Use of research and non-research inputs in policy deliberation: a longitudinal case study of communication in state policymaking regarding adolescent depression screening
Creators: name: Bejarano, William
Publisher: name: No Publisher Supplied
Year: 2024

description: This dissertation focuses on the relatively understudied role of communication in the deliberation phase of state-level policymaking, particularly in relation to the dynamic interactions between policy actors with a stake in policy implementation (e.g., experts, policy advocates, practitioners, and citizens) and policymakers navigating multiple sources of ambiguity regarding implementation. A conceptual framework is proposed for linking actors’ choice of inputs and communication strategy in the policy deliberation context to the likelihood of inputs to changes (minor or major) in the policy deliberated based on the integration of established communication, policymaking, and implementation science theories. A central focus of this framework is on explicating policymaker ambiguity in the specific context of decisions regarding policy implementation. Drawing on multiple conceptions of this construct in the communication and implementation science literature, the framework defines and operationalizes ambiguity as policymakers’ judgments or evaluations regarding the desirability and probability of implementation. Desirability is further conceptualized as the combination of perceived appropriateness and perceived acceptability of implementation. Probability of successful implementation is further conceptualized as the combination of perceived compatibility and perceived feasibility. The proposed framework is predicated on the assumption that inputs provided by policy actors in policy deliberations may inspire changes to policy implementation plans by either decreasing or increasing one or several critical dimensions of policymaker ambiguity. Accordingly, the research questions guiding the study are about the degree to which policy actors are strategic regarding their choice of inputs and communication strategies, the degree to which the content and focus of inputs they routinely provide in the policy deliberation context map onto the sub-dimensions of policymaker ambiguity explicated in the proposed conceptual model, and whether such strategic use of communication can inspire change to policy, and if so, under what circumstances. These research questions, as well as the overall heuristic value of the proposed conceptual model, were explored via a case study analysis of the legislative process, from beginning (bill introduction) to end (bill signed into law), for a policy designed to improve universal access of adolescents to depression screening in schools in the state of New Jersey in line with current recommendations of the US Preventive Services Task Force and youth mental health expert panels. The case study utilized a multi-method approach (textual analysis of official documents and records related to this legislation and key informant interviews with policymakers and other policy actors directly involved in the policymaking process for this legislation) to track and analyze dynamic associations between inputs provided by different actors and changes made to the legislation as it progresses through the legislature. The research design implemented included three related components. Study 1 applied a valid and reliable document analysis research protocol and a measurement instrument to track and analyze use of research and non-research inputs by legislators and other policy actors in the context of school mental health policymaking in New Jersey to identify, characterize, and compare any stable patterns of evidence use (or evidence use routines) of different actors. This was done for the purpose of verifying key assumptions of the conceptual model (e.g., that actors are strategic about choice of evidence and the inputs they provide at different phases of the policymaking process) as well as for informing and contextualizing the more focused empirical investigation employed in Study 2. Study 2 focused exclusively on tracking and analyzing policy deliberations regarding the particular legislation that was the focus of the case study, probing associations among actors, the content and focus of the inputs they provide, and the communication strategies they employed in this context in line with the conceptual framework guiding the study. To corroborate, further contextualize, and triangulate findings emerging from these two studies, a series of key informant interviews were conducted with legislators and policy advocates with first-hand knowledge of the policymaking process for this legislation. The findings across all three components of the study are largely consistent with the assumptions and rationale of the proposed conceptual framework, deeming it a promising target for future development and testing. Thus, there is sound evidence that policy actors regularly provide evidence-backed inputs throughout the policymaking process and particularly in the policy deliberation phase, when structured windows of opportunity open for actors both inside and outside the legislature to provide inputs. At the same time, use of evidence in this context is not monolithic, as different actors use different sources and types of evidence and different strategies for communicating evidence in this setting, and individual actors themselves may apply a variety of strategies, as a function of available resources and circumstances (such as degree of consensus among collaborating advocacy organizations regarding strategy). Next, the findings emerging from both the document analysis and key informant interviews are consistent with the assumption underlying the proposed conceptual model regarding the centrality of policy ambiguity judgments as a mediator of the effect of inputs on policy. The findings of multiple data analyses demonstrate that inputs targeting sub-dimensions of ambiguity regarding policy implementation are associated, to various degrees, with changes to policy (whether minor/incremental or major/substantive), with clear implications regarding policy implementation. In this sense, the findings of this dissertation validate the proposed conceptual model and invites further theoretical development and empirical testing of hypotheses. It is less clear how an actor’s choice of a communication strategy to deliver inputs may be associated with the likelihood of change to policy, in part because policy actors may not be considering this aspect in the context of their advocacy efforts. Of the four potential communication strategies included in the conceptual framework, which were theoretically derived from the strategic communication literature (education, persuasion, pressure, and negotiation), the findings provide significant support to education—and to a degree, to negotiation—as common strategies, with some findings (primarily from the key informant interviews) hinting at pressure as a strategy implemented via coordination of inputs among advocates. One potential practical implication of this is that policy advocates and other intermediaries operating at the science-policy nexus can benefit from adopting (or being trained on the application of) strategic communication planning tools that can increase their ability to promote sound evidence-based policies.