Government Social Research Unit

1
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 Nations Health?
Philip Davies PhD Government Social Research
Unit HM Treasury London SW1A 2HQ
www.gsr.gov.uk
2
How is the policy supposed to work?
Logic Model
Theories of Change
Evidence for Policy
3
Theories of Change/Logic Model Health Trainers
Project
Programme Theory
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
Programme Evidence
? Evidence on effectiveness of knowledge
transmission
? Evidence on effectiveness of attitude change
? Evidence on effectiveness of behavioural change
4
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
Theories of Change
Harness Existing Evidence
Evidence for Policy
5
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

6
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

7
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
What is the nature, size and dynamics of the
problem?
Theories of Change
Harness Existing Evidence
Statistics Surveys Qualitative Research
Descriptive Analytical Evidence
Evidence for Policy
8
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)

9
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
What is the nature, size and dynamics of the
problem?
Theories of Change
Harness Existing Evidence
Statistics Surveys Qualitative Research
Descriptive Analytical Evidence
Evidence for Policy
How to citizens and patients feel about health,
illness and health policy?
Attitudinal and Experiential Evidence
Surveys Qualitative Research Observational Studie
s
10
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

11
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
What is the nature, size and dynamics of the
problem?
Theories of Change
Harness Existing Evidence
Statistics Surveys Qualitative Research
Descriptive Analytical Evidence
Evidence for Policy
How to citizens and patients feel about health,
illness and health policy?
Attitudinal and Experiential Evidence
Evidence of Effective Interventions
Surveys Qualitative Research Observational Studie
s
What Works? At What Costs? With What Outcomes?
Experimental and Quasi-Experimental Studies
12
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)

13
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
What is the nature, size and dynamics of the
problem?
Theories of Change
Harness Existing Evidence
Statistics Surveys Qualitative Research
Descriptive Analytical Evidence
Evidence for Policy
How to citizens and patients feel about health,
illness and health policy?
Economic and Econometric Evidence
Cost-Benefit Cost-Effectiveness Cust-Utility
Analysis
Attitudinal and Experiential Evidence
Evidence of Effective Interventions
Surveys Qualitative Research Observational Studie
s
What is the Cost, Benefit and Effectiveness of
Interventions?
What Works? At What Costs? With What Outcomes?
Experimental and Quasi-Experimental Studies
14
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

15
How is the policy supposed to work?
What evidence already exists?
Logic Model
Systematic Reviews
What is the nature, size and dynamics of the
problem?
Social Ethics Public Consultation
Theories of Change
Harness Existing Evidence
Statistics Surveys Qualitative Research
What are the ethical implications of the policy?
Descriptive Analytical Evidence
Ethical Evidence
Evidence for Policy
How to citizens and patients feel about health,
illness and health policy?
Economic and Econometric Evidence
Cost-Benefit Cost-Effectiveness Cust-Utility
Analysis
Attitudinal and Experiential Evidence
Evidence of Effective Interventions
Surveys Qualitative Research Observational Studie
s
What is the Cost, Benefit and Effectiveness of
Interventions?
What Works? At What Costs? With What Outcomes?
Experimental and Quasi-Experimental Studies
16
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

17
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

18
Contact
philip.davies_at_hm-treasury.x.gsi.gov.uk Government
Social Research Unit HM Treasury 1 Horse Guards
Road London SW1A HQ England Tel [phone]
5156
www.policyhub.gov.uk