Evidence-Based Practice for Public Health Project

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Evidence-Based Practice for Public Health Project

• Funded by a
• CDC/ATPM Cooperative Agreement
• Lamar Soutter Library
• Principal Investigator Elaine Martin, MSLS, MA
• Project Coordinator Hathy Simpson, MPH
• Project Consultant Roger Luckmann, MD, MPH

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Overview

• Rationale background of the project
• Projects goals
• Process used to meet the goals
• Description of the project to date
• Future plans

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Many EBM products have been developed for busy
medical clinicians but few EBPH resources are
available for public health practitioners.
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A Definition of EBM

• The conscientious, explicit, judicious use of the
  current best evidence in making decisions about
  the care of individual patients.
• (Ref Sackett et al, 1996)

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Definition of EBM (cont.)

• EBM practice requires integrating practitioner
  clinical expertise with best evidence from
  systematic research.

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A Definition of EBPH

• The conscientious, explicit, judicious use of the
  current best evidence in making decisions in
  routine PH practice, and in developing PH
  policies and programs.
• (Ref Sackett et al, 1996)

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Definition of EBPH (cont.)

• EBPH practice requires integrating
  practitioner expertise, accumulated PH and basic
  science knowledge, and regulatory requirements,
  with best evidence from systematic research.

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Spectrum of Evidence

1. Definitive clinical and epidemiologic studies of
   human subjects and populations
2. Consensus of experts based on historical
   observation and experience in human populations
3. Findings from basic science research extrapolated
   to humans

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Spectrum of Evidence Clinicaland Epidemiologic
Studies

1. Systematic reviews of multiple valid intervention
   studies
2. One or more randomized controlled trials or other
   intervention studies
3. Systematic reviews of multiple valid
   observational studies or evaluations
4. One or more observational studies or evaluations

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Rationale for Evidence-Based Practice for Public
Health Project

• Increasing amount of high quality, relevant
  research in PH and in disciplines related to PH
  (medical, behavioral, social sciences).
• Great need for high quality, evidence-based
  information by PH practitioners.
• Access to best evidence limited

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Evidence-Based Practice for PH Key Questions

• What are the knowledge domains of PH?
• What is / Where is the relevant evidence for
  each domain?
• What are the needs of PH practitioners for
  current evidence in their fields?
• How can access to required current evidence be
  improved?
• What model/s for information delivery can best
  meet PH information needs?

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Evidence-Based Practice for PH Methods.

• Define the knowledge domains of public health
• Identify and assess existing sources of EBPH
  content and existing means of delivering it
• Examine, classify, evaluate existing models for
  synthesizing and delivering EBM content to
  medical practitioners

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Evidence-Based Practice for PH Methods

• Identify characteristics of EBM
  synthesis/delivery methods potentially relevant
  to models for delivery of EBPH content.
• Propose model/s for synthesis/delivery of current
  EBPH content for selected knowledge domains and
  related practitioner groups.

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Identifying the Knowledge Domains of Public Health

• The field of public health is very broad and
  diverse
• Activities range from disease control to health
  care financing

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Identifying the Knowledge Domains of Public Health

• There are multiple disciplines (knowledge
  domains) within the field of public health

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Public Health is Multidisciplinary

• 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

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What are the Knowledge Domains of Public Health?
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Process Used to Identify the Knowledge Domains
of Public Health

• Examined public health sources
• What knowledge domains or areas of public
  health do these sources include?

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Public Health Sources Used to Identify the
Knowledge Domains of Public Health

• Public health accreditation criteria
• Chapters from an academic public health reference
  book
• Collection categories of the American Journal of
  Public Health

• Public health occupational categories
• Massachusetts Department of Public Health
• American Public Health Association (APHA)

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Public Health Sources Used to Identify the
Knowledge Domains of Public Health

• Healthy People 2010 national health objectives
• Public health guidelines from The Guide to
  Community Preventive Services

• Ten essential services of public health from the
  Public Health Functions Working Group
• Library indexes NLM journal subject headings
  MeSH public health subject headings from the
  Library of Congress

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Example of a Public Health Knowledge Domain
Environmental Health
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We Identified 17 (with their subdomains)Public
Health Knowledge Domains

• Public Health Nursing (3)
• Disaster Control Emergency Services (4)
• Communicable Diseases (16)
• HIV/AIDS (4)
• Chronic Noncommunicable Diseases Conditions
  (18)
• Public Health Laboratory Sciences (5)
• Public Health Informatics (5)
• Global, International Health

• Epidemiology (6)
• Biostatistics (6)
• Vital Statistics Surveillance (7)
• Environmental Health (13)
• Occupational Health (3)
• Health Services Administration (15)
• Social Behavioral Sciences (8)
• Health Promotion Education (4)
• Community Health (18) (includes Maternal Child
  Health)

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The Next Step in the Process

• What is the literature associated with the
  identified knowledge domains of public health?
• Identify public health journals

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Process Used to Identify Public Health Journals

• Used ISIs Journal Citation Reports to identify
  top public health journals by impact factor
• Created a list of public health journals using
  three sources
• CDC Information Center list of the most
  frequently requested journals
• Healthy People 2010 Information Access Project
  list of the most frequently cited journals from
  formulated search strategies
• Journals identified through the MLAs Core Public
  Health Journal Project

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Public Health JournalsIdentified

• List of the top 25 journals by impact factor in
  the subject category Public, Environmental, and
  Occupational Health
• List of 698 public health journals
• Available online?
• Free or by subscription only?
• If free Internet link (URL)?

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The Next Step

• What public health literature is associated for
  the identified knowledge domains of public
  health?
• Match journal titles with knowledge domains

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Example of a Public Health Knowledge Domain

• Maternal and Child Health

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Public Health Knowledge Domain Maternal and
Child Health

• Some associated journals
• Maternal and Child Health Journal
• American Journal of Obstetrics and Gynecology
• Paediatric and Perinatal Epidemiology
• Archives of Disease in Childhood
• Archives of Pediatrics and Adolescent Medicine
• Child Abuse and Neglect
• Child Care, Health and Development
• The Future of Children
• Journal of Child and Family Studies
• Pediatrics International

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Accomplishments To Date

• Identified the knowledge domains of public health
• Identified public health journals
• Created project website
• In progress Match identified knowledge domains
  with public health journals

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The Projects Website

• http//library.umassmed.edu/ebpph

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Future Goals for the Next Year

• Determine the information needs of public health
  workers vs. clinical workers.
• Identify the characteristics of clinical EBM
  products.
• Can any of the characteristics be applied to a
  model for evidence-based public health?
• What is our definition of evidence-based public
  health?

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Future Goals for the Next YearContinued

• Would public health workers use the product?
• What features would public health workers want?
• Choose sample public health knowledge domains to
  test evidence-based model(s) for public health
  practice.

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Evidence-Based Practice for Public Health Project
Personnel

• Principal Investigator Elaine Martin, MSLS, MA
• Project Coordinator Hathy Simpson, MPH
• Project Consultant Roger Luckmann, MD, MPH
• Project Consultant Sharon Telleen, PhD
• Technical Advisor Jocelyn Rankin, PhD