-offs and plates is influenced by state population. The median annual revenue for the income tax check-off was $115,000. Twenty-six states had breast cancer license plates generating more than $4.1 million in revenue. The extra cost of the plates ranged from $20 to 75 (mean = $37). Only Illinois offered a state breast cancer lottery ticket, which raised $4 million from 2005 to 2009. States with medium or high breast cancer mortality rates were 2.5 times more likely to offer breast cancer specialty license plates than states with low breast cancer mortality rates; however, we found no statistically significant difference in breast cancer mortality tertiles by income tax check-off. CONCLUSION: Revenue-generating breast cancer initiatives can be successful strategies for states to raise funds for breast cancer prevention and early detection programs. Although these initiatives can generate revenue, amounts are variable due to population differences, the number of other plates/check-offs/lotteries offered, and the choice to decrease donations during difficult economic times. State breast cancer mortality rates may influence the availability of these initiatives.

A review of obesity-themed policy briefs.

CONTEXT: Policy approaches are one of the most promising population-based means of addressing the epidemic of obesity in the U.S., especially as they create supportive environments for healthy living. Policy briefs can be an effective means of disseminating research information to inform obesity prevention efforts; however, they are often ineffective because of length, density, and inaccessibility. The purposes of this project were to identify a collection of obesity-related policy briefs, analyze the content, and make recommendations for model policy briefs. EVIDENCE ACQUISITION: In 2010, online searching strategies were developed with criteria that included a primary topical focus on obesity, written between 2000 and 2010, targeting any population age group, including a policy-change message, and being readily available online. The research team developed a coding tool and used it to analyze briefs. A subsample of the briefs was used for further analysis on dissemination. EVIDENCE SYNTHESIS: Analyses were conducted on 100 briefs. Most (72%) were developed between 2005 and 2010; the average length was five pages. The majority had no tables, few figures, and only 36% included photos. The average reading level was high. A lack of monitoring or evaluating dissemination efforts prevailed. CONCLUSIONS: Policy briefs represent an effective, often-preferred, potent tool for public health practitioners and researchers to communicate information to policymakers. Recommendations include presenting information clearly, using a concise format, including design elements, noting reference and contact information, employing active and targeted dissemination efforts, and conducting evaluation.