hltb16 lecture 6.pdf

Evidence-Based Interventions HLTB16: Introduction to Public Health Health & Society, UTSC Summer 2024 © Tola Mbulaheni  Agenda 01 Evidence-Based Public Health 02 EBPH...

Evidence-Based Interventions HLTB16: Introduction to Public Health Health & Society, UTSC Summer 2024 © Tola Mbulaheni  Agenda 01 Evidence-Based Public Health 02 EBPH Planning Framework 03 Measures of Occurrence 04 Evidence Databases Canadian HIV/AID Surveillance System © Tola Mbulaheni  Evidence-Based Public Health © Tola Mbulaheni  Evidence-Based Public Health (EBPH) “a process of integrating evidence from scientific research and practice to improve the health of the target population.” Vanagas et al., 2017 © Tola Mbulaheni  Evidence-Informed Decision-Making Making decisions based on the best available peer-reviewed evidence (quantitative and qualitative) Using data information systems systematically Applying program planning frameworks Engaging the community in assessment and decision-making Conducting sound evaluation Disseminating what is learned to key stakeholders and decision makers Brownson et al., 2010 © Tola Mbulaheni  Evidence-Informed Decision-Making Domains that influence evidence-based decision-making Best available Environmental and research evidence organizational context Decision-making Population Resources, characteristics, including needs, values, practitioner and expertise preferences Satterfield et al, 2010 © Tola Mbulaheni  Forms of Evidence Objective Scientific literature in systematic reviews Overemphasis on Scientific literature in one or more journal articles internal validity Public health surveillance data Program evaluations Qualitative data (community members, other stakeholders) Media/marketing data Word of mouth Subjectiv Brownson et al., 2010 © Tola Mbulaheni e  Evidence-Based Public Health (EBPH) “Where did the field get the idea that evidence of an intervention’s efficacy from carefully controlled trials could be generalized as THE best practice for widely varied populations and settings?” Green, 2001,p.167 © Tola Mbulaheni  Evidence Typology evaluative - ext Type 1 Type 2 Type 3 challenges Relationship: strong Relationship: relative Relationship: information on relationship between risk and effectiveness of public health adaptation and translation of disease intervention an effective intervention Setting: clinical/controlled Setting: socially intact Setting: socially intact community groups/community-wide groups/community-wide E.g.: smoking causes lung E.g.: price increases with E.g.: understanding political cancer targeted media campaign challenges of price increases reduce smoking rates or targeting media messages Quantity: more to particular audience Action: something should be Quantity: less segments done Action: this particular intervention should be Quantity: less implemented Action: how an intervention should be implemented Brownson et al., 2010 © Tola Mbulaheni  Analytical Tools some type of data collection and analyses Public health surveillance Systematic Reviews and evidence-based guidelines Economic evaluation Health impact assessment Participatory approaches Brownson et al., 2010 © Tola Mbulaheni  EBPH Planning Framework © Tola Mbulaheni  Approach for evidence-based public health there is overlap, not a chronological order can go back in 'steps' too 1. Community 2. Quantifying the assessment issue 7. Evaluating the 3. Developing a concise program or policy statement of the issue 6. Developing an action plan and 4. Determining what is known implementing interventions through scientific literature 5. Developing and prioritizing program and Adapted from Brownson et al., 2009 © Tola Mbulaheni policy options  'community' is a very loose term Community Assessment foundational step Also known as needs assessment finding out what the needs are for a community Systematic set of procedures undertaken for the purpose of setting priorities and making decisions about program or organizational improvement and allocation of resources Ensure right interventions implemented building or strengthening partnerships Build resource support Baseline measure Strong role of community stakeholders © Tola Mbulaheni  Community Assessment Assessment at all levels of ecological framework Individual targeted population Interpersonal Organizational public transportation system Community larger body of ppl that dont fall into targeted population Government and policy © Tola Mbulaheni  Quantifying data once the needs are established... Descriptive epidemiology Frequency of health condition/risk of affected population Epidemiology skills, tools and techniques © Tola Mbulaheni  Issue Statement Negative Positive Clear and concise articulation of the issue Threats Opportunities SWOT/PEST analyses not too broad issue, b/c oneExternal intervention cannot respond to all the Key components: categories 1. Health conditions/risk factors 2. Population(s) affected Internal Weaknesses Strengths 3. Size and scope of problem 4. Prevention opportunities 5. Potential stakeholders Components of a SWOT/TOWS analysis Stakeholder input Brownson et al., 2009 © Tola Mbulaheni  What is known via Scientific Literature Knowledge on efforts to address issue Relevant information related to issue (scientific studies, reports, conferences) Common approach: formal literature review Original research articles primary research Review articles: narrative summary Review articles quantitative synthesis Guidelines © Tola Mbulaheni  EBPH Databases The Cochrane Collaboration National Collaborating Centre for Methods and Tools The Community Guide PHAC Canadian Best Health Evidence Practices Portal © Tola Mbulaheni  Search: Health Evidence Search: Interventions for individuals in long-term care facilities living with dementia What challenge(s) did I encounter? What could be contributing to it/them? What can I do to minimize/mitigate it/them? © Tola Mbulaheni  Program and Policy Intervention Options Priority-setting processes Key elements Acquire sufficient evidence on all alternatives Approach problem in rational and systematic manner Rely on experience, intuition and judgement Development and use of diverse analytic frameworks and methods © Tola Mbulaheni  Action Planning and Implementing Interventions Strategic planning processes Key elements Clear goals and objectives Clear and respected roles and responsibilities Clear mechanisms of accountability Comprehensive plans Clear mechanisms for evaluation Evidence-based Intervention adaptation Assessment of resource needs © Tola Mbulaheni  Action Planning and Implementing Interventions Ecological frameworks Common principles 1. Data should guide program/policy intervention development 2. Community members’ participation in process. 3. Addresses more than one level of ecological framework 4. Increase community capacity for health promotion 5. Evaluation should emphasize feedback and program improvement © Tola Mbulaheni  Evaluating Program or Policy Intervention Determines the extent to which program/policy goals and objectives were met Types of program evaluations formative process Impact outcome © Tola Mbulaheni  Limitations, Challenges & Trends © Tola Mbulaheni  Challenges/Limitations Lack of resources Lack of strong leadership Lack of incentive Lack of long-term perspective External pressures Inadequate training Lack of time Lack of evidence Lack of information on implementation © Tola Mbulaheni  Tracking progress Set priorities and measure progress Improve surveillance of policy- Partnerships and Growing evidence base related variables engagement Expanding the evidence base on Address tensions between intervention effectiveness participatory decision-making Building evidence on external validity Emerging Issues and EBPH Enhance transdisciplinary work Consider evidence typologies in EBPH across sectors and systems Special populations and sectors Capacity and leadership Understand better use of EB Engage leadership approaches to address disparities Expand training opportunities Make evidence more accessible Enhance accountability for public for policy audiences expenditures Learn from global efforts © Tola Mbulaheni  Next class The Local-Global (Week 8) Reminders: Reading week (June 18-22)! Office hours: today, 11:30am (sign up!) Quiz #2: June 13, 2:00pm - 11:59pm No Tutorial ExamSoft © Tola Mbulaheni