The Relationships Between State Health Department Practitioners’ Perceptions of Organizational Supports and Evidence-Based Decision-Making Skills

2021 ◽  
pp. 003335492098415
Author(s):  
Stephanie Mazzucca ◽  
Rebekah R. Jacob ◽  
Cheryl A. Valko ◽  
Marti Macchi ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Online Survey ◽  
Organizational Capacity ◽  
Health Department ◽  
Evidence Based ◽  
State Health ◽  
State Health Department ◽  
Longitudinal Associations ◽  
Evidence Based Decision Making

Objectives Evidence-based decision making (EBDM) allows public health practitioners to implement effective programs and policies fitting the preferences of their communities. To engage in EBDM, practitioners must have skills themselves, their agencies must engage in administrative evidence-based practices (A-EBPs), and leaders must encourage the use of EBDM. We conducted this longitudinal study to quantify perceptions of individual EBDM skills and A-EBPs, as well as the longitudinal associations between the 2. Methods An online survey completed among US state health department practitioners in 2016 and 2018 assessed perceptions of respondents’ skills in EBDM and A-EBPs. We used χ2 tests, t tests, and linear regressions to quantify changes over time, differences by demographic characteristics, and longitudinal associations between individual skills and A-EBPs among respondents who completed both surveys (N = 336). Results Means of most individual EBDM skills and A-EBPs did not change significantly from 2016 to 2018. We found significant positive associations between changes in A-EBPs and changes in EBDM skill gaps: for example, a 1-point increase in the relationships and partnerships score was associated with a narrowing of the EBDM skill gap (β estimate = 0.38; 95% CI, 0.15-0.61). At both time points, perceived skills and A-EBPs related to financial practices were low. Conclusions Findings from this study can guide the development and dissemination of initiatives designed to simultaneously improve individual and organizational capacity for EBDM in public health settings. Future studies should focus on types of strategies most effective to build capacity in particular types of agencies and practitioners, to ultimately improve public health practice.

scholarly journals “It’s good to feel like you’re doing something”: a qualitative study examining state health department employees’ views on why ineffective programs continue to be implemented in the USA

2022 ◽  
Vol 3 (1) ◽  
Author(s):  
Stephanie Mazzucca ◽  
Louise Farah Saliba ◽  
Romario Smith ◽  
Emily Rodriguez Weno ◽  
Peg Allen ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Population Health ◽  
Health Department ◽  
Evidence Based ◽  
State Health ◽  
Improve Population Health ◽  
Public Health Agencies ◽  
Health Agencies ◽  
Evidence Based Programs

Abstract Background Mis-implementation, the inappropriate continuation of programs or policies that are not evidence-based or the inappropriate termination of evidence-based programs and policies, can lead to the inefficient use of scarce resources in public health agencies and decrease the ability of these agencies to deliver effective programs and improve population health. Little is known about why mis-implementation occurs, which is needed to understand how to address it. This study sought to understand the state health department practitioners’ perspectives about what makes programs ineffective and the reasons why ineffective programs continue. Methods Eight state health departments (SHDs) were selected to participate in telephone-administered qualitative interviews about decision-making around ending or continuing programs. States were selected based on geographic representation and on their level of mis-implementation (low and high) categorized from our previous national survey. Forty-four SHD chronic disease staff participated in interviews, which were audio-recorded and transcribed verbatim. Transcripts were consensus coded, and themes were identified and summarized. This paper presents two sets of themes, related to (1) what makes a program ineffective and (2) why ineffective programs continue to be implemented according to SHD staff. Results Participants considered programs ineffective if they were not evidence-based or if they did not fit well within the population; could not be implemented well due to program restraints or a lack of staff time and resources; did not reach those who could most benefit from the program; or did not show the expected program outcomes through evaluation. Practitioners described several reasons why ineffective programs continued to be implemented, including concerns about damaging the relationships with partner organizations, the presence of program champions, agency capacity, and funding restrictions. Conclusions The continued implementation of ineffective programs occurs due to a number of interrelated organizational, relational, human resources, and economic factors. Efforts should focus on preventing mis-implementation since it limits public health agencies’ ability to conduct evidence-based public health, implement evidence-based programs effectively, and reduce the high burden of chronic diseases. The use of evidence-based decision-making in public health agencies and supporting adaptation of programs to improve their fit may prevent mis-implementation. Future work should identify effective strategies to reduce mis-implementation, which can optimize public health practice and improve population health.

