Putting Evidence to Work for Health

Health department staff are charged with developing and implementing program and policies that keep large populations of people healthy and disease free. Evidence-based decision making (EBDM) uses the best available research evidence to select, implement and evaluate these programs and policies. Use of EBDM within health departments enhances the ability of staff to make informed choices and manage resources, which makes it more likely that people will receive effective programs to help prevent or control diseases.

Our project started in 2012 to learn concrete ways in which state health departments and researchers can support staff and partners in practicing EBDM. This report is a summary of how we worked with 12 state health departments over the last four years, what we learned, and what we recommend for action steps.

Click here to read the full report.

 

 

Recommendations 

 

Recommendation 1:

Provide ongoing, tailored training.

 

  • Identify training sources and support attendance.
  • Provide ongoing, skill-based trainings to all staff (in person or remotely), tailored to their education and experience.
  • Incorporate EBDM into new employee orientation training.
  • Assess existing training needs to fill gaps. We found a common need for training in policy change, program evaluation, change management, and strategies for specific settings or populations.
  • Offer and promote training in leadership processes and practices.
  • Provide and encourage staff training in how to provide technical assistance to partners in communication, strategic planning, policy development, coalition building, quality improvement, performance management, the latest evidence-based approaches and change management.
  • Tie requirements for ongoing training in EBDM to agency plans for accreditation or reaccreditation.

Training requires financial and personnel resources. Partnering with a public health training center or university may help sustain ongoing trainings. Alternative methods, such as conducting some training online, can reduce travel and/or other costs. EBDM encompasses many skills and a broad range of practical experience. One staff person cannot be expected to be expert in every facet; combining work unit/agency expertise can maximize the impact of collective skills to practice EBDM.

 

Recommendation 2:

Create a health department that supports EBDM through culture (shared values/beliefs), climate (employee experience), and leadership.

 

  • Include EBDM in the workplace mission.
  • Develop common language for EBDM processes and principles.
  • Include principles of EBDM in goals, work plans, formal accountability procedures, and/or strategic plans, and develop methods to monitor performance (and acknowledge staff/programs that excel).
  • Provide ready access to low-cost research evidence sources (e.g., academic journals, guidelines, toolkits, evaluation databases, cost-effective modeling for EBDM strategies) through online sources/ digital libraries (potentially through increased university partnerships).
  • Encourage use of on-line sources of data and evidence-based practices (The Community Guide).
  • Have leadership (at all levels) instill EBDM principles by modeling processes, demonstrating long-term commitment and offering safe space for staff to practice EBDM (e.g., protected time to attend trainings, obtain and digest evidence).
  • Formally include EBDM updates/progress in work unit and/or cross-section meetings.
  • Hire individuals committed to EBDM (include in job description and interview questions).
  • Increase the number of staff that have degrees in public health or related fields and/or staff with formalized training in public health.
  • Share resources, data, evaluation findings, programmatic materials, success stories, and research evidence within work units, and across the organization.

 

Change will not happen overnight, and that’s ok. Our recommendations address different roadblocks, depending on the agency. After identifying an area for improvement, we recommend conducting a feasibility assessment before attempting a change in policy or practice. It may also be helpful to talk with other, similar agencies to see how they approached different steps.combining work unit/agency expertise can maximize the impact of collective skills to practice EBDM.

 

Recommendation 3:

Engage health department partners in EBDM practice in ongoing and meaningful ways.

 

  • Develop a process for health department staff to communicate EBDM practice and progress with partners (and policymakers). Provide summaries of emerging issues.
  • Include EBDM expectations and requirements in funding proposals and contracts.
  • Train partners in EBDM or observe how partners are using EBDM and collaborate in planning other trainings.
  • Provide remotely accessed ongoing, short, topic-specific trainings for partners with additional access to archived trainings.
  • Increase university partnerships and/or enhance partnerships through formal agreements.
  • Provide technical support and guidance for partners. Include plan to assess accountability of contracted partners regarding evidence-based interventions.
  • Share resources, data (particularly local data), funding, evaluation findings, program materials, success stories, and research evidence with partners.

Since health departments work with many types of organizations (nonprofits, healthcare organizations, universities), including partners in the EBDM process will be different for each department. In addition, engaging policymakers as partners is critical and brings a different set of challenges to consider. Including partners in assessing, planning, implementing, evaluating and disseminating programs and policies is a core element of EBDM; therefore, developing and supporting effective methods to include partners can only enhance a health department’s own EBDM processes.

 

 

For more information about this work, please contact Peg Allen (pegallen@wustl.edu) or visit the project’s web page.

This work was supported by the National Cancer Institute of the National Institutes of Health (R01CA160327).

 

 

Brownson, Ross C. et al. “Controlling Chronic Diseases Through Evidence-Based Decision Making: A Group-Randomized Trial.” Preventing Chronic Disease 14 (2017): n. pag. Web. 27 June 2018. [Read more].

Jacob, Rebekah R. et al. “Learning About And Using Research Evidence Among Public Health Practitioners.” American Journal of Preventive Medicine 52.3 (2017): S304-S308. Web. 27 June 2018. [Read more].

Hu, Hengrui et al. “Organizational Supports For Research Evidence Use In State Public Health Agencies.” Journal of Public Health Management and Practice (2018): 1. Web. 27 June 2018.  [Read more].

Allen, Peg et al. “Lessons Learned In Promoting Evidence-Based Public Health: Perspectives From Managers In State Public Health Departments.” Journal of Community Health (2018): n. pag. Web. 27 June 2018.  [Read more].