May, 2008

1. May, 2008 Can I Use This Evidence in my Program Decision? Assessment of Applicability and Transferability D. Ciliska, RN, PhD & Helen Thomas, RN, MSc Scientific Co-Directors C. Buffett Funded by the Public Health Agency of Canada Affiliated with McMaster University

2. May, 2008 Funded by the Public Health Agency of Canada Affiliated with McMaster University

3. One of six centres funded by the Public Health Agency of Canada Different topics Different institutions Collective projects 3

4. National Collaborating Centres for Public Health • Mission: to translate existing and new evidence produced by academics and researchers in public health. • Build on existing strengths, foster linkages across various sectors of public health community to enhance efficiency and effectiveness of public health system. • Work as a network which supports knowledge demands around public health goals and priorities

5. Methods and tools for what?

6. Methods and Tools for what? K nowledge S ynthesis T ranslation and E xchange (KSTE)

7. Evidence Transfer Gap Evidence from research Health-care decisions

8. Evidence of Gap in Acute and Primary Care • Consistent evidence of failure to translate research findings into clinical practice • 30-40% patients do not get treatments of proven effectiveness • 20-25% patients get care that is not needed or potentially harmful Schuster, McGlynn, Brook (1998). Milbank Memorial Quarterly Grol R (2001). Med Care

9. Is it any different in public health?

10. Steps of Evidence-Informed Decision-Making 1. Formulate an answerable question 2. Conduct an efficient literature search 3. Critically appraise the evidence 4. Apply the results in health care decisions 5. Evaluate the outcome

11. 4. Apply Decision to Health-Care Issue Applicability and Transferability Tool -to assist managers and planners in decision-making about program priorities for your community

12. Method • Extensive literature search • Pilot tested with relevant group • Sent out for review by managers

13. Criteria  Applicability is it feasible in the local setting? • Political acceptability, barriers or leverage • Social acceptability • Available resources • Organizational expertise and capacity

14. Criteria Transferability can the intervention achieve the same outcomes in the local setting? • Magnitude of the health issue locally • Magnitude of potential reach • Potential cost-effectiveness • Target population characteristics • Overall community capacity to accept and implement

15. Process • Involve relevant stakeholders 2. Give orientation to the process; establish time lines. 3. Choose which of the applicability and transferability criteria are most important for the particular intervention of interest and the local context, if these should be weighted, and what weights to assign.

16. Process 4. Determine if/how final scoring will be done: addition of individual ratings; or discussion and consensus on each criteria. eg: individually rate each criterion on a 1-5 point scale (1 is low impact/relevance or match and 5 indicates high level impact/relevance or match). Priority then goes to the highest scoring program. 5. Document whatever process was used in d).

17. Evaluation • In process • Interviews with users • Will also include unsolicited feedback

18. Questions? National Collaborating Centre for Methods and Tools 1685 Main Street West, Suite 302 Hamilton ON  L8S 1G5 Phone: 905-525-9140, ext. 20455 Fax: 905-529-4184 Email:ciliska@mcmaster.ca Web: www.ccnmo.ca/www.nccmt.ca