This study study aimed to experimentally test different narrative frames as tools for optimizing policymakers’ engagement with Substance Use and Substance Use Disorder research.
This study highlights the power of people with lived experience sharing their stories in optimizing policymakers’ engagement with SU/SUD research, which is critical for improving the use of rigorous, unbiased scientific research in SU/SUD policies and improving public health outcomes.

Author

Elizabeth C. Long, Riley Loria, Jessica Pugel, Patrick O’Neill, Camille C. Cioffi, Charleen Hsuan, Glenn Sterner, D. Max Crowley, J. Taylor Scott

Citation

Elizabeth C. Long, Riley Loria, Jessica Pugel, Patrick O’Neill, Camille C. Cioffi, Charleen Hsuan, Glenn Sterner, D. Max Crowley, J. Taylor Scott, The power of lived experience in optimizing US policymakers’ engagement with substance use research: A series of rapid-cycle randomized controlled trials, Drug and Alcohol Dependence Reports, Volume 13, 2024, 100299, ISSN 2772-7246, https://doi.org/10.1016/j.dadr.2024.100299.


Source
Drug and Alcohol Dependence Reports Volume 13, December 2024
Release date
15/11/2024

The power of lived experience in optimizing US policymakers’ engagement with substance use research: A series of rapid-cycle randomized controlled trials

Research study

Highlights

  • Increasing policymakers’ engagement with substance use research is challenging.
  • Narratives as a best practice for science communication are rarely evaluated.
  • Five trials show the benefit of narratives describing lived experience is nuanced.
  • Engagement generally increased when the sender was the narrative author.
  • This highlights the power of people with lived experience sharing their stories.

Background

Alcohol and other drugs harm has contributed to a decline in life expectancy in the United States, a reversal not seen in any other wealthy country, even prior to the COVID-19 pandemic. In 2021, more than 100,000 U.S. Americans died from narcotic drug overdoses, and approximately 125,200 die from alcohol-attributable causes per year.

125,200
Deaths due to alcohol per year
Every year, 125,000+ people die in the U.S. due to alcohol.

The paradox

These record-breaking rates, in addition to the high prevalence of substance use disorders (SUDs) (Mojtabai, 2022), come despite hundreds of research interventions designed to prevent, treat, or reduce the harms linked with substance use (SU) and SUDs. This paradox may stem from known barriers SU/SUD researchers face in getting rigorous and unbiased research into the hands of policymakers, such as time constraints, university reward structures, lack of training opportunities for researchers to gain knowledge of the process of sharing research with policymakers, and differing norms and objectives between researchers and policymakers.

The conflict

In the absence of rigorous and unbiased research effectively reaching policymakers, industry research efforts and lobbyists fulfill the demand for policy-relevant research evidence. Such research may be biased since it is meant to skew policymakers towards a more favorable view of their cause.

If biased research like this is most accessible to policymakers due to corporate financial backing, evidence-based policy changes that lead to public health benefits may be fruitless.

Alternatively, theory suggests that if unbiased, rigorous, and relevant research reaches the right policymakers at the right time in the right way, they may be more likely to use high quality evidence to inform policy decisions that can achieve population-level impacts. For instance, the Icelandic Model of Adolescent Substance Use Prevention substantially reduced adolescent SU by increasing policymakers’ engagement with research on risk and protective factors through researcher-policymaker collaborations.

The assumption

Researchers and science communicators can increase the successful use of quality scientific evidence in policymaking by improving policymakers’ access to research evidence on SU/SUD through relationships with them.

The SCOPE Model

The SciComm Optimizer for Policy Engagement (SCOPE) model aims to facilitate engagement between researchers and policymakers via research disseminations by using continuous quality improvement to experimentally test different message frames.

The SCOPE model leverages theory pointing to the need for research evidence to be relevant to current policy priorities and available in real time so that it can be used within discrete policy windows.

In fact, one of the most frequently reported facilitators of policymakers’ use of research evidence involves access to relevant and timely research.

This contrasts with one-way dissemination efforts that “push” research information without considering policymakers’ current policy priorities

The SciComm Optimizer for Policy Engagement (SCOPE) Model. Note. CQI = continuous quality improvement.

Policymakers’ current policy goals can be learned through interactions occurring as part of relational research-policy bridging approaches, or through scanning their public discourse.

If several different legislative staff have needs and questions about the same topic or reflect similar priorities, it would be considered timely and relevant enough to respond with broad dissemination of corresponding research syntheses, typically in the form of one- to two-page fact sheets. This dissemination of timely and relevant research evidence can in turn facilitate additional interactions.

Accordingly, the SCOPE model supplements this interactive bridging approach by forming feedback loops and expanding the number of policymakers who receive the research syntheses resulting from the interactions. More specifically, the steps of model include:

  1. assessing policymakers’ current policy priorities,
  2. developing corresponding content in the form of concise fact sheets,
  3. identifying officials and/or staff who are likely to find the content useful,
  4. creating different messaging frames to test,
  5. disseminating the fact sheets, and
  6. analyzing the results so they may inform hypotheses for future testing.

Previous work using the SCOPE model has shown that evoking emotional responses and cueing a topic’s relevance can increase policymakers’ electronic engagement with research evidence.

Research has shown that framing effects can influence behaviors and beliefs. For example, cross-sectional research finds that state legislators’ support for opioid use disorder and behavioral health parity laws were more strongly associated with their personal beliefs about treatment and fiscal impacts rather than their political party, ideology, or individual demographics. Additionally, varying narratives about particular topics can influence public support for mental health and SUD policy issues.

This suggests that framing strategies that increase personal relevance and decrease psychological distance from research messages could be effective in shifting lawmakers’ beliefs and later actions. Topics that feel psychologically closer feel more personally relevant.

