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Government Social Research Unit Evidence-Based Policies and Indicator Systems Conference Regents Park Conference Centre, London, 11-13 July What Can Social Science Contribute to Improving the Nation’s Health? Philip Davies PhD Government Social Research Unit HM Treasury London SW1A 2HQ www.gsr.gov.uk How is the policy supposed to work? Logic Model Theories of Change Evidence for Policy www.gsr.gov.uk Theories of Change/Logic Model Health Trainers Project Programme Theory Provide Personal Health Trainers Develop and sustain motivation to improve personal and family health Change individuals’ and families’ lifestyles ? ? ? Evidence on effectiveness of knowledge transmission Evidence on effectiveness of attitude change Evidence on effectiveness of behavioural change Provide advice and information on healthy living Improve health/reduce morbidity and mortality Programme Evidence www.gsr.gov.uk How is the policy supposed to work? Logic Model Theories of Change What evidence already exists? Systematic Reviews Harness Existing Evidence Evidence for Policy www.gsr.gov.uk What Makes a Review Systematic? • Systematic and comprehensive searching of literature • Systematic critical appraisal of studies identified • Transparency of inclusion/exclusion criteria and judgements • Systematic and transparent extraction of data • Systematic statistical testing and analysis • Regular updating www.gsr.gov.uk Sources of Systematic Review of Health and Healthcare • Cochrane Collaboration www.cochrane.org • NHS Centre for Reviews and Dissemination (CRD) www.york.ac.uk/inst/crd • Centre for Evidence-Informed Policy and Practice (EPPI) www.eppi.ioe.ac.uk/ • National Institute of Clinical Excellence (NICE) • www.nice.org.uk/ • Social Care Institute of Excellence (SCIE) www.scie.org.uk • Campbell Collaboration www.campbellcollaboration.org • ESRC Centre for EBPP and the Evidence Network www.evidencenetwork.org www.gsr.gov.uk How is the policy supposed to work? Logic Model Systematic Reviews What evidence already exists? What is the nature, size and dynamics of the problem? Theories of Change Evidence for Policy Harness Existing Evidence Descriptive Analytical Evidence Statistics Surveys Qualitative Research www.gsr.gov.uk Health Surveys and Descriptive Analyses • Health Survey for England (since 1991) • National Survey of NHS Patients / Patient Survey Programme • ONS General Household Survey (GHS) • Surveys of Drug Use, Smoking and Drinking ,Contraception and Sexual Health • Whitehall I and Whitehall II Survey (Michael Marmot) • MRC Twenty-07 Study, MRC Social and Public Health Unit • Measuring Health, Variations in Health and Determinants of Health in Scotland, MRC Social and Public Health Unit • Welsh Health Survey / Health in Wales Survey • Northern Ireland Health and Social Well Being Survey (2001) www.gsr.gov.uk How is the policy supposed to work? Logic Model Systematic Reviews What evidence already exists? What is the nature, size and dynamics of the problem? Theories of Change Harness Existing Evidence Descriptive Analytical Evidence Evidence for Policy Attitudinal and Experiential Evidence Statistics Surveys Qualitative Research How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research Observational www.gsr.gov.uk Studies Attitudinal and Experiential Surveys • British Social Attitudes Survey (since 1983) • European Social Survey • National Attitudinal Survey of Sexual Behaviour • National Survey of Sexual Attitudes and Lifestyles • National Scottish Survey of Public Attitudes to Mental Health • DIPEx (Database of Individual Patient Experiences) • The Healthcare Experiences of Patients with Low Literacy • Patients’ Experiences of Epilepsy and Health Care www.gsr.gov.uk How is the policy supposed to work? Logic Model What evidence already exists? Systematic Reviews What is the nature, size and dynamics of the problem? Theories of Change Harness Existing Evidence Descriptive Analytical Evidence Evidence for Policy Evidence of Effective Interventions Experimental and Quasi-Experimental Studies Attitudinal and Experiential Evidence Statistics Surveys Qualitative Research How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research What Works? Observational www.gsr.gov.uk At What Costs? Studies With What Outcomes? Types and Sources of Social Experiment Types of Experiment • Randomised Controlled Trials (e.g. RIPPLE study) • Regression Discontinuity Designs • Propensity Score Matching Studies • Interrupted Time Series Studies Sources of Experiment • Cochrane Central Register of Controlled Trials • Campbell Social, Psychological and Educational Controlled Trials Register (C2SPECTR) www.gsr.gov.uk How is the policy supposed to work? Logic Model What evidence already exists? Systematic Reviews What is the nature, size and dynamics of the problem? Theories of Change Harness Existing Evidence Descriptive Analytical Evidence Evidence for Policy Cost-Benefit Cost-Effectiveness Cust-Utility Analysis What is the Cost, Benefit and Effectiveness of Interventions? Economic and Econometric Evidence Evidence of Effective Interventions Experimental and Quasi-Experimental Studies Attitudinal and Experiential Evidence Statistics Surveys Qualitative Research How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research What Works? Observational www.gsr.gov.uk At What Costs? Studies With What Outcomes? Sources of Economic Analysis • Office of Health Economics • Centre for Health Economics / Health Economics Resource Centre, University of York • Health Economics Research Group (Brunel University) • Centre for the Economics of Health (Bangor University) • Cochrane and Campbell Economics Methods Group • National Institute of Health and Clinical Excellence (NIHCE) • HM Treasury Green Book www.gsr.gov.uk How is the policy supposed to work? Cost-Benefit Cost-Effectiveness Cust-Utility Analysis What is the Cost, Benefit and Effectiveness of Interventions? What evidence already exists? Systematic Reviews What is the nature, size and dynamics of the problem? Social Ethics Public Consultation What are the ethical implications of the policy? Logic Model Theories of Change Ethical Evidence Economic and Econometric Evidence Harness Existing Evidence Descriptive Analytical Evidence Evidence for Policy Evidence of Effective Interventions Experimental and Quasi-Experimental Studies Attitudinal and Experiential Evidence Statistics Surveys Qualitative Research How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research What Works? Observational www.gsr.gov.uk At What Costs? Studies With What Outcomes? Types of Ethical Evidence/Public Consultation • Rawls’ ‘Veil of Ignorance’ • ‘Good Innings Theory’ • Oregon Method • Citizens’ Juries • Delphi Method • Nominal Group Technique • Critical Incidence Analysis www.gsr.gov.uk Take Home Message • Social science has much to offer policy making • In health / health care, and other substantive areas • There is no one ‘social science’ method • Rather, a range of methods, techniques, and perspectives to help people make well-informed decisions…. • ….based on the best available evidence from social science research www.gsr.gov.uk Contact [email protected] Government Social Research Unit HM Treasury 1 Horse Guards Road London SW1A HQ England Tel: +44 (0)20 7270 5156 www.policyhub.gov.uk www.gsr.gov.uk