Fostering More-Effective Public Health by Identifying Administrative Evidence-Based Practices A Review of the Literature

Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri 63110, USA.
American journal of preventive medicine (Impact Factor: 4.53). 09/2012; 43(3):309-19. DOI: 10.1016/j.amepre.2012.06.006
Source: PubMed


The aim of evidence-based decision-making in public health involves the integration of science-based interventions with community preferences to improve population health. Although considerable literature is available on the development and adoption of evidence-based guidelines and barriers to their implementation, the evidence base specific to public health administration is less developed. This article reviews the literature from public health and related disciplines to identify administrative evidence-based practices (A-EBPs; i.e., agency-level structures and activities that are positively associated with performance measures).
A "review of reviews" was carried out to assess the evidence for the effectiveness of A-EBPs covering the time frame January 2000 through March 2012. The following steps were used: (1) select databases; (2) determine search parameters and conduct the search; (3) screen titles and abstracts; (4) obtain selected documents; (5) perform initial synthesis; (6) abstract data; and (7) synthesize evidence.
In both the reviews and original empiric studies, the most common outcome reported was performance of the local health department or local public health system. On the basis of a synthesis of data from 20 reviews, a total of 11 high-priority A-EBPs were identified (i.e., practices that local public health systems potentially can modify within a few years). The A-EBPs covered five major domains of workforce development, leadership, organizational climate and culture, relationships and partnerships, and financial processes.
As the body of practice-based research continues to grow and the ability to measure administrative evidence-based practices improves, this initial list can be further developed and improved.

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Available from: Kathleen Duggan, Dec 29, 2014
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    • "However, few studies remain at a national level and the largest competency gaps between EBDM and practice were found in economic evaluation, communicating research to policymakers, evaluation designs, and adapting interventions (Jacob et al., 2014). The scientific evidence for effective populationlevel interventions has grown rapidly over the past few decades, as summarized in systematic reviews such as the Cochrane Collaboration and the Community Guide (Brownson et al., 2012). Several tools have been developed to meet EBPH needs, including free online resources in health surveillance, policy tracking and surveillance. "
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    ABSTRACT: Background: Public health policies aim to prevent suicide in the general population. Assessing their effectiveness is required to further guide public health policies. The present article focuses on the French paradox. The French health care system was classified as the best in the world according the World Health Organization (WHO). However, suicide rates in France remain high compared to other European countries. The aim of the present article was to analyze (i) the evolution of suicide Age-Standardized Death (ASDRs) in France during the last three decades and the associations with socio-economic parameters and (ii) to understand which populations may specifically benefit from further targeted suicide prevention policies. Methods: The database of the World Health Organization (WHO), freely available, was explored in April 2015. ASDRs were calculated each year by ratio between the number of deaths by suicide and the total population (per 100,000 inhabitants). Number of deaths by gender and age were also analyzed. Results: Overall, ASDR suicide has decreased since 1987 in France (-32.8% between 1987 and 2010). However, France kept the same rank (10/26) when compared to other European countries between 1987 and 2010. The relative burden of suicide in all-causes mortality increased during the same period (+28.2%) while the total number of deaths by suicide increased only slightly (+3.9%). More specifically, the number of deaths by suicide increased substantially in [35-54] years old (+40%) and 75+ years old (+27%) males, and in [35-54] (+41%) years old females. Between 2000 and 2010, suicide rates significantly decreased when yearly mean income increased, and when general and psychiatric care beds decreased. Conclusion: Although ASDR suicide has decreased in France since 1987, this decline is quite modest when considering its universal access to care, the prevention of depression and suicide public policies. Suicide prevention public policies should focus on evaluation and improvement of prevention and care in the [35-54] years old population, and in the males aged 75+.
    Journal of Affective Disorders 12/2015; 188:232-238. DOI:10.1016/j.jad.2015.08.048 · 3.38 Impact Factor
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    • "Based on literature in the emerging field of dissemination and implementation research [8,9], the scale-up of effective workforce capacity-building approaches is a key need for research and practice [10]. The public health workforce is transdisciplinary by nature and represents diverse educational backgrounds and job types [11-14]. "
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    ABSTRACT: Background There are few studies describing how to scale up effective capacity-building approaches for public health practitioners. This study tested local-level evidence-based decision making (EBDM) capacity-building efforts in four U.S. states (Michigan, North Carolina, Ohio, and Washington) with a quasi-experimental design.Methods Partners within the four states delivered a previously established Evidence-Based Public Health (EBPH) training curriculum to local health department (LHD) staff. They worked with the research team to modify the curriculum with local data and examples while remaining attentive to course fidelity. Pre- and post-assessments of course participants (n¿=¿82) and an external control group (n¿=¿214) measured importance, availability (i.e., how available a skill is when needed, either within the skillset of the respondent or among others in the agency), and gaps in ten EBDM competencies. Simple and multiple linear regression models assessed the differences between pre- and post-assessment scores. Course participants also assessed the impact of the course on their work.ResultsCourse participants reported greater increases in the availability, and decreases in the gaps, in EBDM competencies at post-test, relative to the control group. In adjusted models, significant differences (p¿<¿0.05) were found in `action planning,¿ `evaluation design,¿ `communicating research to policymakers,¿ `quantifying issues (using descriptive epidemiology),¿ and `economic evaluation.¿ Nearly 45% of participants indicated that EBDM increased within their agency since the training. Course benefits included becoming better leaders and making scientifically informed decisions.Conclusions This study demonstrates the potential for improving EBDM capacity among LHD practitioners using a train-the-trainer approach involving diverse partners. This approach allowed for local tailoring of strategies and extended the reach of the EBPH course.
    Implementation Science 09/2014; 9(1):124. DOI:10.1186/s13012-014-0124-x · 4.12 Impact Factor
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    • "Furthermore, communication networks between LHDs across the nation are sparse (27). However, a focus on workforce training is linked to quality improvement and accreditation, creating opportunities to strengthen dissemination and implementation of innovative practice (28). As an example, the Public Health Accreditation Board requires agencies to conduct CHAs and CHIPs as a prerequisite to application (29). "
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    ABSTRACT: The extent of obesity prevention activities conducted by local health departments (LHDs) varies widely. The purpose of this qualitative study was to characterize how state obesity prevention program directors perceived the role of LHDs in obesity prevention and factors that impact LHDs' success in obesity prevention. From June 2011 through August 2011, we conducted 28 semistructured interviews with directors of federally funded obesity prevention programs at 22 state and regional health departments. Interviews were transcribed verbatim, coded, and analyzed to identify recurring themes and key quotations. Main themes focused on the roles of LHDs in local policy and environmental change and on the barriers and facilitators to LHD success. The role LHDs play in obesity prevention varied across states but generally reflected governance structure (decentralized vs centralized). Barriers to local prevention efforts included competing priorities, lack of local capacity, siloed public health structures, and a lack of local engagement in policy and environmental change. Structures and processes that facilitated prevention were having state support (eg, resources, technical assistance), dedicated staff, strong communication networks, and a robust community health assessment and planning process. These findings provide insight into successful strategies state and local practitioners are using to implement innovative (and evidence-informed) community-based interventions. The change in the nature of obesity prevention requires a rethinking of the state-local relationship, especially in centralized states.
    Preventing chronic disease 03/2014; 11:E39. DOI:10.5888/pcd11.130260 · 2.12 Impact Factor
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