Management Practices to Build Evidence-Based Decision-Making Capacity for Chronic Disease Prevention in Georgia: A Case Study

Abstract

BackgroundResearch shows that training can improve skills needed for evidence-based decision making, but less is known about instituting organizational supports to build capacity for evidence-based chronic disease prevention.Community ContextThe objectives of this case study were to assess facilitators and challenges of applying management practices to support evidence-based decision making in chronic disease prevention programs in the public health system in Georgia through key informant interviews and quantitatively test for changes in perceived management practices and skills through a pre–post survey.MethodsLeadership of the chronic disease prevention section hosted a multiday training, provided regular supplemental training, restructured the section and staff meetings, led and oversaw technical assistance with partners, instituted transparent performance-based contracting, and made other changes. A 65-item online survey measured perceived importance of skills and the availability of skilled staff, organizational supports, and use of research evidence at baseline (2014) and in 2016 (after training). A structured interview guide asked about management practices, context, internal and external facilitators and barriers, and recommendations.Capacity-Building Activities and Survey FindingsSeventy-four staff members and partners completed both surveys (70.5% response). Eleven participants also completed a 1-hour telephone interview. Interview participants deemed leadership support and implementation of multiple concurrent management practices key facilitators to increase capacity. Main challenges included competing priorities, lack of political will, and receipt of requests counter to evidence-based approaches. At posttest, health department staff had significantly reduced gaps in skills overall (10-item sum) and in 4 of 10 individual skills, and increased use of research evidence to justify interventions. Use of research evidence for evaluation, but not skills, increased among partners.InterpretationThe commitment of leaders with authority to establish multiple management practices to help staff members learn and apply evidence-based decision-making processes is key to increased use of evidence-based chronic disease prevention to improve population health.

Preferred modalities for delivering continuing education to the public health workforce: a scoping review

“…We identified public health training programs delivered in over 11 countries: Australia, 10,16,17 Bolivia, 18 Brazil, 19 Canada, [20][21][22] Greece, 23 the Islamic Republic of Iran, 24 Mexico, 25 Rwanda, 26,27 Uganda, 28 the United Kingdom 29 and the United States of America (USA). [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] One program offered trainings in over 77 countries, 46 and another trained participants in Austria, Lithuania and the Netherlands. 9 Within the past 7 years, 19 of these articles were published.…”

“…Approaches to evaluation included surveys; 26,27,38,42,43 pre/post questionnaires; 30,31,33,41 participant completion statistics; 19 interviews; 28,45 and mixed methods (a combination of either focus groups or interviews and surveys or questionnaires with participants). 9,10,[16][17][18][20][21][22][23][24][25]29,32,[34][35][36]39,40,44 Evaluations after participation captured participants' demographic information, subject knowledge before and after training, satisfaction with and post-training use of their newly gained knowledge.…”

“…24 Employer support, for instance by providing tools such as computers and designated time to complete the training, was an essential factor in facilitating program completion. 10,19,20,22,25,44,45 Barriers to completing public health training In the context of online training, technological challenges such as sound quality and network issues were cited as one of largest barriers to completing training, 18,20,32 especially in rural locations. 17,26 In one study, some training participants did not use computers in their daily work so they were not familiar with the technologies used for the course, which resulted in poor uptake.…”

Préférences en matière de modalités pour assurer la formation continue du personnel en santé publique : revue de la portée

“…Les objectifs et les méthodologies des évaluations étaient variés, l'évaluation reposant sur des sondages 26,27,38,42,43 , des questionnaires au début et à la fin de la formation 30,31,33,41 , des statistiques sur l'achève ment de la formation par les participants 19 , des entrevues 28,45 et des méthodes mixtes (combinaison de groupes de discussion ou d'entrevues avec des sondages ou des questionnaires à remplir par les participants) 9,10,1618,2025,29,32,3436,39,40,44 .…”

General Practitioners’ Perceptions of their Practice of Evidence-based Chronic Disease Prevention Interventions: A Quantitative Study in Shanghai, China

“…The efficient global prevention and control of chronic disease has gradually become a focus for scholars [1][2]. Evidence-based chronic disease prevention (EBCDP) has emerged and become popularized as a scientific tool to increase the efficiency of preventing and controlling diseases in developed countries [3].…”