Developing & searching a population health question

1. Mercer University School of Medicine Libraries Developing & searching a population health question

2. Identify a health concern Example: you are working in the East Georgia Healthcare Center in Swainsboro and notice that a lot of your patients have diabetes. Formulating a Population Health Query

3. Why are there so many people in Emanuel County with diabetes? What Causes Disease?

4. How you conceptualize your topic affects how you search for relevant information. What Causes Disease? Consider the interaction and interdependenceof various factors

5. What causes disease? • Think about the wider context of your topic. • Do some preliminary exploration.

6. Don’t forget: You can copy-paste this slide into other presentations, and move or resize the poll.

7. What percentage of the United States population is diagnosed with diabetes? You will need to look for statistics. Preliminary Exploration

8. Preliminary exploration • To find health statistics, go to the libraries page at http://med.mercer.edu/library and choose Health Statistics & Research from the pulldown menu. • Click on CDC: Diseases and Conditions

9. 8.4% of Adults in the U.S and 10% in Georgia were Diagnosed with Diabetes in 2009

10. What percentage of people in Emanuel County have diabetes? http://www.cdc.gov/diabetes/atlas/countydata/atlas.html Centers for Disease Control & Prevention, Diabetes Public Health Resources, Diabetes Interactive Atlas, 2009 data Preliminary Exploration

11. 11.2% of Adults in Emanuel County were Diagnosed with Diabetes in 2009

12. Why do more adults in Emanuel County have diabetes than the national average? If your topic is too narrow, it may prove difficult to find research If your topic is too broad, it may be impossible to cope with the vast amount of literature on an unfocused topic Is your topic researchable?

13. What does PICO stand for? P stands for Population or Patient I stands for Intervention C stands for Comparison O stands for Outcome Focus your research with a PICO Question.

14. What Population do you want to research? In this case, it is adults with diabetes. Focus your research with a PICO Question.

15. What would be an Intervention? In this case, think about what might contribute to diabetes. Focus your Research with a PICO question.

16. Sometimes a Point-of-Care database with distilled information will help you focus. Focus your Research with a PICO question. • Go to the Dynamed Database (found in the pulldown menu on the library page http://med.mercer.edu/library)

19. What percentage of adults in the United States Smoke? http://apps.nccd.cdc.gov/statesystem/InteractiveReport/InteractiveReports.aspx Centers for Disease Control, Smoking and Tobacco Use, Interactive Maps, 2010 Explore A concept

20. 19% of adults in the U.S & 17.6% in Georgia, 2010

21. What is the percentage of adults in Emanuel County smoke? http://www.countyhealthrankings.org/app/#/georgia/2013/measure/factors/9/map County Health Rankings and Roadmaps, 2013 Explore a Concept

22. Preliminary exploration • To find health statistics, go to the libraries page at http://med.mercer.edu/library and choose Health Statistics & Research from the pulldown menu. • Click on CDC: Diseases and Conditions

23. 23% of Adults in Emanuel County Smoke

24. What is your Intervention? In this case it would be smoking cessation Is there a comparison? You don’t have to have one. What is the Outcome you want? In this case it would be improved health Focus Your research with a pico question.

25. Your PICO question would be In adults with Diabetes Mellitus, does smoking cessation result in improved health? Focus your research with a pico question.

26. Go to the library webpage at http://med.mercer.edu/library and select PubMed from the pulldown menu. Searching the literature

27. You can type in keywords Searching the literature

28. If you want to narrow results, select MESH Databases Searching the literature

29. Type “Smoking Cessation”, select it, and add it to the search builder Searching the literature

30. Type “diabetes,” select Diabetes Mellitus, and add it to the search builder Searching the literature

31. Click Search PubMed Searching the literature

32. View your results Searching the literature

33. Searching the literature • To narrow further, you can can filter your results

34. In this case limited to Randomized Controlled Trials Searching the literature

35. Click on the “Get It @ MUSM Medical Libraries” button to see if the libraries have a subscription/access so that full text is free to you. Searching the literature

36. Searching the literature • If we don’t have a subscription, we can order the article for you from another library via InterLibrary Loan. • Go to the libraries webpage at http://med.mercer.edu/library and look for InterLibrary Loan under Services. • It might arrive the same day, or it might take several days, depending on the library that owns it.

37. What do you do if you have too many results? Think about your PICO. Do you need to refine and narrow your research? What if you have too few results? Think about your PICO. Do you need to refine and broaden your research? Searching the literature

38. If you are not getting many results, maybe you need to look in another database. Try Google Scholar Go to the library webpage at http://med.mercer.edu/library and select Google Scholar from the pulldown menu. Searching the literature

39. You can refine your results by using the Advanced Search Searching the literature

40. You can look for all of the words, the exact phrase, a least one of the words, without the words, anywhere in the article, in the title of the article, by a specific author, or in a specific journal or a specific date. Searching the literature

41. You can sort by relevance or by date. Click on “Get it @ MUSM Libraries” to see if the libraries have a subscription/access so that full text is free to you. Searching the literature

42. Does involving the male partners of pregnant teens increase the uptake of prenatal care? Does eliminating vending machines in middle schools result in decreased student obesity in those schools? In a workplace with a mostly sedentary environment, do workplace ergonomic interventions result in increased workforce productivity? In women with HIV, do peer-based interventions reduce health inequities? In children and youth aged 5 to 17 years, what is the effect of regular and frequent physical activity at school on measures of learning performance or absenteeism? Are adults or children exposed to poor air quality at increased risk for impaired cognitive performance? Example Population Health Questions

43. Macon: reference.ill@gain.mercer.edu 478.301.4056 Savannah: library@memorialhealth.com 912.350.8345 For assistance