Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C.; Skala, Mahree

doi:10.1177/0145721715601736

Cited by 9 publications

(14 citation statements)

References 18 publications

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“…PHAB lists the Guide as an evidence-based resource ( 9 ). Studies have found that accreditation is related to use of more EBIs in LHDs ( 29 ) and use of evidence in SHDs ( 30 ). In a study by Cilenti et al, LHD participants interviewed reported that accreditation helped to promote use of evidence-based practices, because it required implementing approaches that resulted in desired outcomes ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs

et al. 2020

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Introduction The Community Guide (Guide) is a user-friendly, systematic review system that provides information on evidence-based interventions (EBIs) in public health practice. Little is known about what predicts Guide awareness and use in state health departments (SHDs) and local health departments (LHDs). Methods We pooled data from 3 surveys (administered in 2016, 2017, and 2018) to employees in chronic disease programs at SHDs and LHDs. Participants (n = 1,039) represented all 50 states. The surveys asked about department practices and individual, organizational, and external factors related to decisions about EBIs. We used χ 2 tests of independence for analyses. Results Eighty-one percent (n = 498) of SHD and 54% (n = 198) of LHD respondents reported their agency uses the Guide. Additionally, 13% of SHD participants reported not being aware of the Guide. Significant relationships were found between reporting using the Guide and academic collaboration, population size, rated importance of forming partnerships, and accreditation. Conclusion Awareness and use of the Guide in LHD and SHD chronic disease programs is widespread. Awareness of the Guide can be vital to implementation practice, because it enhances implementation of EBI practices. However, awareness of the Guide alone is likely not enough for health departments to implement EBIs. Changes at the organizational level, including sharing information about the Guide and providing training on how to best use it, may increase its awareness and use.

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Section: Discussionmentioning

confidence: 99%

Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs

et al. 2020

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“…10 – 13 A quantitative study of LHDs in Missouri assessed the use of 20 diabetes-related EBPPs, feasibility of EBPPs, and personal/organizational barriers to evidence-based practice and found LHDs have an important role in implementing EBPPs. 14 Findings indicate that more widespread adoption of EBPPs would be enhanced by increased education about and encouragement of evidence-based decision making (EBDM). EBDM involves making decisions based on the best available scientific or rigorous program evaluation evidence, applying program planning and quality improvement frameworks, engaging the community in assessment and decision making, adapting and implementing EBPPs for specific populations or settings, and conducting sound evaluation.…”

mentioning

confidence: 99%

Factors Facilitating or Hindering Use of Evidence-Based Diabetes Interventions Among Local Health Departments

Poehler

Parks²,

Tabak³

et al. 2019

Journal of Public Health Management and Practice

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Objective: The objective of this study was to assess facilitators, barriers, and capacities to use of evidence-based programs and policies (EBPPs) in local health departments (LHDs). Design: A qualitative study design was used to elicit a contextual understanding of factors. One-hour interviews were conducted among directors and diabetes/chronic disease practitioners from LHDs. A consensus coding approach was used to identify themes. Setting and Participants: Twenty-four participants from 14 Missouri LHDs completed interviews. Results: Themes were identified as facilitators, barriers, or capacities that enhance EBPP use. Facilitators included awareness of EBPPs, leadership and supervisor support of EBPP use, and facilitators to increase capacity to implement EBPPs. Skills development, targeted messaging, and understanding of evidence-based decision-making (EBDM) terminology were needed. Barriers to EBPPs use were described at the individual, organizational, and interorganizational levels and included community buy-in, limited resources, relevance to partners, and time scarcity. Capacities included the ways LHDs learn about EBPPs, methods that influence the use of EBPPs, and resources needed to sustain EBPPs. Top ways to learn about EBPPs were in-person interactions. Staff meetings, meetings with decision makers, and relevant evidence influenced decision making. Resources needed were funding, organizational capacity, and partnerships. Directors' and practitioners' views differed on type of agency culture that promoted EBPP use, preferences for learning about EBPPs, ways to influence decisions, needs, and barriers to EBPPs. Conclusions: These findings can inform future strategies to support uptake of EBPPs in diabetes and chronic disease control in LHDs. LHDs have a good understanding of EBPPs, but subtle differences in perception of EBPPs and needs exist between directors and practitioners. Investment in capacity building and fostering an organizational culture supportive of EBDM were key implications for practice. By investing in employee skill development, LHDs may increase agency capacity. Researchers should use preferred channels and targeted messaging to disseminate findings.

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“…A pilot study of LHDs in Missouri found organizational characteristics such as LHD size and accreditation status were positively associated with delivering EBIs. 39 While this cross-sectional study does not allow for assessment of causation, it is notable that, at the LHD level, there was a positive association between diabetes prevalence in the state and offering several of the EBIs. This suggests that higher diabetes prevalence may elevate the issue of diabetes as a priority, and LHDs and their partners may respond with additional EBIs; alternately, higher diabetes prevalence may lead to more funding from the Centers for Disease Control and Prevention.…”

Section: Discussionmentioning

confidence: 93%

“…For example, a pilot study in Missouri LHDs found delivering EBIs to be associated with the perception that the agency gives incentives and rewards to help employees use EBDM principles. 39 There is a growing literature that capacity for EBDM can be built with sustained efforts (eg, training, technical assistance). 40 …”

Section: Discussionmentioning

confidence: 99%

Patterns and correlates of use of evidence-based interventions to control diabetes by local health departments across the USA

Tabak

Parks

Allen

et al. 2018

BMJ Open Diab Res Care

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ObjectiveThe nearly 3000 local health departments (LHDs) nationwide are the front line of public health and are positioned to implement evidence-based interventions (EBIs) for diabetes control. Yet little is currently known about use of diabetes-related EBIs among LHDs. This study used a national online survey to determine the patterns and correlates of the Centers for Disease Control and Prevention Community Guide-recommended EBIs for diabetes control in LHDs.Research design and methodsA cross-sectional study was conducted to survey a stratified random sample of LHDs regarding department characteristics, respondent characteristics, evidence-based decision making within the LHD, and delivery of EBIs (directly or in collaboration) within five categories (diabetes-related, nutrition, physical activity, obesity, and tobacco). Associations between delivering EBIs and respondent and LHD characteristics and evidence-based decision making were explored using logistic regression models.ResultsAmong 240 LHDs there was considerable variation among the EBIs delivered. Diabetes prevalence in the state was positively associated with offering the Diabetes Prevention Program (OR=1.28 (95% CI 1.02 to 1.62)), diabetes self-management education (OR=1.32 (95% CI 1.04 to 1.67)), and identifying patients and determining treatment (OR=1.27 (95% CI 1.05 to 1.54)). Although all organizational supports for evidence-based decision making factors were related in a positive direction, the only significant association was between evaluation capacity and identifying patients with diabetes and determining effective treatment (OR=1.54 (95% CI 1.08 to 2.19)).ConclusionSupporting evidence-based decision making and increasing the implementation of these EBIs by more LHDs can help control diabetes nationwide.

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Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments

Cited by 9 publications

References 18 publications

Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs

Use and Awareness of The Community Guide in State and Local Health Department Chronic Disease Programs

Factors Facilitating or Hindering Use of Evidence-Based Diabetes Interventions Among Local Health Departments

Patterns and correlates of use of evidence-based interventions to control diabetes by local health departments across the USA

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