Study Design196
This dissertation presented a retrospective, sequential, mixed methods case study design that seeks to gather information on what factors influence the passage or failure of health-related legislation in Florida. The research aimed to create a roadmap for stakeholders to follow for potentially increased efficacy in the pursuit of health-related legislative and policy changes. However, prospective policy analysis inherently brings many challenges.197 The mixed methods design allowed the testing of legislative factors, compiled using the literature review and
researcher-selected factors, through an online survey and key informant interviews.
The online survey contained quantitative elements that were descriptive in nature. The structured key informant interview questions contained qualitative elements derived from previous case studies found in the literature review and from the results of the online survey. Both open-ended and closed-ended questions were included. The blended mixed methods approach identified factors and their levels of influence on the outcome (successful legislation). The study design is outlined in Figure 2.
Figure 2. Mixed Methods, Sequential Explanatory Design198
Data Collection Procedures [See Appendix C for Key Terms Defined.]
Data for this study were derived from two sources: an online survey of key stakeholders (quantitative) and 20 key informant interviews (qualitative).
Multiple information sources were examined and cross-referenced to: 1. identify bill proponents and opponents, including lobbyists and constituencies, 2. to add specific context to tested factors, 3. to better understand bill language changes that impacted bill support, 4. to observe the interactions of relevant parties, and 5. to inform additional guiding prompts for key informant interviews.These background data sources included relevant documents for each of
Quantitative Data Collection Cross-sectional, web-based survey Integration of the Quantitative and Qualitative Results Comparative interpretation and explanation of the quantitative and qualitative results, discussion, implications Qualitative Data Analysis ●Coding and thematic grouping analysis, within- case (bill) and across-case theme development, cross
thematic analysis, MAXQDA software ●Analysis by Influential Stakeholder group ●Analysis by Influential Factor group ●Review of Respondent
Role and Political Affiliation
Qualitative Data collection Key informant interviews
with 20 stakeholders, in- person, videoconference, or on phone Connecting Quantitative and Qualitative Phases ●Purposefully selecting participants
from each group (n=20) ●Derive additional interview questions based on survey
results Quantitative Data Analysis
*Data screening, analysis, frequencies, descriptive statistics
●Analysis by Influential Stakeholder group (5):
1) Legislative Branch, 2) Executive Branch, 3) Lobbyists, 4) Constituencies,
5) Other
●Analysis by Influential Factor group (6): 1) General Factors, 2) Constituencies, 3) Legislature,
4) Professional Lobbyists, 5) Highest Government
Leadership, 6) Other ●Analysis by Respondent Role
records that are accessible as public records online or through special order via the Florida Legislature and The Florida Channel.
Online Qualtrics Survey (Quantitative Focus) [See Appendix A for Online Survey and Consent Forms.]
An online, self-administered survey entitled “Why Did That Bill Pass?”199 comprised the main quantitative survey research component. The survey was distributed via email through Qualtrics. Using a Likert scale, stakeholders were asked to weigh the level of influence of
different factors on the success or failure of the specific piece of legislation. Prior to distribution, the survey was tested on three individuals who each had been involved in Florida government for at least 10 years at the time of testing.
These individuals were asked for general feedback on items such as wording, the sensibility of the survey questions, and the amount of time needed for survey completion.
The survey consisted of five sections. The first section listed 22 factors derived primarily from the literature review and then augmented by factors from my knowledge of Florida politics. The survey taker was asked to respond to each factor’s level of influence in passing a particular bill on a scale of one (1) through five (5), with “1” being “Less Influential,” and “5” being “More Influential.” “I don’t know” was also an option. The respondent was able “hover” over each factor for additional description of the factor. (See Appendix D for more information on the Qualtrics Survey Question Coding and Hover Function Descriptions.) The survey allowed respondents the ability to type up to three unlisted subjective factors and provided respondents the opportunity to type additional thoughts into an open field.
The second part asked respondents to rank the influence of 14 stakeholder groups (with the possible addition of up to three write-ins) from “1” (less influential) to “5” (more influential). The Qualtrics hover function was employed to provide the respondent with additional description
of each stakeholder group. The third part asked the respondent to generally identify their occupational position/role at the time of the bill passage by clicking on one of 12 categories, such as “Professional Lobbyist.” The Qualtrics hover function was also employed in this section and provided detailed descriptions for the occupations listed. The fourth part asked the
participant to select their political affiliation as listed on their 2014 voter registration card. The fifth part, which was optional, asked the survey taker to type into an open field any additional comments or thoughts on what they felt was influential but not previously listed.
For each of the two selected bills, all legislative members on committees of reference, all registered health-related lobbyists of record for the bills (lobbyists representing organizations with interests in the bills derived from state lobbyist registrations in combination with legislative committee records and videos), executive branch agents, and testifying stakeholders, were invited to participate if contact information was available. Contact information was derived from the legislative lobbyist directory, government webpages, and public records. This totaled 215 unique individuals.
Surveys were sent electronically with an email introduction to 187 cannabis bill
stakeholders and 188 needle exchange stakeholders, which included an overlap of 160 legislators (120 House member and 40 Senate members). Eighteen messages to cannabis stakeholders and 24 messages to needle exchange stakeholders were returned as undeliverable, for a net total of 169 cannabis stakeholders and 164 needle exchange stakeholders presumably reached. Up to five reminder emails were sent to potential respondents over a three-month period. Participants received an email directly from Qualtrics requesting participation and issuing a unique link to the survey instrument. The link brought the participant to an informed consent and confidentiality
while ensuring protection of the participant’s identity. I was not privy to the identity of survey participants. Participants were able to stop or pause the survey and resume it at a later time.
The results of the quantitative online survey were not statistically useful for
generalization because of a very low participation rate (see Chapter 4, Results, for additional