Developing and evaluating a decision support tool to disseminate tobacco control research and inform policy implementation

PROJECT SUMMARY Adolescent use of electronic nicotine delivery systems (ENDS, or e-cigarettes) has increased rapidly and can lead to nicotine addiction and adversely affect brain development. Conversely, ENDS products can help adults quit smoking, decreasing their cancer risk. This creates a major tradeoff in risks and benefits that must be considered when evaluating ENDS control policies, in addition to other aspects such as costs and political feasibility. State public health administrators are at the forefront of ENDS control policy efforts. Public health research could guide their decision making, but research evidence is often inaccessible to decision makers or not synthesized concisely and meaningfully. Without strategies to disseminate evidence in an accessible way it is of limited public health impact. Existing dissemination strategies have been largely untested and have not accounted for the inherent complexity of policy decisions (e.g., tradeoffs). The goal of this proposal is to develop and evaluate a potential dissemination strategy: a decision support tool. Such tools can help manage decision complexity by systematically presenting information on relevant attributes of specific policies that are important to administrators (e.g., reach of policy, potential harms and benefits, costs to implement), and improve research accessibility by synthesizing evidence for each attribute. In the K99 phase of the award, Dr. Smith, a postdoctoral fellow at the Harvard Chan School, will quantify the relative importance of key attributes of policies that administrators consider in their decision making using a discrete choice experiment. In the R00 phase, she will build a decision support tool for administrators using principles of multi-criteria decision analysis, peer-reviewed research evidence, and quantitative results from the K99 phase. She will then conduct a pilot study with administrators to evaluate the potential for the decision support tool to improve research dissemination by assessing the tool’s acceptability, appropriateness, and feasibility, three key preconditions for success. This research will provide much-needed evidence on the use of decision support tools to advance evidence-informed policymaking. Further, this award will enable Dr. Smith to achieve her long-term career goal of becoming an independent investigator focused on evidence-informed public health policies for cancer prevention. Dr. Smith has a strong foundation in simulation modeling and economic evaluation; this award will build on this foundation by providing advanced training in decision science methods and develop her expertise in tobacco control policy. Her K99 training plan draws on the unique strengths of her transdisciplinary mentorship team and educational and professional resources available through the Harvard T.H. Chan School of Public Health. Overall, the research and training activities in this proposal will provide Dr. Smith with the experience necessary to launch her career as an independent scientist working at the intersection of decision science, policy implementation and dissemination science, and cancer prevention and control policies.