Transcript International Dissemination of Evidence Based Practice

International Dissemination of
Evidence Based Practice
Fernando Salazar, Ph.D.
Universidad Peruana Cayetano Heredia
San Francisco
30 May, 2013
• What is happening and what is needed
to support the development of effective
practice in South/Central America and
for it to become and agendas item for
policy makers and practitioners
Focus attention on the need:
• Better understanding of wide range of determinants of the use and
abuse of drugs including biological factors and environmental, as
well as social and behavioral determinants on health and well-being;
• Promoting research about social and physical environments, in all
the social gradient, with emphasis on underserved and vulnerable
communities;
• Focus on research strategies that can better serve to reduce
existing inequalities of access to prevention and treatment of the
use and abuse of drugs, including inequalities within and between
the countries;
Based on: IADR Global Health Inequalities Research Agenda (IADR-GOHIRA®): A Call to Action. J Dent Res 92(3):209-211, 2013
Some research challenges as:
• Gaps in knowledge of prevention and treatment of the use and
abuse of drugs and, in particular, the insufficient focus on social
policy.
• The separation of drug use and abuse from general health; and
• Inadequate evidence-based data (including research-driven
programs, capacity-building strategies, standardized systems for
measuring and monitoring, etc.).
To address these challenges:
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Identify critical gaps in knowledge about the use and abuse of drugs.
Develop and implement, in partnership with peer evidence-based
organizations, a knowledge base that uses a standard set of reporting
criteria and includes a registry of implementation trials.
Give emphasis to the importance of social and psychological determinants
of the use and abuse of drugs, behavior related to their use, abuse and
search for services, in the general population and at-risk and vulnerable
populations.
Emphasis on the importance of the integrating research on inequities in
the prevention and attention of the use and abuse of drugs. Approach
should be broad to impact in reduction of health inequalities as a whole.
To address these challenges:
• Emphasize the importance of multi-disciplinary and translational
research, seeking input from a range of social scientists and health
professionals.
• Develop strategies prevention of the use and abuse of drugs based
on their social determinants and environmental, as well as
combining population wide strategies (upstream) with strategies at
local level and individual (downstream).
• Advocate for the inclusion of policies of prevention
and treatment of the use and abuse of drugs in
policies of elsewhere, in line with the Adelaide
Declaration on health in all policies (WHO,2010).
A PRACTICAL APPROACH
The CICAD model:
• Use of quality standards as guidance for
prevention programs.
• Competence based certification of
practitioners.
• Prevention programs accreditation.
Based on: Salazar F, Luna M. Minimum quality standards for drug abuse prevention programs.
OEA/CICAD, Washington DC, 2012
A quality prevention program:
• Core principles: ethics and scientific approach.
• A general process: continuous quality improvement
(CQI).
• Sequential steps: needs and resources assessment,
strategic planning and delivery, process and outcome
evaluation and dissemination.
The quality indicators:
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Informed consent.
Proof of efficacy.
PDCA plan.
Baseline information and explicit prioritization of
problems susceptible of prevention.
• Intervention strategic plan.
• Outcome evaluation and dissemination plan.
Competence based certification:
• Development of a curriculum based
training program to strengthen and certify
the needed prevention competences of the
field workers.
Prevention programs accreditation.
• Fulfillment of the MQS
• Certification of prevention programs staff.
Thanks