Table 6 Example for identifying and describing bridging factors necessary for policy D&I success (Recommendation 6)

Example scenario

Researchers are studying local Board of Education policymakers’ use of evidence when designing school district immunization requirements for meningococcal disease. The national disease control agency and several professional medical societies recommend meningococcal vaccination for all school-age children. A parental advocacy group stages a local protest against vaccine requirements.

EPIS framework application steps

1. Specify the contexts being investigated to understand the stakeholders involved (see recommendations 1 and 4).

  • The government agency, professional medical societies, and advocacy group all operate in the outer context.

  • The Board of Education represents the highest level of the inner context with individual schools in the board’s district operating at lower levels of the inner context.

2. Conduct interviews, attend public meetings to determine whether either of the outer context entities (i.e., professional medical societies, parental advocacy group) evolve as “intermediary” bridging factors by directly providing Board of Education policymakers with information about the pros or cons of the proposed immunization policy.

  • Examine the type of information or “capital exchanged” (e.g., scientific evidence about vaccine safety, misinformation, personal beliefs) being shared by “intermediaries”.

  • Determine which phase(s) (i.e., exploration, preparation implementation, or sustainment) intermediaries play an active role delivering information/capital.

  • Investigate how the presence of a bridging factor, like a professional medical society, influences how immunization requirements are defined in policy, disseminated to parents, and implemented in practice.