The limited role of evidence in public health policy making.

Background: Evidence informed health policy making is an international development, which aims to make sure that public health policy decisions are based on the best available evidence. The Dutch National Institute for Public Health and the Environment (RIVM) aims to improve the usefulness of their information about effectiveness for policy makers. As both national and local policy makers are an important target group of the products of the RIVM, it is important to know the role of effectiveness information in policy making and the needs in the way the RIVM communicates about effectiveness. We used linear and interaction models to analyze the use and needs of effectiveness information by public health policy makers. Methods: We used a qualitative study design. We carried out focus group interviews with national and local public health policy makers, using semi structured interviews. The interviews are recorded and transcribed. We extracted the data using a qualitative software program, Atlas.ti, to electronically code data, and to generate a report of coded texts for analysis. Results: The participants do not regard effectiveness information as the key factor in health policy making. Especially the political context has a strong influence on the use of effectiveness information. Participants argue that they use the Intervention database a lot as a source of effectiveness information, but sometimes relevant aspects of information are missing. Participants are dissatisfied with the understandability, accessibility, size of reports, language use, and clarification of the information. Participants wish to interact more with researchers. Conclusions: Effectiveness information has a part in policy decisions, but it is not the primary factor. Research evidence plays a secondary role in policy making. The RIVM should bridge the gap between researchers and policy makers by investing in more interaction and co-production, to increase usefulness of their information.