A pragmatic evaluation of a Public Health Knowledge Broker mentoring education program: A convergent mixed methods study

Abstract Background: Public health professionals are expected to use the best available research and contextual evidence to inform decision making. The National Collaborating Centre for Methods and Tools developed, implemented, and evaluated a Knowledge Broker mentoring program aimed at facilitating organization-wide evidence-informed decision making in ten public health units in Ontario, Canada. The purpose of this study was to pragmatically assess the impact of the program.Methods: A convergent mixed methods design was used to interpret quantitative results in the context of the qualitative findings. Quantitatively, participants’ knowledge and skills for finding, interpreting, and using evidence were measured before and after program completion via multiple-choice tests. Changes in scores were assessed using paired t-tests. Qualitatively, program participants and management at enrolled public health units were interviewed to explore the effect of program participation. A secondary analysis of these interviews was conducted to determine whether organizations met their evidence use goals set at baseline, and to identify key factors related to implementation of EIDM within the organization.Results: Post-program scores for knowledge and skills for EIDM were higher compared to pre-program scores (mean difference = 14.0%, 95% CI 8.2%, 19.8%). Organizations met their goals for evidence use to varying degrees. Key themes identified that support an organizational shift to EIDM include definitive plans for participants to share knowledge during and after program completion, embedding evidence into decision making processes, and supportive leadership with organizational investment of time and resources. The location, setting or size of health units was not associated with attainment of EIDM goals; small, rural health units were not at a disadvantage compared to larger, urban health units.Conclusions: The Knowledge Broker mentoring program effectively increased participants’ knowledge and skill, allowing them to share their learning and support change at their health units. When paired with organizational supports such as supportive leadership and resource investment, this program holds promise as an innovative knowledge translation strategy for organization wide EIDM among public health organizations.

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A Pragmatic Evaluation of a Public Health Knowledge Broker Mentoring Education Program: A Convergent Mixed Methods Study

10.21203/rs.3.rs-819746/v1 ◽

2021 ◽

Author(s):

Emily Clark ◽

Bandna Dhaliwal ◽

Donna Ciliska ◽

Sarah Neil-Sztramko ◽

Marla Steinberg ◽

...

Keyword(s):

Public Health ◽

Decision Making ◽

Mixed Methods ◽

Program Completion ◽

Knowledge Broker ◽

Mentoring Program ◽

Evidence Use ◽

Supportive Leadership ◽

Knowledge And Skills ◽

The Impact

Abstract Background: Public health professionals are expected to use the best available research and contextual evidence to inform decision making. The National Collaborating Centre for Methods and Tools developed, implemented, and evaluated a Knowledge Broker mentoring program aimed at facilitating organization-wide evidence-informed decision making in ten public health units in Ontario, Canada. The purpose of this study was to pragmatically assess the impact of the program. Methods: A convergent mixed methods design was used to interpret quantitative results in the context of the qualitative findings. Quantitatively, participants’ knowledge and skills for finding, interpreting, and using evidence were measured before and after program completion via multiple-choice tests. Changes in scores were assessed using paired t-tests. Qualitatively, program participants and management at enrolled public health units were interviewed to explore the effect of program participation. A secondary analysis of these interviews was conducted to determine whether organizations met their evidence use goals set at baseline, and to identify key factors related to implementation of EIDM within the organization. Results: Post-program scores for knowledge and skills for EIDM were higher compared to pre-program scores (mean difference = 14.0%, 95% CI 8.2%, 19.8%). Organizations met their goals for evidence use to varying degrees. Key themes identified that support an organizational shift to EIDM include definitive plans for participants to share knowledge during and after program completion, embedding evidence into decision making processes, and supportive leadership with organizational investment of time and resources. The location, setting or size of health units was not associated with attainment of EIDM goals; small, rural health units were not at a disadvantage compared to larger, urban health units. Conclusions: The Knowledge Broker mentoring program effectively increased participants’ knowledge and skill, allowing them to share their learning and support change at their health units. When paired with organizational supports such as supportive leadership and resource investment, this program holds promise as an innovative knowledge translation strategy for organization wide EIDM among public health organizations.

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Participation in the National Collaborating Centre for Methods and Tools’ Knowledge Broker Mentoring Program: a public health inspector perspective

Environmental Health Review ◽

10.5864/d2021-004 ◽

2021 ◽

Vol 64 (1) ◽

pp. 14-16

Author(s):

Andrea Powers ◽

T. Pelletier ◽

R. Ray ◽

A. Reynolds ◽

C. Howarth ◽

...

