Salt And Public Health: Contested Science And The Challenge Of Evidence-Based Decision Making

2012 ◽  
Vol 31 (12) ◽  
pp. 2738-2746 ◽  
Author(s):  
Ronald Bayer ◽  
David Merritt Johns ◽  
Sandro Galea
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Evidence Based Decision Making

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.

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 Rugged landscapes: complexity and implementation science

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Joseph T. Ornstein ◽  
Ross A. Hammond ◽  
Margaret Padek ◽  
Stephanie Mazzucca ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Quality Improvement ◽  
Evolutionary Biology ◽  
Public Health Practice ◽  
Evidence Based ◽  
Health Practice ◽  
Context Specific ◽  
Evidence Based Programs ◽  
Evidence Based Decision Making

Abstract Background Mis-implementation—defined as failure to successfully implement and continue evidence-based programs—is widespread in public health practice. Yet the causes of this phenomenon are poorly understood. Methods We develop an agent-based computational model to explore how complexity hinders effective implementation. The model is adapted from the evolutionary biology literature and incorporates three distinct complexities faced in public health practice: dimensionality, ruggedness, and context-specificity. Agents in the model attempt to solve problems using one of three approaches—Plan-Do-Study-Act (PDSA), evidence-based interventions (EBIs), and evidence-based decision-making (EBDM). Results The model demonstrates that the most effective approach to implementation and quality improvement depends on the underlying nature of the problem. Rugged problems are best approached with a combination of PDSA and EBI. Context-specific problems are best approached with EBDM. Conclusions The model’s results emphasize the importance of adapting one’s approach to the characteristics of the problem at hand. Evidence-based decision-making (EBDM), which combines evidence from multiple independent sources with on-the-ground local knowledge, is a particularly potent strategy for implementation and quality improvement.

Perceptions of Evidence-Based Decision-Making Among Full-Time Teachers and Senior Undergraduates in Public Health: A Nationwide Survey in Taiwan

2020 ◽  
Vol 32 (4) ◽  
pp. 209-214
Author(s):  
Yi-Hao Weng ◽  
Chun-Yuh Yang ◽  
Ya-Wen Chiu
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Scale Up ◽  
Nationwide Survey ◽  
School Curriculum ◽  
Evidence Based ◽  
Full Time ◽  
Teachers And Students ◽  
Evidence Based Decision Making ◽  
Structured Questionnaire

Using current best evidence to make decisions can improve outcomes of public health. Thus, establishing the capacities of evidence-based public health (EBPH) has become one of the core competences. To better scale up EBPH movement, efforts should focus on introduction of EBPH into school curriculum. However, data indicating the extent to which EBPH is used in universities are scant. In the current study, we conducted a nationwide questionnaire survey to investigate the perceptions toward EBPH among full-time teachers and senior undergraduates at all universities with a Department of Public Health in Taiwan. A structured questionnaire was distributed by post to all potential participants of nine universities in 2017. Questions included items related to awareness, knowledge, skills, behaviors, and barriers of EBPH. Results showed teachers were more aware of EBPH than students. In addition, teachers more often had sufficient knowledge and skills of EBPH, and more often applied the findings to decision-making after critical appraisal than students. Furthermore, personal barriers toward EBPH were more common in students than teachers. In conclusion, there are differences in awareness, knowledge, skills, behaviors, and barriers of EBPH between teachers and students. The data suggest that an initiative of systematically teaching EBPH to undergraduates is important.

scholarly journals Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Laura Yarber ◽  
Carol A. Brownson ◽  
Rebekah R. Jacob ◽  
Elizabeth A. Baker ◽  
Ellen Jones ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Train The Trainer ◽  
Evidence Based Decision Making

scholarly journals Laying the Groundwork for Evidence-Based Public Health: Why Some Local Health Departments Use More Evidence-Based Decision-Making Practices Than Others

2015 ◽  
Vol 105 (S2) ◽  
pp. S189-S197 ◽  
Author(s):  
Kay A. Lovelace ◽  
Robert E. Aronson ◽  
Kelly L. Rulison ◽  
Jeffrey D. Labban ◽  
Gulzar H. Shah ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Evidence Based ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Evidence Based Decision Making

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.

Sign in / Sign up

Export Citation Format

Share Document