1. The Power of Information A Survey of State Health Policymakers Research Supported by The Robert Wood Johnson Foundation

2. Objectives Identify the formal and informal information sources of state health policy makers Ascertain usefulness of various modes of communications Identify and anticipate information needs and health policy priorities Identify ways to address key issues of import

3. Methodology Telephone Interviews – November 15, 2000 and January 31, 2001 Average length: 38 minutes Random samples from 9 regions of the country

4. Sample (n=292; Margin of Error 9%) Legislators (1398) Legislative Staff (400) Executive Managers (1050) 98 97

5. Sample (cont.) Executive branch officials included directors and deputy directors of: - Insurance Departments - Health Departments - Medicaid programs - SCHIP programs - Agencies on Aging - Mental Health Departments - Budget offices - Governors’ advisors N = 8-10 per cell

6. Profile Average age: 50 - Executive Branch, 51 Current Position: 6.5 years - Executive Branch, 4 years** In Health: 14.1 years - Executive Branch, 18 years* * Longest**Shortest

7. INFORMATION HABITS

8. What percentage of information do you receive do you read or never get to? Never Get To Read

9. How often do you read an article or report rather than skim? (weekly) LegislatorsLegislative StaffExecutive Branch Daily or more 43%44%48% 3-416% 23% 0-227%35%24%

10. What percent of the information you receive is relevant to you? 49% Why? Related to current debate (67%) Impact on people/constituents (25%) Experience of states like mine (11%) Easy to read/concise (11%)

11. What makes information least useful? Not relevant (36%) Too long/dense (22%) Too much data/too technical (20%) Not objective/biased (19%) Too general/global (14%)

12. What causes you to stop skimming and read an article? Relevant to current debate/something I am working on 86%

13. INFORMATION USE

14. How useful is __ in making policy decisions? (1=not at all 5=very) USEFUL Summaries or briefs (4.0) Reports on demographically-similar states (3.9) Reports on other states in your region (3.9) In-state meetings (3.5)

15. How useful is __ in making policy decisions? (1=not at all 5=very) USEFUL Summaries or briefs (4.0) Reports on demographically-similar states (3.9) Reports on other states in your region (3.9) In-state meetings (3.5) NOT USEFUL Audiotapes of articles (2.0) Audioconferences (2.0) Listserves (2.7) Press releases (2.7)

16. Usefulness Summary LegislatorsLegislative Staff Executive Managers Summaries/Briefs (3.9) Internet Websites (4.1) Summaries/Briefs (4.1) In-state MeetingsReports on states in region Reports on demographically- similar states Reports on states in your region Summaries/BriefsE-mail

17. Usefulness Summary (Executive Branch) 1. Summaries or briefs (4.1) 2. Reports of demographically similar states (3.9) 3. Reports on other states in your region (3.8) 4. Out-of-town meetings (3.6) 5. E-mail (3.8) 6. Internet websites (3.5) 7. Newsletters (3.5) 8. In-state meetings (3.5)

18. Rank Data Preference (high = 1; low = 3) 1. Data from your state 1.6 2. State to state comparative data 2.1 3. National data 2.3

19. Which health policy journals and newsletters do you read regularly? State Health Notes107 Health Affairs70 JAMA23 NEJM20

20. Which do you read most frequently: electronic or hard copy? LegislatorsLegislative Staff Executive Managers TOTAL Electronic 13%41%27% Hard Copy 80%52%64%65%

21. Which do you read most frequently: electronic or hard copy? AGE<3030-3940-4950-5960+ Electronic56%38%32%27%6% Hard Copy 11%58%61%66%88%

22. Which in-state meetings do you try to regularly attend? Health association meetings36% Don’t attend30% Agency hearings27% Issue specific meetings 22%

23. Which out-of-town meetings do you try to regularly attend? Government service org meetings49% Don’t attend29% Health professional19% Federal agency hearings12% Issue-specific meetings 9%

24. Which out-of-town meetings do you try to regularly attend? n NCSL42 NAIC12 Medicaid Directors9 Milbank Reforming States8 Robert Wood Johnson7

25. Who do you trust? National organizations 73% Publications 33% State organizations 21% Foundations 21% Government agency 19% Think tanks 14% Health care associations 14%

26. Who do you trust? (n=244) n National Conference of State Legislatures93 Robert Wood Johnson Foundation31 Kaiser Family Foundation23 Health Affairs22 National Governors’ Association21 Urban Institute14 State Health Notes13 Council of State Governments13 Health Care Financing Administration13

27. Who do you turn to when you need more information? Government agencies 69% Gov’t service organizations26% Trade associations24% Advocacy groups17%

28. Which of the following best matches your feelings? When I obtain information about health policy I want… Research findings plus implications and recommendations 89% Research findings only10%

29. What other information services or materials would be helpful to you? Better, more timely data19% More short updates/synopses of research 12% Get too much10% Don’t know17%

30. Conclusions

31. Information is Highly Valued 44.5% said they read an article or report once a day or more 89.4% said they want the research findings plus the author(s)’ implications or recommendations

32. Timeliness is Everything Enormous time pressures – 35% of what they receive they never get to – Summaries and briefs are most useful (4.0) Highly focused on current agendas – 86% read for detail if it is relevant to current debate – 63% decide what to read if it is relevant or timely – 49% of what they receive is considered relevant

33. Information About States is Valued Policymakers Value: Data from their own states Reports on states in their region Reports on demographically similar states But Place Less Value On: National data Reports on bellwether states

34. But Keep it Brief! Overwhelming interest in short summaries Punchy headlines, bullets, graphs make information more accessible/inviting

35. And Layer it! Legislators rarely want more than a summary. Executive managers want a summary and details. Legislative staff want it all: Summary, details, data, and methodology. Use the Web to give readers options.