While many factors can influence psychological closeness, the researchers focus on the use of narratives in the current study for several reasons:

  • Narratives are especially useful in engaging communication, with past work showing that narratives, especially first-person narratives, are effective in reducing psychological distance.
  • In communications research, transportation theory describes how narratives can reduce the psychological distance of a topic. Being engrossed and invested in a story allows readers to internalize a message with which they might not normally engage deeply.
  • First-person narratives are particularly good at reducing distance as they naturally evoke perspective taking.

Accordingly, using narratives may be an effective strategy for improving policymakers’ engagement with SU/SUD research.

The challenges

  1. However, many persuasion/advocacy techniques, including narratives, have yet to be tested in the unique context of messages to policymakers.
  2. Additionally, there is a great deal of competition for policymakers’ attention.

The potential

Since lawmakers have a particularly powerful and direct influence on SU/SUD policies, it is vital to investigate framing strategies to optimize research engagement efforts with this population.

The aim of the present study is to experimentally test different narrative frames as tools for optimizing policymakers’ engagement with SU/SUD research. We hypothesized that using narratives in the email bodies would result in more email opens, clicks on the fact sheet links, and email replies than not using narratives.

The researchers generated more specific hypotheses between each trial based on the prior trial’s results, predicting that lived experience with SUD, first-person narratives, shorter narratives, and the sender being the narrative author would generate greater engagement compared to the control. These predictions are all driven by an overarching theory that increasing psychological closeness should increase engagement.

Findings

The present study aimed to test the use of narratives and sender effects (i.e., fact sheet author/editor vs. narrative author) on state and federal policymakers’ engagement with SU/SUD research.

The results were nuanced and the study hypothesis that using narratives would improve policymakers’ engagement with SU/SUD was only supported under certain conditions. At times, using narratives even backfired.

First, whether the use of narratives in the email body is an effective strategy for optimizing engagement may depend on the sender. Specifically, narratives seem to be particularly effective when they are sent from the same person telling the story, as opposed to someone else telling their story. This highlights the potential power of people with lived experience in telling their story.

Second, narratives were beneficial when the sender’s identity appears to be congruent with a person’s background, as opposed to when the story is from someone with multiple relevant identities that require the recipient to reconcile. For example, a researcher with lived experience of SUDs may be difficult to reconcile because of the stigmatization of people with SUD. These complex identities may make reducing psychological distance more challenging.

When the sender shared someone else’s narrative, narratives did not improve engagement and sometimes hindered it, regardless of whether the narrative was written in first or third person or length of the narrative.

Though the researchers expected first-person narratives to be more effective, these results suggest that direct engagement with the actual narrative author may be necessary for narratives to increase psychological closeness.

Adding the additional step of someone else’s narrative may make the narrative seem more contrived and make the recipient less inclined to engage. If the value of narratives as a messaging tool lies in its ability to connect the reader and its author, then it follows that an added layer of distance in the form of a third-party sender would dampen its effects. Collectively, it seems that being authentic and transparent is effective for reducing psychological distance and optimizing policymakers’ engagement with research.

The findings are somewhat consistent with the broader literature showing that framing can influence behaviors and beliefs. More specifically, McGinty and colleagues found that portraying successful treatment of mental disorders and SUDs improves public support and reduces stigma, which is consistent with the study findings showing that the fact sheets in emails with narratives from individuals who have had success with treatment and are in active recovery were clicked on more than the control emails.

While the current study focused on testing narratives within the email body rather than subject lines, the researchers’ prior work focused on testing whether different subject lines influenced email open rates. They have shown, for instance, that using words that evoke emotional responses in the subject lines of emails disseminating racial justice research and cueing relevance with personalized subject lines of emails disseminating research that was timely during the COVID-19 pandemic increased the likelihood of policymakers’ opening the email.

Future work is needed, however, to investigate whether these findings generalize to emails disseminating SU research and whether certain subject lines increase the open rates of emails with narratives of lived experience more than others.

Conclusions

This work helps to inform strategies for increasing policymakers’ electronic engagement with SU/SUD research by demonstrating that the benefit of using narratives for this purpose is nuanced.

In general, policymakers were more likely to engage with research when the narrative was about the sender, and when the sender’s identity appeared to be congruent with the person’s background, but not when the sender was the fact sheet author or editor.

This work highlights the power of people with lived experience sharing their stories in optimizing policymakers’ engagement with SU/SUD research, which is critical for improving the use of rigorous, unbiased scientific research in SU/SUD policies and improving public health outcomes.

Abstract

Background

Research can inform policies on substance use/substance use disorders (SU/SUDs), yet there is limited experimental investigation into strategies for optimizing policymakers’ engagement with SU/SUD research. This study tested the use of narratives to boost policymakers’ research engagement.

Methods

In five rapid-cycle randomized controlled trials, SU/SUD research fact sheets were emailed to US legislative policymakers. The researchers tested the use of narratives on the number of email opens, fact sheet clicks, and replies, relative to control emails without narratives.

Narratives described lived experience with SU/SUD or motivations to study SU/SUD. The sender was a person with lived experience who authored the narrative or an author of the fact sheet.

Results

When the narrative was about the sender’s own lived experience (Trial 1), or when the narrative was about the sender’s motivations to study SU/SUDs (Trial 2), the fact sheet was clicked more than the control.

When the narrative was about someone else’s experience (Trials 3 and 4), the email was opened and replied to less, and the fact sheet was clicked less.

Lastly, emails with lived experience narratives were replied to more than the control, regardless of sender, but were opened more if the sender authored the narrative.

Conclusions

Policymakers’ engagement with SU/SUD research generally increased when the sender was telling their own story. This work highlights the power of people with lived experience and informs strategies for optimizing policymakers’ engagement with SU/SUD research.


Source Website: Science Direct