Research Centers & Affiliations
IUHR - Intervention to Increase Use of Data in the Decision-Making Process of the Massachusetts HIV Prevention Planning Group
Intervention to Increase Use of Data in the Decision-Making Process of the Massachusetts HIV Prevention Planning Group
Hortensia D. Amaro, Ph.D., Northeastern University
Allison C. Morrill, J.D., Ph.D., Northeastern University
Jianyu Dai, M.M., M.P.H., Northeastern University
Samantha Dunn, B.A., Northeastern University
Name & Mailing Address of Corresponding Author:
Allison C. Morrill
Institute on Urban Health Research
360 Huntington Ave., Stearns 503
Boston, MA 02115
Telephone & Email:
The Massachusetts Department of Public Health, Under a Grant from the Centers For Disease Control and Prevention (CDC)
Body of Abstract
The Centers for Disease Control and Prevention require states receiving federal funds for HIV prevention to involve community members in the planning process. The Massachusetts Prevention Planning Group (MPPG) includes providers, consumers and department of public health employees. It meets regularly to advise the department on which populations and interventions to prioritize. The purpose of this study is to assess effects of an intervention to increase the MPPG's use of data in its decisions. We studied three factors that influence decision-making: (a) data inputs, (b) group structure, and (c) member characteristics.
The study used a one-group multiple time measures design to assess changes over time. Data collected from May, 2000 to December, 2002 included archival review of MPPG meeting records, directed observation of meetings, in-depth interviews with members, and yearly surveys of MPPG members (n=31, 35, & 28). Observer notes were coded for themes. Survey responses were combined to create indexes of reliance on personal experience, knowledge/skills, perceived decision-making structure, satisfaction with data, satisfaction with decision-making process, satisfaction with decisions, and leadership. Results from 2000 were used to design the intervention which began in 2001. It entailed structural changes, including standards for data presentations, training of leaders, a system for handling data requests, expanded diversity of membership, defining member roles, clarify decision-making rules, and building trust. Observers noted changes in themes over time, and T-tests compared indices pre- and post-intervention.
Data inputs. Baseline observation of meetings in 2000 noted deficits in the quality and completeness of data presented. Steps to improve presentations were implemented in 2002. Observers noted improvement but it was not reflected in 2002 survey responses. Reliance on data in decision-making remained unchanged. Group structure: At baseline, observers noted inconsistency in the rules for making decisions, and few opportunities for formal decisions. Interviewees seemed accepting of the group's advisory role, although a few were dissatisfied with the group's influence. While many survey respondents cited conflict (52%) and stress (60%) around decision-making, 86% felt their participation was worthwhile. After implementation of the intervention, observers noted improvement in clarity of decision-making procedures. Surveys in 2001 showed improvement in perceived structure (p=.002), satisfaction with decision-making process (p=.004) and leadership (p=.02). Member characteristics: Although at baseline, over 70% of respondents reported 'moderate' or 'extensive' ability to use most types of data, a substantial majority reported 'some,' or 'very little or no' skill in interpreting findings on evaluation effectiveness (60%) and cost-effectiveness (84%). Despite turnover in 2001 that lowered average educational level, knowledge scores did not change.
Findings suggest that while changes in group structure and decision making processes may be easily improved, there may be real limitations in short-term approaches to equalizing skills in the use of data in educationally diverse community advisory groups. It is possible that either different interventions than those used or longer exposure to the intervention are needed to achieve change in the use of data in decision making in community advisory groups like the MPPG. The final year of observations and member surveys will be completed in September 2003 and will be used to assess whether any changes occurred during the intervention's final year.