Transcript Session 1: Defining Evidence

Defining Evidence
Session Objectives
• Define evidence-based public health
practice
• Discuss two important targets of
evidence-based intervention
- behavior of individuals and groups
- environment
• Discuss benefits and challenges
associated with using evidence
Question
What do you think of
when you hear
“evidence-based”?
What is evidence?
“the available body of facts or
information indicating whether a
belief is true or valid”
Brownson R.C., Baker, E.A., Leet T.L., Gillespie, K.N. (2003).
Evidence-Based Public Health. New York: Oxford University Press.
What is evidence in public health?
• Personal experience
• Word of mouth
• Program evaluation
• An intervention research study
• Systematic reviews of multiple intervention
studies
• Surveillance data
Research and Practice Create Evidence
• Evidence derived from research:
– Intervention that has been tested in a research
study
– Systematic review of multiple studies
– Policy analysis
• Evidence derived from practice:
– Intervention or policy developed, implemented
and evaluated in an organization, community or
geographic region
Social Ecological Model
• Health is affected by a variety of factors including:
– individual characteristics
– attitudes and behaviors of peers
– physical surroundings / environment
– policies in community
• Public health approaches should include activities that produce
change at multiple levels of the model
– individuals
– environments
– policies
Social Ecological Model
Different Evidence-based Options for
Promoting Public Health
Evidence-based Approaches
Packaged
Programs
Strategies
Policies
(recommended after
systematic review)
Environment or Behavior
Packaged Programs
Interventions that include instructions and specify
materials needed to implement with success
Pool Cool
available on RTIPS
and at www.poolcool.org
Body and Soul
available on RTIPs
Pathways to Freedom
available on RTIPs and
the CDC’s website
Pool Cool Sun-Safety Program
• Aim: Raise awareness, motivation and sun protection practices to
reduce skin cancer
• Setting: swimming pools
• Target audience: children enrolled in swimming lessons
• Program components:
• Eight 5-minute lessons during swim class
• Five optional sun-safe Poolside Activities
• Sun safety signs
• Program materials:
• Developed in efficacy and diffusion trials and process evaluations
• Available for free, online
Policies
• A system of laws, regulatory measures,
courses of action, and funding priorities
concerning a given topic
– Public policy: regulation set by government or
local authorities (e.g., laws for coverage,
ordinances)
– Organizational policy: organizational rule or
regulation (e.g., worksite health plans, patient
navigation services)
Public Policy
• North Carolina enacted
legislation that prohibits the
purchase of tobacco products
by persons under the age of 18
Organizational Policy
A school or workplace implements Recommendations
for Cafeteria, Vending, and Break Room Food
Standards in Utah Workplaces
Food Item
Recommendation
Rationale
Beverages
Contain 100% fruit Fruits/vegetables contain
juice with no
necessary nutrients
added sweetener
IN: Vegetable and fruit
juice
Snacks,
sweets,
and sides
Sugar: No more
than 35% by
weight
IN: Some granola bars,
trail mix, animal crackers,
fat-free fudge bar, frozen
fruit bar
OUT: Some granola bars,
some cookies, all candy
Eliminate foods that
•Are high in calories
•Are low in nutrients
•Promote dental caries
Examples of what would be
IN and OUT
Evidence-based Strategies
• Broad recommendation based on systematic
review of multiple studies
The Community Guide: A Source of
Evidence-based Strategies
Aim: Increase physical
activity
Aim: Increase CRC
screening
Environmental strategy:
Point-of-decision prompts
Individual strategy: Small
media
Program Material:
Program Material:
Discussion
• What are some
challenges you have
encountered in using
evidence?
• How have you
addressed those
challenges?
Take Home Points: Advantages
of Evidence-based Options
• Adds value to a grant application
• Saves time and resources during
planning and implementation
• Helps focus your evaluation
• Increases your likelihood of success
Take Home Points
• There are different types of evidencebased approaches (i.e., packaged
programs, policies, strategies)
• Evidence-based approaches can:
• Increases your likelihood of success
• Saves time and resources instead of
new program development
Questions?