Government Social Research Unit Philip Davies PhD Government Social Research Unit HM Treasury London SW1A 2HQ What Can Social Science Contribute to Improving the Nation’s Health? Evidence-Based Policies and Indicator Systems Conference Regents Park Conference Centre, London, July

Evidence for Policy Theories of Change How is the policy supposed to work? Logic Model

Theories of Change/Logic Model Health Trainers Project Provide Personal Health Trainers Provide advice and information on healthy living Develop and sustain motivation to improve personal and family health Change individuals ’ and families ’ lifestyles Improve health/reduce morbidity and mortality ? Evidence on effectiveness of knowledge transmission Programme Theory Programme Evidence ? Evidence on effectiveness of attitude change ? Evidence on effectiveness of behavioural change

Evidence for Policy Theories of Change How is the policy supposed to work? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews

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 What Makes a Review Systematic?

Sources of Systematic Review of Health and Healthcare Cochrane Collaboration NHS Centre for Reviews and Dissemination (CRD) Centre for Evidence-Informed Policy and Practice (EPPI) National Institute of Clinical Excellence (NICE) Social Care Institute of Excellence (SCIE) Campbell Collaboration ESRC Centre for EBPP and the Evidence Network

Evidence for Policy Theories of Change Descriptive Analytical Evidence How is the policy supposed to work? What is the nature, size and dynamics of the problem? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews Statistics Surveys Qualitative Research

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)

Evidence for Policy Theories of Change Descriptive Analytical Evidence How is the policy supposed to work? What is the nature, size and dynamics of the problem? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews Statistics Surveys Qualitative Research Attitudinal and Experiential Evidence How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research Observational 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

Evidence for Policy Theories of Change Descriptive Analytical Evidence How is the policy supposed to work? What is the nature, size and dynamics of the problem? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews Statistics Surveys Qualitative Research Attitudinal and Experiential Evidence How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research Observational Studies Evidence of Effective Interventions What Works? At What Costs? With What Outcomes? Experimental and Quasi-Experimental Studies

Types and Sources of Social Experiment Randomised Controlled Trials (e.g. RIPPLE study) Regression Discontinuity Designs Propensity Score Matching Studies Interrupted Time Series Studies Types of Experiment Sources of Experiment Cochrane Central Register of Controlled Trials Campbell Social, Psychological and Educational Controlled Trials Register (C2SPECTR)

Evidence for Policy Theories of Change Descriptive Analytical Evidence How is the policy supposed to work? What is the nature, size and dynamics of the problem? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews Statistics Surveys Qualitative Research Attitudinal and Experiential Evidence How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research Observational Studies Evidence of Effective Interventions What Works? At What Costs? With What Outcomes? Experimental and Quasi-Experimental Studies Economic and Econometric Evidence What is the Cost, Benefit and Effectiveness of Interventions? Cost-Benefit Cost-Effectiveness Cust-Utility Analysis

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

Evidence for Policy Theories of Change Descriptive Analytical Evidence How is the policy supposed to work? What is the nature, size and dynamics of the problem? Logic Model Harness Existing Evidence What evidence already exists? Systematic Reviews Statistics Surveys Qualitative Research Attitudinal and Experiential Evidence How to citizens and patients feel about health, illness and health policy? Surveys Qualitative Research Observational Studies Evidence of Effective Interventions What Works? At What Costs? With What Outcomes? Experimental and Quasi-Experimental Studies Economic and Econometric Evidence What is the Cost, Benefit and Effectiveness of Interventions? Cost-Benefit Cost-Effectiveness Cust-Utility Analysis Ethical Evidence What are the ethical implications of the policy? Social Ethics Public Consultation

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

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

Contact Government Social Research Unit HM Treasury 1 Horse Guards Road London SW1A HQ England Tel: +44 (0)