Keyword(s):

Public Health ◽

Decision Making ◽

Informed Decision ◽

Knowledge Broker ◽

Rapid Review ◽

Practice Research ◽

Mentoring Program ◽

Informed Decision Making ◽

Successful Completion ◽

Time Commitment

Although evidence-informed decision making is an important part of the field of public health inspection, finding the time to stay informed of current research can be a challenge amidst day-to-day job expectations. This article will explore how two Public Health Inspectors (PHIs) from Ottawa Public Health, a municipal public health unit in Ontario, incorporated evidence-informed decision making (EIDM) into their work. They built their EIDM skills through participating in the 18-month Knowledge Broker (KB) Mentoring Program offered by the National Collaborating Centre for Methods and Tools. The program required a substantial time commitment, including nine in-person workshop days and dedicated hours to practice research appraisal skills and to complete a rapid review. The inspectors were approved and supported to spend the necessary time; however, they still found it difficult to designate hours for learning while balancing their frontline inspection workload. This article will share observations about the PHI’s involvement, including benefits and challenges as well as factors that facilitated their successful completion of the KB Mentoring Program.

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The Knowledge Broker Mentoring Program: Developing capacity for evidence-informed decision making

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.170 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

C Howarth ◽

M Steinberg ◽

S Neil-Sztramko ◽

M Dobbins

Keyword(s):

Public Health ◽

Decision Making ◽

Program Planning ◽

Scale Up ◽

Informed Decision ◽

Knowledge Broker ◽

Organizational Level ◽

Rapid Review ◽

Mentoring Program ◽

Informed Decision Making

Abstract Background Evidence-informed decision making (EIDM) is important to ensure that practice is evidence-informed and resources are used efficiently and effectively. However, public health professionals can face barriers to EIDM. Knowledge Brokers can support and champion EIDM within an organization. The National Collaborating Centre for Methods and Tools (NCCMT) developed a Knowledge Broker (KB) Mentoring program, a hands-on mentorship program to develop capacity for evidence-informed decision making. Objectives The objectives of the KB Mentoring program are to build individual and organizational capacity for evidence-informed decision making. The program takes place over 20 months and includes an organizational assessment, nine face-to-face workshop days, monthly webinars, completion of a rapid review, and a period post-program to connect with mentors. Participating cohorts are evaluated qualitatively. Results To date, two cohorts of five organizations each have completed the program (n = 56 participants). At the individual level, participants reported increased: confidence; EIDM knowledge and skills; and interpersonal connections. At the organizational level, the groups reported conducting rapid reviews, critically appraising evidence, and using evidence in program planning decisions. Additionally, organizations have put in place ongoing supports to build EIDM capacity. Participants noted that they would like more support both before and after the program. This recommendation was put in place for the third cohort, currently in progress. Conclusions Participants indicated the KB mentoring program was high quality and increased EIDM capacity and behaviour in their organizations. This innovative program is important across settings and countries as public health continues to face changes to public health practice. In order to scale up the program to diverse geographic settings, an online KB mentoring program is currently in development. Key messages Knowledge Broker mentoring supports public health practitioners to use evidence in practice. Knowledge broker mentoring raises the confidence, knowledge, skills, and connections of participants.

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

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.942 ◽

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.

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The Impact of Public Health Interventions on The First and Second Waves of COVID-19 in Trinidad And Tobago – A Simple Epidemic Model

Caribbean Medical Journal ◽

10.48107/cmj.2020.12.007 ◽

2020 ◽

Author(s):

Loren De Freitas ◽

Han-I Wang

Keyword(s):

Public Health ◽

Decision Making ◽

Trinidad And Tobago ◽

Specific Treatment ◽

Health Interventions ◽

Public Health Interventions ◽

Support Methods ◽

The Impact ◽

Second Wave ◽

Combined Interventions

Introduction The COVID-19 pandemic has resulted in more than 35 million confirmed cases worldwide. Currently, there is no specific treatment for the disease or available vaccine to reduce the spread of COVID-19. As such, countries rely on a range of public health interventions to assist in halting the spread of transmission. Caribbean countries have also adopted many public health interventions. In this paper, we use mathematical modelling to demonstrate the impact of public health interventions on the progression of COVID-19 in order to provide timely decision support. Methods A cohort Markov model, based on the concept of the SEIR model, was built to reflect the characteristics of the COVID-19 virus. Five possible public health interventions in the first wave and a projection of current second wave were simulated using the constructed model. Results The model results indicate that the strictest combined interventions of complete border closure and lockdown were the most effective with the number of deaths less than ten in the first wave. For the current second wave, it will take around 30 days for the pandemic to pass its peak after implementing the wearing of face masks policy. Conclusions This paper shows the impact of common public health interventions on the COVID-19 pandemic, using Trinidad and Tobago as an example. Such impacts may be useful in reducing delays in decision-making and improving compliance by populations. However, given the limitations associated with mathematical models, decision-making should be guided by economic assessments, infectious disease and public health expertise.

