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This session explores evidence-based practices in public health, identifying best resources, portals, and search pathways for professionals in health promotion, epidemiology, and more.
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Identifying Evidence-Based Resources in Public Health Sharon Telleen, Ph.D. Hatheway Simpson, MPH Skills Building Session March 5, 2006 Association of Maternal and Child Health Programs Annual Conference
Identifying Evidence-Based Practices in Public Health • Sharon Telleen, Ph.D., Research Associate Professor, University of Illinois at Chicago. Email: telleen@uic.edu • Hatheway Simpson, MPH, Public Health Project Coordinator, University of Massachusetts Medical School Library. Email: Hathy.Simpson@umassmed.edu
Evidence-Based Practice for Public Health Projecthttp://library.umassmed.edu/ebpph Partners in Information Access for the Public Health Workforce Projecthttp://PHPartners.org
Evidence-Based Practice for Public Health Projecthttp://library.umassmed.edu/ebpph Dr. Elaine Martin, Principal Investigator Lamar Soutter Library University of Massachusetts Medical School Funded by the Centers for Disease Control and Prevention and the Association of Teachers of Preventive Medicine 2002 - 2005
National Library of MedicineRegional Medical Library • National Network of Libraries of Medicine, New England Region http://nnlm.gov/ner 222 Maple Avenue, Shrewsbury, MA 01545 • University of Massachusetts Medical School http://library.umassmed.edu55 Lake Avenue, Worcester, MA 01655
Objectives • Overview of evidence-based public health resources • Identify portals of access • Develop a search pathway
Evidence-Based + Public Health • “the conscientious, explicit, and judicious use of current best evidence in making decisions about • the care of communities and populations in the domain of health protection, disease prevention, health maintenance and improvement.” Source: Jenicek M. Epidemiology, evidenced-based medicine, and evidence-based public health. J Epidemiol. Dec 1997;7(4):187-197.
Public Health: Health of Populations Clinical Medicine: Health of Individuals
Epidemiologists Statisticians Environmental Engineers Animal Control Officers Sanitarians Food Scientists Industrial Hygienists Health Care Administrators Health Economists Politicians Social Workers Mental Health Workers Substance Abuse Counselors Doctors Nurses Teachers Disaster Relief Workers Nutritionists Lab Technicians Librarians The Public Health Workforce
General Public Health Epidemiology Biostatistics Vital Statistics & Surveillance Environmental Health Occupational Health Health Services Administration Social & Behavioral Sciences Health Promotion & Education Community Health Maternal & Child Health Public Health Nursing Disaster Control & Emergency Services Communicable Diseases HIV/AIDS Nutrition Chronic Diseases Public Health Laboratory Sciences Public Health Informatics Global Health Identified Knowledge Domains Public Health
Why EBPH? • Need credible filtered information to make informed decisions. • Research evidence is valued. • So much information, too little time!
Evidence for Public Health Practice and Policy Decisions • “I make a lot of decisions about how money is going to be spent, and I would like to always be able to back it up and say that this is proven, or evidence-based.” • Politicians need evidence to make decisions about public health programs.
CDC/ATPM Qualitative StudyInvestigation of Information Needs of Public Health Professionals Nancy La Pelle, PhD Roger L. Luckmann, MD, MPH E. Hatheway Simpson, MPH Elaine R. Martin, DA Identifying Strategies to Improve Access to Credible and Relevant Information for Public Health Professionals: A Qualitative Study 2006
Findings from Study of Public Health Workforce Information Needs • There are many relevant websites to search: need for one portal access. • Bombarded with unfiltered, irrelevant information: need filtered searches. • Too little information on legislation and policy change and newly identified health threats.
Findings Continued • Need information from areas beyond biomedical domains. • Need access to systematic reviews and summary information. • Need access to full-text journal articles, government reports (grey literature), and conference proceedings. • Need for training in accessing evidence-based resources.
Evidence-Based Public Health Best Evidence from Research Social values, Politics, Economics $ Expertise, Knowledge • Decisions for Public Health Practice • Interventions • Programs • Policies
Evidence Pyramid Systematic Reviews & Meta-analyses Adapted from: The Medical Research Library of Brooklyn, http://servers.medlib.hscbklyn.edu/ebm/2100.htm
Evidence Matrix Petticrew M, Roberts H. Journal of Epidemiology and Community Health, 2003
Journal literature Books Conference proceedings & abstracts Dissertations & theses Unpublished scientific papers Government reports Policy statements, laws & regulations Surveillance data Newsletters Teleconferences & webcasts Alert systems Listservs Internet sources Expert knowledge & opinion Sources of Public Health Evidence
Evidence-Based Public Health Process • Define the public health problem. • Search and find the best evidence. • Critically appraise the evidence for validity and relevance. • Apply the evidence to practice. • Evaluate the results. • Adopted from: • Source: Sackett DL, Rosenberg WM. The need for evidence-based medicine. J R Soc Med. Nov 1995;88(11):620-624. • Sibbald WJ. Some opinions on the future of evidence-based medicine. Crit Care Clin. 1998;14(3):549-558.
Define the public health problem Convert the information needs into focused questions
Forming a Searchable Public Health QuestionPICO P - Population I - Intervention C - Comparison O - Outcome
Sample Question You will be working with health teachers in a rural Southern high school. They have heard girls talking about what sounds like STD symptoms and you the teachers want to start teaching safer sex education. The principal espouses abstinence-only education. You want to compile some evidence about the effectiveness of sex education curricula to bring to a discussion with the superintendent and the principal.
Search and find the best evidence Critically appraise the evidence for validity and relevance
Search Pathway • Evidence-Based Guidelines • Systematic Reviews • Pre-formulated Searches • Best and Model Practices • Bibliographic Databases • Public Health Journals • Health Data and Statistics • Legislation and Policy • Government Reports
Evidence-Based Resources for Public Health Practice • Evidence-Based Guidelines • Systematic Reviews • Pre-formulated Searches • Best & Model Practices • Public Health Bibliographic Databases • Public Health Journals Project Web Site:http://library.umassmed.edu/ebpph
Guide to Community Preventive Serviceshttp://www.thecommunityguide.org
Guide to Community Preventive ServicesSummary of Findings: Tobacco Use Prevention and Control
Link to Full-Text Article from the American Journal of Preventive Medicine
Evidence-Based Resources for Public Health Practice • Evidence-Based Guidelines • Systematic Reviews • Pre-formulated Searches • Best & Model Practices • Public Health Bibliographic Databases • Public Health Journals Project Web Site:http://library.umassmed.edu/ebpph
Cochrane Health Promotion and Public Healthhttp://www.vichealth.vic.gov.au/cochrane/activities/reviews.htm
Cochrane Library http://www3.interscience.wiley.com/cgi-bin/mrwhome/106568753/HOME?CRETRY=1&SRETRY=0
Evidence-Based Resources for Public Health Practice • Evidence-Based Guidelines • Systematic Reviews • Pre-formulated Searches • Best & Model Practices • Public Health Bibliographic Databases • Public Health Journals Project Web Site:http://library.umassmed.edu/ebpph
Healthy People 2010 Information Access Projecthttp://phpartners.org/hp