Preparing Public Health Professionals to Make Evidence-Based Decisions: A Comparison of Training Delivery Methods in the United States

Abstract

Background: Evidence-based decision making (EBDM) in health programs and policies can reduce population disease burden. Training in EBDM for the public health workforce is necessary to continue capacity building efforts. While in-person training for EBDM is established and effective, gaps in skills for practicing EBDM remain. Distance and blended learning (a combination of distance and in-person) have the potential to increase reach and reduce costs for training in EBDM. However, evaluations to-date have focused primarily on in-person training. Here we examine effectiveness of in-person trainings compared to distance and blended learning.Methods: A quasi-experimental pre-post design was used to compare gaps in skills for EBDM among public health practitioners who received in-person training, distance and blended learning, and controls. Nine training sites agreed to replicate a course in EBDM with public health professionals in their state or region. Courses were conducted either in-person (n = 6) or via distance or blended learning (n = 3). All training participants, along with controls, were asked to complete a survey before the training and 6 months post-training. Paired surveys were used in linear mixed models to compare effectiveness of training compared to controls.Results: Response rates for pre and post-surveys were 63.9 and 48.8% for controls and 81.6 and 62.0% for training groups. Participants who completed both pre and post-surveys (n = 272; 84 in-person, 67 distance or blended, and 121 controls) were mostly female (89.0%) and about two-thirds (65.3%) were from local health departments. In comparison to controls, overall gaps in skills for EBDM were reduced for participants of both in-person training (β = −0.55, SE = 0.27, p = 0.041) and distance or blended training (β = −0.64, SE = 0.29, p = 0.026).Conclusions: This study highlights the importance of using diverse methods of learning (including distance or blended in-person approaches) for scaling up capacity building in EBDM. Further exploration into effective implementation strategies for EBDM trainings specific to course delivery type and understanding delivery preferences are important next steps.

The University of California San Francisco (UCSF) Training Program in Implementation Science: Program Experiences and Outcomes

“…Both training platforms effectively enhanced competency of learners in implementation science skills. This finding parallels other comparisons of online vs. in-person trainings (19,20), in which the competency and skills delivered over the short-to medium term are approximately the same between modes of delivery. The longitudinal distance mentorship in our training program likely offset typical critiques of lack of personal interaction within online platforms.…”

The Public Health Leadership and Implementation Academy for Noncommunicable Diseases

“…The summer course was followed by a structured 9-month, in-country mentored phase that involved distance learning through monthly webinars and participant-led implementation projects (Box). Interactive webinars were used to reinforce learning and promote trainee engagement during the in-country program phase (26,27). Mentorship is critical to career development among junior investigators (28) and to implementation research training (14); thus, it was offered to all trainees to promote in-country project completion and trainee career development.…”

“…The use of technology for distance learning, which was instrumental to deliver the in-country portion of our program, is another strategy worth exploring to sustain the program. Evidence from the United States shows distance learning is an effective, wide-reach strategy to build evidence-based decision making capacity (27); thus, using distance learning strategies could help increase the scale and reach of the PH-LEADER program.…”

The Association Between Evidence-Based Decision Making and Accreditation of State Health Departments

“…Evidence-based decision making (EBDM) in public health practice involves “making decisions using the best available scientific evidence, systematically using data and information systems, applying program-planning frameworks (that often have a foundation in behavioral science theory), engaging the community in assessment and decision making, conducting sound evaluation, and disseminating what is learned.” 8 (p177) Both individual-level and organizational-level supports for EBDM have been identified, including the quality of leadership, workforce training in EBDM, and formal relationships between public health practice and academia. 9 , 10 Although there has been relatively less focus on the association between accreditation and EBDM, several of the findings described previously involve administrative evidence-based practices as delineated by Brownson et al, 11 including governance, use of process-improvement activities, values and expectations of leaders, and interorganizational partnerships. Yeager et al 12 recently analyzed data from the 2017 Public Health Workforce Interests and Needs Survey, showing that respondents from accredited health departments (state or local) were more likely to report awareness of evidence-based public health practice than respondents from (as yet) unaccredited health departments.…”