Contexts for Scaling Up Evidence-Based Preventive Interventions: Examining Factors That Influence the Likelihood of the Use of Research Language in Substance Use Legislation.

Abstract

Understanding the factors that influence whether research evidence on substance use and substance use disorders (SU/SUD) gets written into legislation can help identify opportunities for maximizing its uptake by policymakers and scaling up preventive interventions. Yet, limited work has examined the contexts that influence the adoption of evidence-based interventions and other uses of research evidence (URE) in US state-level bills. Baseline data were drawn from a randomized clinical trial. Using a multi-level design, we tested whether state-level contextual variables (level 2; e.g., economic conditions) and bill-level variables (level 1; e.g., sponsor count) influenced whether research was used in SU/SUD bills, and whether bill enactment was associated with its inclusion of URE. Legislation introduced between 2017 and 2022 (N = 47,087 bills) from 30 US states was examined. Of the 14 variables analyzed, five were significantly associated with URE. These included two level 2 state context variables: professionalism and innovation rate, as well as two level 1 bill-level variables: sponsor/co-sponsor count and bipartisan sponsorship/co-sponsorship, which were associated with an increased likelihood of SU/SUD bills containing URE. Lobbying regulations (a level 2 state context variable) was associated with a decreased likelihood. Bills that were enacted were more likely to contain URE than those that were not enacted. The variables that increased the likelihood of SU/SUD bills containing URE may reflect state legislators' capacity to use research and their value of it. However, some variables that were theoretically hypothesized to be associated with URE in bills were not (e.g., research and development expenditure). These findings suggest opportunities remain to improve URE in SU/SUD legislation.