Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

Brownson, Ross C.; Fielding, Jonathan E.; Green, Lawrence W.

doi:10.1146/annurev-publhealth-040617-014746

Cited by 251 publications

(332 citation statements)

References 169 publications

(214 reference statements)

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“…Provision of training and technical assistance with external partners is also essential to advance the work of state health department chronic disease units, since local partners both within and outside of the public health sector implement complex multi-level evidence-based approaches [2, 9, 11, 37]. One of the ten essential public health services is to mobilize community partnerships to address public health issues [6, 9].…”

Section: Discussionmentioning

confidence: 99%

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments

et al. 2018

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Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders’ role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

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Section: Discussionmentioning

confidence: 99%

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments

et al. 2018

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“…Health department staff and public health leaders emphasize the importance of clear communication of EBDM principles, expectations, and processes, and sharing of information across programs (2,9–11,14–17). A health department in Ottawa, Canada, found that focusing solely on obtaining and disseminating evidence was not enough, as staff had to learn to think about different ways of approaching their jobs, which raised anxieties (10).…”

Section: Discussionmentioning

confidence: 99%

“…Health departments are directing resources to areas with poor health outcomes but lack of political will for EBDM persists in some corners. Skepticism about the effectiveness of prevention, racism and social inequality, and reluctance in some communities to partner across racial, economic, and rural/urban strata are common challenges requiring nontraditional transdisciplinary work (2). …”

Section: Discussionmentioning

confidence: 99%

“…Evidence-based decision making for chronic disease prevention (EBDM) involves complex processes, including applying program planning and quality improvement frameworks; engaging partners in assessment and decision making; adapting and implementing evidence-based policies and programs; conducting sound evaluation; and using evaluation findings to improve implementation and reach (1,2). Both individual skills and organizational supports are needed to apply and sustain EBDM processes.…”

Section: Introductionmentioning

confidence: 99%

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

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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.

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“…These skills are critical to effective practice and to meeting Public Health Competencies, Public Health Accreditation Board Standards for EBPH, and workforce development goals (8–10). To recognize and deliver EBPH, public health agencies need sufficient capacity (ie, the availability of resources and structures, and a prepared workforce) (5,11). …”

Section: Introductionmentioning

confidence: 99%

Scaling Up Evidence-Based Public Health Training

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Evidence-based public health (EBPH) is the process of integrating science-based interventions with community preferences. Training in EBPH improves the knowledge and skills of public health practitioners. To reach a wider audience, we conducted scale-up efforts including a train-the-trainer version of the EBPH course to build states’ capacity to train additional staff. In this essay, we describe formats for course delivery and local adaptations to content, and we review success factors and barriers for state-based replication of the EBPH training course. Findings were based on our experiences and interviews. EBPH training was delivered in varied blended formats as well as in person and in distance courses, each with advantages and disadvantages. Adaptations were made to meet the needs of learners. Success factors included having committed and competent coordinators and trainers, organizational incentives, leadership support, funding, internal and external collaborators, the infrastructure to support training, and models to learn from. Barriers reported included insufficient staff or trainer capacity; time constraints for organizers, trainers, and participants; and lack of sustained funding. We hope our experience and findings will be a guide for states that are committed to building and sustaining capacity through continued EBPH training. Our lessons may also apply more generally to other workforce development training efforts.

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Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

Cited by 251 publications

References 169 publications

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments

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

Scaling Up Evidence-Based Public Health Training

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