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Are ICTs Prerequisites for the Eradication of Poverty?

The International Review of Information Ethics ◽

10.29173/irie31 ◽

2007 ◽

Vol 7 ◽

pp. 283-294

Author(s):

H P P Lötter

Keyword(s):

Decision Making ◽

Information And Communication Technologies ◽

Communication Technologies ◽

Knowledge And Skills ◽

Information And Communication ◽

The Rich ◽

Effective Use ◽

The Impact ◽

The Relationship

I provide a philosophical analysis of the claim that ICTs are necessary preconditions for the eradication of poverty. What are the links between information and communication technologies (ICTs) and poverty? I first define technology and then give a brief depiction of ICTs. Thereafter I define poverty and give a brief expla-nation of its context and causes. Next I discuss the relationship between poverty and ICTs in three paradigm cases: [i] the role of ICTs in poor societies, [ii] the effect of poor ICT knowledge and skill of individuals in highly developed technological societies, and [iii] the impact of impoverished ICT knowledge and skills on the rich, powerful, and intelligent ones in society. I propose a procedure for decision making about the appropria-tion of ICTs by individuals and societies. I assess the claim that both access to ICTs and effective use of them are preconditions for the eradication of poverty.

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Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

10.21203/rs.3.rs-60056/v1 ◽

2020 ◽

Author(s):

Xiaoshuang Liu ◽

Xiao Xu ◽

Guanqiao Li ◽

Xian Xu ◽

Yuyao Sun ◽

...

Keyword(s):

Public Health ◽

United States ◽

Decision Making ◽

The United States ◽

School Closure ◽

Health Interventions ◽

Public Health Interventions ◽

The Us ◽

The Impact ◽

Individualized Decision

Abstract The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

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Essential skills for using research evidence in public health policy: a systematic review

Evidence & Policy A Journal of Research Debate and Practice ◽

10.1332/174426421x16250726996691 ◽

2021 ◽

Author(s):

Saliha Ziam ◽

Pierre Gignac ◽

Élodie Courant ◽

Esther Mc Sween-Cadieux

Keyword(s):

Public Health ◽

Systematic Review ◽

Decision Making ◽

Research Evidence ◽

Informed Decision ◽

Decision Makers ◽

Informed Decision Making ◽

Evidence Use ◽

Public Health Decision ◽

Health Decision

Background: Decisions related to the development and implementation of public health programmes or policies can benefit from more effective use of the best available knowledge. However, decision makers do not always feel sufficiently equipped or may lack the capacity to use evidence. This can lead them to overlook or set aside research results that could be relevant to their practice area.Aims and objectives: The objective of this systematic review was to synthesise the essential skills that facilitate the use of research evidence by public health decision makers.Methods: Thirty-nine articles that met our inclusion criteria were included. An inductive approach was used to extract data on evidence-informed decision-making-related skills and data were synthesised as a narrative review.Findings: The analysis revealed three categories of skills that are essential for evidence-informed decision-making process: interpersonal, cognitive, and leadership and influencing skills. Such cross-sectoral skills are essential for identifying, obtaining, synthesising, and integrating sound research results into the decision-making process.Discussion and conclusions: The results of this systematic review will help direct capacity-building efforts towards enhancing research evidence use by public health decision makers, such as developing different types of training that would be relevant to their needs. Also, when considering the evidence-informed decision-making skills development, there are several useful and complementary approaches to link research most effectively to action. On one hand, it is important not only to support decision makers at the individual level through skills development, but also to provide them with a day-to-day environment that is conducive to evidence use. Key messages <ul><li>Public health programmes or policies can benefit from more effective use of the best available knowledge;</li> <li>This review identified 39 studies on skills related to evidence-informed decision making;</li> <li>Three categories of skills are proposed: cognitive, interpersonal and leadership and influencing skills;</li> <li>It will help direct capacity-building efforts towards enhancing evidence use by decision makers.</li></ul>

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‘An exploration of stakeholder involvement in decision-making: a qualitative study of commissioning for alcohol services’

