kirstyevidence

Musings on research, international development and other stuff


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Does public (mis)understanding of science actually matter?

Many parents feel reassured by pseudoscientific treatments - although experts point out that a similar amount of reassurance could be achieved by investing the cost of treatments in wine and chocolate.

Babies suffer through a lot of bogus treatments for the sake of placebo-induced parental reassurance.

So, as regular readers know, I have recently become a mum. As I mentioned in my last post*, I was really shocked by how much pseudoscience is targeted at pregnant women. But four months after the birth, I have to tell you that it is not getting any better. What I find most concerning is just how mainstream the use of proven-not-to-work remedies are. Major supermarkets and chemists stock homeopathic teething powders; it is common to see babies wearing amber necklaces to combat teething; and I can’t seem to attend a mother and baby group without being told about the benefits of baby cranial osteopathy.

I find this preponderance of magical thinking kind of upsetting. I keep wondering why on earth we don’t teach the basics of research methodologies in high schools. But then sometimes I question whether my attitude is just yet another example of parents being judgey. I mean, other than the fact that people are wasting their money on useless treatments, does it really matter that people don’t understand research evidence? Is worrying about scientific illiteracy similar to Scottish people getting annoyed at English people who cross their hands at the beginning, rather than during the second verse, of Auld Lang Syne: i.e. technically correct but ultimately unimportant and a bit pedantic?

I guess that I have always had the hypothesis that it does matter; that if people are unable to understand the evidence behind medical interventions for annoying but self-limiting afflictions, they will also find it difficult to make evidence-informed decisions about other aspects of their lives. And crucially, they will not demand that policy makers back up their assertions about problems and potential solutions with facts.

But I have to admit that this is just my hypothesis.

So, my question to you is, what do you think? And furthermore, what are the facts? Is there any research evidence which has looked at the links between public ‘science/evidence literacy’ and decision making?? I’d be interested in your thoughts in the comments below. 

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* Apologies by the way for the long stretch without posts – I’ve been kind of busy. I am happy to report though that I have been using my time to develop many new skills and can now, for example, give virtuoso performances of both ‘Twinkle Twinkle’ and ‘You cannae shove yer Granny’.†,‡

† For those of you unfamiliar with it, ‘You cannae shove yer Granny (aff a bus)’ is a popular children’s song in Scotland. No really. I think the fact that parents feel this is an important life lesson to pass on to their children tells you a lot about my country of birth…

‡ Incidentally, I notice that I have only been on maternity leave for 4 months and I have already resorted to nested footnotes in order to capture my chaotic thought processes. This does not bode well for my eventual reintegration into the world of work.

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Scottish independence and the falacy of evidence-BASED policy

indyrefAs I may have mentioned before, I am a proud Scot. I have therefore been following with interest the debates leading up to the Scottish referendum on independence which will take place on the 18th September (for BBC coverage see here or, more entertainingly, watch this fabulous independence megamix). Since I live in England, I don’t get to vote – and even if I did, as a serving civil servant it would not be appropriate for me to discuss my view here. But I do think the independence debate highlights some important messages about evidence and policy making – namely the fact that policy can not be made BASED on evidence alone.

The main reason for this is that before you make a policy decision you need to decide what policy outcome you wish to achieve – and this decision will be influenced by a whole range of factors including your beliefs, your political views, your upbringing etc. etc. So in the case of the independence debate, as eloquently pointed out by @cairneypaul in this blog, the people of Scotland need to decide what their priorities for the future of Scotland will be. Some will feel that financial stability is the priority, others will focus on the future of the Trident nuclear deterant, some will focus on their desire for policy decisions to be made locally, while others will care most about preservation of a historic union.

Only once people are aware of what their priorities are, will evidence really come in to play. In an ideal world there would then be a perfect evidence base which would provide an answer on which option (yes or no) would be most likely to lead to different policy outcome(s). But of course we all know that we don’t live in an ideal world, and so in the independence debate – as in most policy decisions – the evidence is contradictory, incomplete and contested. And therefore a second reason why a decision cannot be fully ‘evidence-based‘ is that voters will need to assess the evidence, and a certain degree of subjectivity will inevitably come into this appraisal.

It is for the above reasons that I strongly prefer the term ‘evidence-informed’ to the term ‘evidence-based’*. Evidence-informed decision making IS possible – it involves decision makers consulting and appraising a range of evidence sources and using the information to inform their decision. As such, two policy makers may make completely different policy decisions which have both been fully informed by the evidence. Likewise, my decision to happily eat a large slice of chocolate cake instead of going to the gym can be completely evidence-informed since I get to choose which outcomes I am seeking :-).

A final point is that since evidence can inform policies designed to lead to diverse outcomes, evidence-informed policy making is not inevitably a ‘good thing’; if a policy maker has nefarious aims, she can use evidence to help her achieve these in the same way that a more altruistic policy maker can use evidence to benefit others. Thus efforts to support evidence-informed policy will only be beneficial when those making decisions are actually motivated to improve the lives of others.

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*n.b. I am a big supporter of the ‘evidence-based policy in development’ network since I suspect the name choice is mainly historical rather than a statement of policy. In fact, judging by discussions via the listserve, I would suspect that most members prefer the term evidence-informed policy.

 


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Whose experience is it anyway?

I was born and brought up in Scotland but throughout my school days I had a dirty little secret… my parents are English. I was terrified that my school friends would find out and taunt me mercilessly for this. To this day, one of the easiest ways to annoy me is to tell me that I am ‘not really Scottish’. This has nothing to do with any latent anti-English feeling. I love England and indeed have chosen to live in England for over a decade. But I find it insulting for someone else to question my identity. For a start there are some outward signs that I suggest I am Scottish (my addiction to diet irn bru, my usage of the word ‘wee’ to mean something other than urine…) but more important is the fact that I FEEL Scottish. Telling me that I am not really Scottish makes me feel that you are invalidating my experience – suggesting that my self-identity is somehow fraudulent.

Perhaps the above explains why I get so fed up with the constant sniping in international development circles about whose voice is authentic and valid. I think that those who work in international development are often afraid to express the complexity of their experiences and feelings because they fear they will be shot down as not being experienced enough to hold opinions (or worse, accused of being racist). There are some brave exceptions (see for example this remarkable account of development work in Haiti). But too often those who do express their views attract a barrage of criticism from people saying they are not experienced enough to comment.

Take this excellent series of articles by Martin Robbins commenting on the development industry propaganda-machine he encountered when visiting Kenya. Before long, comments accusing him of only having visited Kenya twice appeared. Laura Seay received a similar response to this article about journalism on Africa with one journalist accusing her of not having spent enough time living in Africa to be able to comment. Members of the African diaspora have also been accused of not being African enough to comment on Africa as described by Ida Horner here.

I think these comments are missing the point. People’s experiences are ALWAYS valid. Even if someone has visited a country only once, the experience they have there is still valid. If your experience is different, by all means, describe it. If you disagree completely with the conclusions they draw from their experiences – great! Explain why you disagree. Engage with the debate. Use it as an opportunity to move the discourse forward. But please don’t discount an opinion because the person writing is not African (or Scottish) enough to have it!