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Developing Policy When Evidence Is Lacking ONLINE FIRST

David Rubin, MD, MSCE1,2
[+] Author Affiliations
1PolicyLab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Pediatr. Published online August 08, 2016. doi:10.1001/jamapediatrics.2016.1945
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This Viewpoint discusses how the Commission to Eliminate Child Abuse and Neglect Fatalities developed policy recommendations in the absence of trial data, relying strongly on aggregate testimony from communities.

Bridging research to policy can be a noble but daunting task. We all hope that the body of research we develop, if disseminated well, will inform policies for children. We often confront barriers to this, such as incongruence of research and policy time frames, misalignment of stakeholders, and disagreement on goals of objectives, but what does one do when the gravity of an issue requires an urgent policy response but the quality of evidence is lacking? Such was my experience as a White House appointee on the Commission to Eliminate Child Abuse and Neglect Fatalities. The commission, created through the Protect Our Kids Act of 2012, was charged to develop a national strategy for reducing child abuse fatalities. After visiting state officials, community leaders, and families across the country over 2 years, the commission concluded that an innovative cross-sector public health approach was needed. However, arriving at that conclusion was not simple.1

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