1. National Network of Libraries of Medicine South Central Region FROM PROBLEM TO PREVENTION: EVIDENCE BASED PUBLIC HEALTH SCR CONNECTions April 16, 2014 Naomi Gonzales, MLS Public Health Coordinator

2. 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

3. LET’S START WITH THE BASICS…

4. 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?

5. SO WHAT IS EVIDENCE-BASED PUBLIC HEALTH?

6. 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…

7. 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 EBPHEBM Primary FocusPopulationsIndividuals 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?

8. Adapted from: Brownson RC, Baker EA, Left TL, Gillespie KN, True WR. Evidence-Based Public Health. 2nd edition ed. Oxford University Press; 2010. Identify the need Formulate the question Search the literature Implement intervention Evaluation THE EBPH PROCESS

9. Step 1 IDENTIFYING THE NEED

10. Get input from your community! Surveys Focus groups Quantitative vs. Qualitative COMMUNITY ASSESSMENT

11. Community Toolbox - http://ctb.ku.edu/en Community Toolbox UCLA Center for Health Policy Research - http://healthpolicy.ucla.edu/Pages/home.aspx UCLA Center for Health Policy Research Community Health Improvement Resources – http://health.mo.gov/data/chir/ Community Health Improvement Resources RESOURCES FOR COMMUNITY ASSESSMENTS

12. http://nnlm.gov/evaluation/guides.html Community assessment information Outreach Evaluation Resource Center Free! RESOURCE BOOKLETS

13. FORMULATING THE QUESTION Step 2

14. 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

15. http://libguides.lhl.uab.edu/content.php?pid=317367&sid=2597223 P –Population/Problem I – Intervention C – Comparison (if any) O – Outcome PICO

16. 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

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

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

19. Step 3 Part a FINDING & SEARCHING THE LITERATURE

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

21. Includes: Clinical Effectiveness Research (CER) Systematic Reviews Clinical Guidelines https://www.ncbi.nlm.nih. gov/pubmedhealth/ PUBMED HEALTH

22. “ ” “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

23. National Association of County and City Health Officials naccho.org (programs  models) NACCHO MODEL PRACTICE DATABASE

24. 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

25. Step 4 IMPLEMENT THE INTERVENTION

26. Step 5 EVALUATION

27. Yes! Accountability to stakeholders Measure effectiveness of current program/intervention Allow for development of future programs/interventions IS IT NECESSARY?

28. Adapted from: Brownson RC, Baker EA, Left TL, Gillespie KN, True WR. Evidence-Based Public Health. 2nd edition ed. Oxford University Press; 2010. Formative Assess whether element of program is appropriate Conducted prior to program initiation Process Assess program during delivery Quality control: what is being delivered vs. what is intended Impact Assess program objectives being met May be completed after program or after program has been established for some time TYPES OF EVALUATION

29. GETTING HELP!

30. 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/frame work/index.htm Community toolbox  Learn a skill  Evaluation (chapters 36-39) Evaluating the Initiative Toolkit http://ctb.ku.edu/en EVALUATION RESOURCES

31. Questions? Comments? Evaluation! WRAP UP

32. Naomi Gonzales Public Health Coordinator National Network of Libraries of Medicine South Central Region naomi.gonzales@exch.library.tmc.edu 800-338-7657 THANK YOU!

33.  1 Hour MLA CE  Complete Survey by COB May 14, 2014  https://www.surveymonkey.com/s/SCREBPH https://www.surveymonkey.com/s/SCREBPH  Due to travel conflict with MLA there will be no SCRCONNECTions Webinar in May MLA CE