10.21203/rs.3.rs-24294/v1 ◽

2020 ◽

Author(s):

hayley Alderson ◽

Eileen Kaner ◽

David Hunter ◽

Amy O'Donnell ◽

Angela Bate

Keyword(s):

Public Health ◽

Decision Making ◽

Focus Groups ◽

Health Care Policy ◽

Service Providers ◽

Stakeholder Involvement ◽

Fluid Environment ◽

Key Issues ◽

Perceived Involvement ◽

The Impact

Abstract Background: The concept of providing individuals with a ‘voice’ via stakeholder involvement has been advocated within English health care policy for several decades. Stakeholder involvement encourages people affected by an issue to contribute to planning and decision making regarding treatment and care, inclusive of providers and recipients of care. This paper explores stakeholder involvement within the commissioning of public health alcohol services and illustrates whether stakeholders perceived that meaningful involvement had taken place. Methods: We conducted a qualitative case study, inclusive of in-depth interviews with 10 Alcohol commissioners, 11 alcohol service providers and 6 general practitioners plus three facilitated focus groups with 31 alcohol service users. All interviews and focus groups were audio-recorded and data were transcribed verbatim. Thematic analysis drawing on Arnstein’s theory was used to discuss key issues related to participants involvement which are illuminated using direct quotes. Results: Overall findings suggest that most participants were aware of and could name various methods of stakeholder involvement, methods varied from formal strategically imposed mechanisms to innovative opportunities. We found that strategic mechanisms of involvement focused on collating data to help construct a national picture regarding service delivery. Using Arnstein’s ladder to illustrate the extent of stakeholder involvement, the majority of the participants perceived involvement to occur at the level of informing or consultation implying a level of tokenism. In addition, the impact of stakeholder involvement is not systematically monitored making it hard to identify the impact that involvement methods have had. Conclusion: This paper has shown a lack of consistency regarding the opportunities within the commissioning process for stakeholder involvement to influence service design and delivery. It is essential within public health that a deeper understanding is generated of who stakeholders are within this complex and fluid environment and to develop a clearer understanding of the different roles that stakeholders can play within the entire commissioning process in order to maximise its utility. Future commissioning guidance also needs to reflect more dimensionality than ladders of involvement currently afford.

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Effects of Education on Symptom Recognition and Management of Pseudobulbar Affect: A Mixed-Methods Evaluation of Clinician Knowledge and Behavior Changes

10.21203/rs.2.11238/v1 ◽

2019 ◽

Author(s):

Wendy Turell ◽

Anne Roc ◽

Erik Pioro ◽

Alexandra Howson

Keyword(s):

Clinical Practice ◽

Mixed Methods ◽

Qualitative Interviews ◽

The United States ◽

Matched Pair ◽

Pseudobulbar Affect ◽

Knowledge And Skills ◽

Symptom Recognition ◽

The Impact ◽

Case Based

Abstract Background Pseudobulbar affect (PBA) is under-recognized and often undertreated in clinical practice. There are few resources to support clinicians in the recognition and treatment of PBA symptoms, despite the approval by the United States Food and Drug Administration of a PBA-specific treatment. We evaluated the impact of a virtual education symposium on clinician knowledge and competence designed to improve knowledge and skills associated with identifying and managing PBA in patients with neurologic injury. Methods We designed a mixed methods outcomes methodology that included survey-based methods and qualitative interviews to measure trends in knowledge and competence. We measured changes in knowledge and competence via pre- and post-test online surveys that included case-based competence questions and knowledge-focused questions. McNemar test compared matched pair responses. Effect size was computed using Cohen’s d for all significant findings. Significance testing was conducted for matched pairs of learners who completed both pre/post and pre/survey, respectively. We explored the impact of the educational intervention on clinician knowledge, competency, and perspectives on PBA via qualitative interviews with a subsample of education participants. We used a process of constant comparison to structure analysis of participant responses to questions both across and within interviews. Results Participants’ PBA symptom recognition knowledge and skills increased following program participation and were maintained at follow-up. Responses to post-activity case-based questions showed that exposure to education enabled participants to better recognize and describe symptoms redolent of PBA. Following education, most participants said they would initiate therapy with on-label versus off-label medications. Qualitative descriptions of what interviewees say they would do in clinical practice were reflected in actual responses to knowledge and competence questions. Conclusions This mixed-method study demonstrates that online education is an effective and accessible tool for building knowledge and supporting clinical competence concerning PBA symptom recognition and management.

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