1. Defining Evidence

2. 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

3. What do you think of when you hear “evidence-based”? Question

4. 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.

5. 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

6. 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

7. 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

8. Social Ecological Model

9. Different Evidence-based Options for Promoting Public Health Environment or Behavior Strategies (recommended after systematic review) Policies Packaged Programs Evidence-based Approaches

10. Packaged Programs Interventions that include instructions and specify materials needed to implement with success Pool Cool available on RTIPS and at www.poolcool.orgwww.poolcool.org Body and Soul available on RTIPs Pathways to Freedom available on RTIPs and the CDC’s website

11. 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

12. 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)

13. Public Policy North Carolina enacted legislation that prohibits the purchase of tobacco products by persons under the age of 18

14. Organizational Policy Food ItemRecommendationRationale Examples of what would be IN and OUT Beverages Contain 100% fruit juice with no added sweetener Fruits/vegetables contain necessary nutrients IN: Vegetable and fruit juice Snacks, sweets, and sides Sugar: No more than 35% by weight Eliminate foods that Are high in calories Are low in nutrients Promote dental caries IN: Some granola bars, trail mix, animal crackers, fat-free fudge bar, frozen fruit bar OUT: Some granola bars, some cookies, all candy A school or workplace implements Recommendations for Cafeteria, Vending, and Break Room Food Standards in Utah Workplaces

15. Organizational P0licies for Promoting Mammography Client reminders –Annual workplace communication campaign –Require insurers to send reminders to enrolled workers Reduce structural barriers –Time off for mammography –Bring mobile van to the worksite Reduce out of pocket costs –Paid time off for mammography –Reduce or eliminate cost of on-site screening –Promote BCCCP/Komen to under and uninsured workers

16. Evidence-based Strategies Broad recommendation based on systematic review of multiple studies

17. The Community Guide: A Source of Evidence-based Strategies Aim: Increase physical activity Environmental strategy: Point-of-decision prompts Program Material: Aim: Increase CRC screening Individual strategy: Small media Program Material:

18. Discussion What are some challenges you have encountered in using evidence? How have you addressed those challenges?

19. 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

20. Take Home Points There are different types of evidence- based 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

21. Questions?