Evidence-Based Decision-Making (Part 1): Origins and Evolution in the Health Sciences

2009 ◽  
Vol 24 (4) ◽  
pp. 298-305 ◽  
Author(s):  
David A. Bradt
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based Medicine ◽  
Strategic Decision ◽  
Systematic Research ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Strength Of Evidence ◽  
Based Medicine ◽  
Evidence Based Decision Making

AbstractEvidence is defined as data on which a judgment or conclusion may be based. In the early 1990s, medical clinicians pioneered evidence-based decision-making. The discipline emerged as the use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine required the integration of individual clinical expertise with the best available, external clinical evidence from systematic research and the patient's unique values and circumstances. In this context, evidence acquired a hierarchy of strength based upon the method of data acquisition.Subsequently, evidence-based decision-making expanded throughout the allied health field. In public health, and particularly for populations in crisis, three major data-gathering tools now dominate: (1) rapid health assessments; (2) population based surveys; and (3) disease surveillance. Unfortunately, the strength of evidence obtained by these tools is not easily measured by the grading scales of evidence-based medicine. This is complicated by the many purposes for which evidence can be applied in public health—strategic decision-making, program implementation, monitoring, and evaluation. Different applications have different requirements for strength of evidence as well as different time frames for decision-making. Given the challenges of integrating data from multiple sources that are collected by different methods, public health experts have defined best available evidence as the use of all available sources used to provide relevant inputs for decision-making.

scholarly journals The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Development ◽  
Digital Health ◽  
Resource Planning ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

Cancer Prevention Through Scaling-Up the Process of Evidence-Based Decision-Making in a State Health Department

2018 ◽  
Author(s):  
Peg M. Allen ◽  
Linda J. Ahrendt ◽  
Kiley A. Hump ◽  
Ross C. Brownson
Keyword(s):  
Decision Making ◽  
Organizational Climate ◽  
Cancer Prevention ◽  
Management Practices ◽  
Scale Up ◽  
Organizational Capacity ◽  
Health Agency ◽  
Evidence Based ◽  
Leadership Support ◽  
Evidence Based Decision Making

This case study provides an example of a collaboration between a university and a public health agency to build organizational capacity to spread data-driven decision-making, implementation, and evaluation of evidence-based cancer prevention strategies. The Office of Chronic Disease Prevention and Health Promotion at the South Dakota Department of Health provided the key management practices for scale-up of evidence-based decision-making (EBDM): leadership support, training, a supportive organizational climate and culture, inclusion of partners, and outcomes-based contracting with partnering organizations. A pre–post survey showed increased use of research evidence for several job tasks, including selection of interventions and evaluation. Perceived work unit access to skills in prioritization and adapting interventions also increased. The 16 staff and partners interviewed perceived leadership support, federal funding requirements, and an initial multi-day training as the key facilitators for spreading EBDM.

Evidence-Based Decision Making in Public Health

1999 ◽  
Vol 5 (5) ◽  
pp. 86-97 ◽  
Author(s):  
Ross C. Brownson ◽  
James G. Gurney ◽  
Garland H. Land
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Evidence Based Decision Making

scholarly journals 965. Partnering with State Health Departments: A Road Map for Collaboration Using Public Health Enhanced HIV/AIDS Reporting System (eHARS)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S513
Author(s):  
John R Bassler ◽  
Emily B Levitan ◽  
Lauren Ostrenga ◽  
Danita C Crear ◽  
Kendra L Johnson ◽  
...  
Keyword(s):  
Public Health ◽  
Reporting System ◽  
Health Department ◽  
Distributed Data ◽  
Summary Statistics ◽  
Health Departments ◽  
State Health ◽  
State Health Department ◽  
Data Network ◽  
Hiv Aids

Abstract Background Academic and public health partnerships are a critical component of the Ending the HIV Epidemic: A Plan for America (EHE). The Enhanced HIV/AIDS Reporting System (eHARS) is a standardized document-based surveillance database used by state health departments to collect and manage case reports, lab reports, and other documentation on persons living with HIV. Innovative analysis of this data can inform targeted, evidence-based interventions to achieve EHE objectives. We describe the development of a distributed data network strategy at an academic institution in partnership with public health departments to identify geographic differences in time to HIV viral suppression after HIV diagnosis using eHARS data. Figure 1. Distributed Data Network Methods This project was an outgrowth of work developed at the University of Alabama at Birmingham Center for AIDS Research (UAB CFAR) and existing relationships with the state health departments of Alabama, Louisiana, and Mississippi. At a project start-up meeting which included study investigators and state epidemiologists, core objectives and outcome measures were established, key eHARS variables were identified, and regulatory and confidentiality procedures were examined. The study methods were approved by the UAB Institutional Review Board (IRB) and all three state health department IRBs. Results A common data structure and data dictionary across the three states were developed. Detailed analysis protocols and statistical code were developed by investigators in collaboration with state health departments. Over the course of multiple in-person and virtual meetings, the program code was successfully piloted with one state health department. This generated initial summary statistics, including measures of central tendency, dispersion, and preliminary survival analysis. Conclusion We developed a successful academic and public health partnership creating a distributed data network that allows for innovative research using eHARS surveillance data while protecting sensitive health information. Next, state health departments will transmit summary statistics to UAB for combination using meta-analytic techniques. This approach can be adapted to inform delivery of targeted interventions at a regional and national level. Disclosures All Authors: No reported disclosures

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