Implementation Research and Practice, Volume 4, Issue , January-December 2023.
BackgroundCommunication research demonstrates that messages often have unintended consequences, but this work has received limited attention in implementation science. This dissemination experiment sought to determine whether state-tailored policy briefs about the behavioral health consequences of adverse childhood experiences (ACEs), compared to national policy briefs on the topic, increased state legislators’/staffers’ perceptions of the policy brief relevance and parental blame for the consequences of ACEs, and whether effects differed between Democrats and Republicans.MethodA preregistered, web-based survey experiment with U.S. state legislators/staffers was conducted in 2021 (n = 133). Respondents were randomized to view a policy brief about the behavioral health consequences of ACEs that included state-tailored data (intervention condition) or national data (control condition) and then answered survey questions. Dependent variables were perceived policy brief relevance and parental blame for the consequences of ACEs.ResultsThe mean policy brief relevance score was 4.1% higher in the intervention than in the control condition (p = .24), but the mean parental blame score was 16.5% higher (p = .02). When outcomes were dichotomized, 61.2% of respondents in the intervention condition rated parents as “very much to blame” for the consequences of ACEs compared to 37.1% in the control condition (p = .01). When the sample was stratified by political affiliation, the effect of the state-tailored policy brief on parental blame was larger in magnitude among Democrats and not significant among Republicans. The intervention policy brief increased the mean parental blame score by 22.8% among Democrats relative to the control policy brief (p = .007) and doubled the proportion rating parents as “very much to blame” (52.2% vs. 26.1%, p = .03).ConclusionsDespite limited statistical power, state-tailored policy briefs significantly increased state legislators’/staffers’ perceptions of parental blame for the behavioral health consequences of ACEs, relative to a policy brief with national data. Unintended messaging effects warrant greater attention in dissemination research and practice.Plain Language SummaryPrior studies have tested the effects of dissemination strategies on policymakers’ engagement with research evidence. However, little research has assessed the potential unintended consequences of disseminating evidence to policymakers. This knowledge gap is important because a large body of communication research has found that messages often have negative and unintended effects. This paper adds to the literature on disseminating evidence about behavioral health issues to policymakers. A web-based survey experiment was conducted in which U.S. state legislators/staffers were randomized to view a policy brief about adverse childhood experiences (ACEs) that was tailored to present data from their state (intervention condition) or a policy brief that presented national data and then completed a survey. Legislators/staffers who viewed the state-tailored policy brief perceived the brief as slightly more relevant, but also rated parents as being significantly more to blame for the behavioral health consequence of ACEs. The effect of the state-tailored policy brief on parental blame is an unintended messaging effect that signals cause for caution when disseminating evidence about ACEs to policymakers and other practice audiences. More broadly, the findings highlight a need to consider unintended messaging effects in dissemination research and practice.