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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
Overview
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Rationale & background of the project
Project’s goals
Process used to meet the goals
Description of the project to date
Future plans
Many EBM products have
been developed for busy
medical clinicians but few
EBPH resources are available
for public health
practitioners.
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)
Definition of EBM (cont.)
EBM practice requires integrating
practitioner clinical expertise with
best evidence from systematic
research.
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)
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.
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
Spectrum of Evidence: Clinical
and 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
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, evidencebased information by PH practitioners.
• Access to best evidence limited
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?
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
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.
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
Identifying the Knowledge
Domains of Public Health
• There are multiple disciplines
(knowledge domains) within
the field of public health
Public Health is Multidisciplinary
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•
•
•
•
•
•
•
•
•
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
What are the
Knowledge Domains
of Public Health?
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?
Public Health Sources Used to
Identify the Knowledge
Domains of Public Health
1.
Public health
accreditation criteria
2. Chapters from an
academic public health
reference book
3. Collection categories of
the American Journal
of Public Health
4. Public health
occupational categories
5. Massachusetts
Department of Public
Health
6. American Public Health
Association (APHA)
Public Health Sources Used to
Identify the Knowledge
Domains of Public Health
7. Healthy People 2010
national health
objectives
8. Public health guidelines
from The Guide to
Community Preventive
Services
9. Ten essential services of
public health from the
Public Health Functions
Working Group
10. Library indexes: NLM
journal subject headings
& MeSH; public health
subject headings from
the Library of Congress
Example of a Public Health Knowledge Domain:
Environmental Health
P roposed
K now ledge
D om ain of
P ublic H ealth
A ccreditation
C riteria, C ouncil
on E ducation for
P ublic H ealth,
K now ledge A reas
M axcy-R osenauL ast P ublic H ealth
& P reventive
M edicine
C hapters
A m erican Journal
of P ublic H ealth,
C ollection
C ategories
T he P ublic H ealth
W ork F orce,
E num eration 2000
O ccupational
C ategories
E nvironm ental
H ealth
п‚·пЂ Toxicology
п‚·пЂ H azardous
M aterials
п‚·пЂ E cology
п‚·пЂ E nvironm ental
M icrobiology
п‚·пЂ E nvironm ental
M onitoring
п‚·пЂ E nvironm ental
E pidem iology
п‚·пЂ Industrial & Land
Pollution
E nvironm ental
H ealth Sciences
п‚·пЂ B iological Factors
п‚·пЂ Physical Factors
п‚·пЂ C hem ical Factors
E nvironm ental
H ealth
п‚·пЂ Toxicology
E nvironm ent
E nvironm ental
E ngineer
п‚·пЂ E nvironm ental
E ngineer
Technician
п‚·пЂ C hem ical
E ngineer
п‚·пЂ Testing
Technician
п‚·пЂ O utdoor
E nvironm ental
Scientist &
Specialist
п‚·пЂ E nvironm entalist
п‚·пЂ E nvironm ental
Science &
Protection
Technician
п‚·пЂ E nvironm ental
H ealth Specialist
п‚·пЂ Soil & Plant
Scientist
п‚·пЂ H azardous
M aterials Specialist
п‚·пЂ Toxicologist
Pollution
- H ousing &
H ealth
- B uildings &
H ealth
- Lead Poisoning
- A sbestos
- R adon in H om es
E nvironm ental
H ealth
A ssessm ent
п‚·пЂ C om m unity
A ssessm ent
Program
п‚·пЂ E nvironm ental
H ealth Education
Program
п‚·пЂ E nvironm ental
E pidem iology
Program
п‚·пЂ E nvironm ental
Toxicology
Program
& H ealth
H ealth P eople
2010,
F ocus A reas &
п‚­ L eading H ealth
Indicators
E nvironm ent
E nvironm ental
H ealth
п‚·пЂ Toxics & W aste
п‚·пЂ Infrastructure &
Surveillance
п‚­ E nvironm ental
Q uality
T he G uide to
C om m unity
P reventive
Services,
T opics
P ublic H ealth
F unctions
W orking G roup,
E ssential P ublic
H ealth Services
D iagnose and
Investigate
H ealth P roblem s
E nforce L aw s and
R egulations
п‚·пЂ Follow -up of
H azards &
E xposure-related
D iseases
NLM ,
Journal Subject
H eadings
P ublic H ealth
E nvironm ental
H ealth
п‚·пЂ E cology
п‚·пЂ Pollution
T oxicology
п‚·пЂ Pesticides
п‚·пЂ Poisoning
п‚·пЂ X enobiotics
NLM ,
M edical Subject
H eadings
E nvironm ental
H ealth
E nvironm ental
M edicine
E nvironm ental
M icrobiology
п‚·пЂ A ir M icrobiology
п‚·пЂ Food
M icrobiology
п‚·пЂ Soil M icrobiology
п‚·пЂ W ater
M icrobiology
L ibrary of
C ongress
Subject H eadings
E nvironm ental
H ealth
п‚·пЂ E nvironm ental
Toxicology
п‚·пЂ E nvironm entally
Induced D iseases
E nvironm ental
E ngineering
п‚·пЂ E nvironm ental
M onitoring
п‚·пЂ E nvironm ental
Testing
E nvironm ental
M onitoring
D isorders of
E nvironm ental
O rigin
п‚·пЂ O utdoor
Pollution
E ngineer,
Technician
п‚·пЂ A ir Pollution
Specialist
п‚·пЂ H ousing
A m erican P ublic
H ealth
A ssociation,
Sections & Special
Interest G roups
E nvironm ental
P ollution
п‚·пЂ A ir
A ir
Pollution
п‚·пЂ Indoor
M assachusetts
D ept. of P ublic
H ealth,
B ureaus &
P rogram s
A ir
Q uality
п‚·пЂ Indoor
A ir Q uality
Lead
Poisoning
Prevention Program
п‚·пЂ C hildhood
п‚·пЂ H ealthy
H om es &
H ealthy
C om m unities
- Indoor A llergens
- O ffice B uilding
A ir Q uality
- R adon in H om es
- Lead -based
Paint
- Substandard
H ousing
п‚·пЂ E nforcem ent
of
A ir Pollution
A ir Pollution
A ir Pollution,
Indoor
п‚·пЂ H ousing
H ousing
A sbestos
A batem ent
C lean A ir
Standards
&
H ealth
L ead A batem ent
We Identified 17 (with their subdomains)
Public Health Knowledge Domains
• 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)
• 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
The Next Step in the Process:
What is the literature
associated with the identified
knowledge domains of public
health?
–Identify public health journals
Process Used to Identify
Public Health Journals
• Used ISI’s Journal Citation Reports to identify
top public health journals by impact factor
• Created a list of public health journals using
three sources:
1. CDC Information Center: list of the most
frequently requested journals
2. Healthy People 2010 Information Access
Project: list of the most frequently cited journals
from formulated search strategies
3. Journals identified through the MLA’s Core
Public Health Journal Project
Public Health Journals
Identified
1. List of the top 25 journals by impact
factor in the subject category: “Public,
Environmental, and Occupational Health”
2. List of 698 public health journals
– Available online?
– Free or by subscription only?
– If free: Internet link (URL)?
The Next Step
What public health literature is
associated for the identified
knowledge domains of public health?
– Match journal titles with knowledge
domains
Example of a Public Health
Knowledge Domain:
Maternal and Child Health
Public Health Knowledge Domain:
Maternal and Child Health
Some associated journals:
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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
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
The Project’s Website
http://library.umassmed.edu/ebpph
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 evidencebased public health?
Future Goals for the Next Year
Continued
• 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.
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
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