Capacity building for evidence-based decision making in local health departments: scaling up an effective training approach

Abstract

BackgroundThere are few studies describing how to scale up effective capacity-building approaches for public health practitioners. This study tested local-level evidence-based decision making (EBDM) capacity-building efforts in four U.S. states (Michigan, North Carolina, Ohio, and Washington) with a quasi-experimental design.MethodsPartners within the four states delivered a previously established Evidence-Based Public Health (EBPH) training curriculum to local health department (LHD) staff. They worked with the research team to modify the curriculum with local data and examples while remaining attentive to course fidelity. Pre- and post-assessments of course participants (n = 82) and an external control group (n = 214) measured importance, availability (i.e., how available a skill is when needed, either within the skillset of the respondent or among others in the agency), and gaps in ten EBDM competencies. Simple and multiple linear regression models assessed the differences between pre- and post-assessment scores. Course participants also assessed the impact of the course on their work.ResultsCourse participants reported greater increases in the availability, and decreases in the gaps, in EBDM competencies at post-test, relative to the control group. In adjusted models, significant differences (p < 0.05) were found in ‘action planning,’ ‘evaluation design,’ ‘communicating research to policymakers,’ ‘quantifying issues (using descriptive epidemiology),’ and ‘economic evaluation.’ Nearly 45% of participants indicated that EBDM increased within their agency since the training. Course benefits included becoming better leaders and making scientifically informed decisions.ConclusionsThis study demonstrates the potential for improving EBDM capacity among LHD practitioners using a train-the-trainer approach involving diverse partners. This approach allowed for local tailoring of strategies and extended the reach of the EBPH course.

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

“…While capacity building is recognized as a core activity for furthering EBPH (105), it is also recognized that capacity building is multifaceted and is often a difficult concept to define (e.g., over 80 distinct characteristics of capacity building have been identified (165)) (74, 119). Capacity building is often described more precisely within the business and management literature than in the health literature (74).…”

Evaluation of an online training for improving self-reported evidence-based decision-making skills in cancer control among public health professionals

“…Several previous evaluations of trainings in EBPH have shown effectiveness 12,13,15,16 but unlike EBCC, these trainings relied on in-person delivery. An evaluation of a train-the-trainer approach for scaling up StL-PRC's EBPH course 13 which was delivered primarily in-person and is very similar to the EBCC training, found overall improvement in EBDM skill availability in participating agencies and, similar to this evaluation's results, specifically improved the availability of evaluation designs, action planning, and communicating research to policy makers skills.…”

“…The training was introduced at conference presentations, via meetings, personal phone calls, newsletters and through tailored emails. During this period, some Nebraska public health professionals also attended the PRC-StL's in-person EBPH training 13,20 in August 2012, but they were excluded from the follow-up sample.…”

“…12,13,15,16 Some of these training programs utilized technology, 11,14 but their effectiveness was not evaluated. Distance learning has been emphasized as a promising training modality in Institute of Medicine's call for improving the capacity of the public health workforce.…”

Barriers and Incentives to Rural Health Department Accreditation

“…[31][32][33] The provision of technical support to RLHDs is another area needed to support for both MOVAP and PHAB accreditation. Using a train-the-trainer model (shown successful for LHDs in related content areas), 34 staff from accredited LHDs could be used as change agents to move the accreditation process forward by providing technical expertise to those rural health departments where accreditation is not seen as a priority. In Missouri, LHDs located in regions with a high proportion of MICH accredited LHDs were more likely to be MICH accredited.…”