Attitudes of health economists to policy engagement activities: a Q methodology study

Health economists are key actors in analysing and advising on healthcare policy decisions. Policy engagement is increasingly emphasised in health research, yet little is known about how health economists perceive their role in this process. This study explored the attitudes of health economists in the UK and the Netherlands to policy engagement activities and identified the factors shaping their approaches.

Q methodology was used to capture and compare attitudes on policy engagement strategies. As part of this, a set of 28 statements mapped from nine categories of policy engagement activities was developed. Thirty-one health economists, from the UK and the Netherlands, ranked the statements onto a quasi-normal shaped grid and provided qualitative comments. Factor analysis was used to identify patterns in the ranking data, which - together with the qualitative data - were interpreted as attitudes to policy engagement activities.

Four distinct attitudes were revealed: investing in relationships; intrinsic motivation; incentive driven; and effective communication. These attitudes captured differing perspectives about how to approach engagement and what drives impact, including trust-based collaboration, personal ethics, institutional incentives and strategic communication tailored to policy needs.

The attitudes to policy engagement differs among health economists. Therefore, flexible strategies acknowledging that their motivations, perceived barriers and facilitators, and institutional and policy contexts differ, are likely to facilitate and stimulate more effective translation of health economics research into policy.