Variations in Definitions of Evidence-Based Interventions for Behavioral Health in Eight Selected U.S. States

Area of Science:

• Public Health Policy
• Health Services Research

Background:

• State legislatures play a key role in promoting evidence-based interventions (EBIs) through laws and regulations.
• Understanding how states define EBIs in their mandates is crucial for effective implementation.

Purpose of the Study:

• To analyze the terminology used by selected U.S. states to describe EBIs within their statutes and regulations.
• To examine how these terms are defined and elaborated upon in state mandates.

Main Methods:

• A qualitative analysis of legislative mandates from eight purposefully selected states.
• Coding of state mandates using the Westlaw Legal Research Database to identify EBI-related terms and definitions.

Main Results:

• Significant variation exists in terms used for EBIs; "evidence-based" was most common (60%), but 29 other terms were used.
• Most terms lacked clear definitions; when defined, external sources were frequently cited.
• Three distinct approaches to defining EBIs were identified: "single definition," "hierarchies of evidence levels," and "best available evidence."

Conclusions:

• Inconsistent terminology and lack of clear definitions in state mandates may hinder behavioral health agencies' understanding and implementation of EBIs.
• Ambiguity in state guidance can impede the adoption of effective interventions, especially for agencies with limited technical expertise.