National Network of Libraries of MedicineSouth Central Region

FROM PROBLEM TO PREVENTION:

EVIDENCE BASED PUBLIC HEALTH

SCR CONNECTionsApril 16, 2014Naomi Gonzales, MLSPublic Health Coordinator

•Define and describe evidence-based public health • Identify a need and formulate a question•Locate and search applicable literature and resources•Understand importance of evaluation/follow-up

OBJECTIVES

LET’S START WITH THE BASICS…

The 20th Century's Ten Great Public Health Achievements in the United States via What is Public Health and the Centers for Disease Control and Prevention :http://www.whatispublichealth.org/impact/achievements.html

WHAT EXACTLY IS PUBLIC HEALTH?

SO WHAT IS EVIDENCE-BASED PUBLIC HEALTH?

Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):517-421.

“Evidence-based public health is the process of integrating science-based interventions with community preferences to improve the health of populations.”

ONE BASIC DEFINITION…

Adapted from: Fineberg, Harvey, MD, PhD, Dean, Harvard University School of Public Health, 1990. Traditional Distinctions Between Public Health and Medicine. Table 5-1, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Institute of Medicine, 2003. / Phpartners.org

EBPH EBM

Primary Focus Populations Individuals

Emphasis • Prevention• Health Promotion• Whole

Community

• Diagnosis• Treatment• Whole Patient

Paradigm Interventions aimed at Environment, Human Behavior and Lifestyle, and Medical Care

Medical Care

Organizational Lines of Specialization

• Analytical (Epidemiology)

• Setting and Population (Occupational Health)

• Organ (Cardiology)

• Patient Groups (Pediatrics)

EBPH OR EVIDENCE-BASED MEDICINE?

Adapted from: Brownson RC, Baker EA, Left TL, Gillespie KN, True WR. Evidence-Based Public Health. 2nd edition ed. Oxford University Press; 2010. 

THE EBPH PROCESS

Step 1

IDENTIFYING THE NEED

• Get input from your community!• Surveys• Focus groups• Quantitative

vs. Qualitative

COMMUNITY ASSESSMENT

• Community Toolbox - http://ctb.ku.edu/en

• UCLA Center for Health Policy Research - http://healthpolicy.ucla.edu/Pages/home.aspx

• Community Health Improvement Resources – http://health.mo.gov/data/chir/

RESOURCES FOR COMMUNITY ASSESSMENTS

http://nnlm.gov/evaluation/guides.html

• Community assessment information

• Outreach Evaluation Resource Center

• Free!

RESOURCE BOOKLETS

FORMULATING THE QUESTION

Step 2

• An assisted living facility has seen a rise in STDs among residents. You would like to create a sex education program specifically for older adults but need to come up with evidence that putting effort into the program will reduce STD rates.

SCENARIO

http://libguides.lhl.uab.edu/content.php?pid=317367&sid=2597223

• P –Population/Problem• I – Intervention • C – Comparison (if any)• O – Outcome

PICO

• P –Population / Problem

• I – Intervention • C – Comparison (if

any)• O – Outcome

• An assisted living facility has seen a rise in STDs among residents. You would like to create a sex education program specifically for older adults but need to come up with evidence that putting effort into the program will reduce STD rates.

APPLYING PICO

• P – Assisted living home residents• I – A sex education program• C – No sex education program• O – Lower STD rate

RESULTS

Will a sex education program for older adults reduce the rate of STDs within the assisted living community?

THE QUESTION

Step 3Part a

FINDING & SEARCHING THE

LITERATURE

• Basic + advance search• Filters• Accessing articles• Structured Evidence Queries (SEQs) • pubmed.gov

PUBMED

Includes:• Clinical Effectiveness

Research (CER)• Systematic Reviews• Clinical Guidelines• https://

www.ncbi.nlm.nih.gov/pubmedhealth/

PUBMED HEALTH

• ““The Community Guide is a website that houses the official collection of all Community Preventive Services Task Force (Task Force) findings and the systematic reviews on which they are based.””

• http://www.thecommunityguide.org

COMMUNITY GUIDE

• National Association of County and City Health Officials• naccho.org (programsmodels)

NACCHO MODEL PRACTICE DATABASE

• Joint effort between U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality (AHRQ)

• http://www.guideline.gov/

NATIONAL GUIDELINE CLEARINGHOUSE

Step 4

IMPLEMENT THE INTERVENTION

Step 5EVALUATION

• Yes! • Accountability to stakeholders• Measure effectiveness of current

program/intervention• Allow for development of future

programs/interventions

IS IT NECESSARY?

Adapted from: Brownson RC, Baker EA, Left TL, Gillespie KN, True WR. Evidence-Based Public Health. 2nd edition ed. Oxford University Press; 2010. 

TYPES OF EVALUATION

GETTING HELP!

CDC Program Performance and Evaluation Office

Community Toolbox

• Steps• Standards• Self-Study Guide• Links to additional

resources include step-by-step guides, manuals, websites, and journals

http://www.cdc.gov/eval/framework/index.htm

• Community toolbox Learn a skill Evaluation (chapters 36-39)

• Evaluating the Initiative Toolkit

http://ctb.ku.edu/en

EVALUATION RESOURCES

Questions? Comments? Evaluation!

WRAP UP

Naomi GonzalesPublic Health Coordinator National Network of Libraries of MedicineSouth Central Region naomi.gonzales@exch.library.tmc.edu800-338-7657

THANK YOU!

1 Hour MLA CEComplete Survey by COB May 14, 2014

https://www.surveymonkey.com/s/SCREBPH

Due to travel conflict with MLA there will be no SCRCONNECTions Webinar in May

MLA CE