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

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 : 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): “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, 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, / 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?

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

Step 1 IDENTIFYING THE NEED

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

Community Toolbox - Community Toolbox UCLA Center for Health Policy Research - UCLA Center for Health Policy Research Community Health Improvement Resources – Community Health Improvement Resources RESOURCES FOR COMMUNITY ASSESSMENTS

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

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 3 Part 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 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.” COMMUNITY GUIDE

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

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

Step 4 IMPLEMENT THE INTERVENTION

Step 5 EVALUATION

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; 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

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 work/index.htm Community toolbox  Learn a skill  Evaluation (chapters 36-39) Evaluating the Initiative Toolkit EVALUATION RESOURCES

Questions? Comments? Evaluation! WRAP UP

Naomi Gonzales Public Health Coordinator National Network of Libraries of Medicine South Central Region THANK YOU!

 1 Hour MLA CE  Complete Survey by COB May 14, 2014   Due to travel conflict with MLA there will be no SCRCONNECTions Webinar in May MLA CE