Evidence-based medicine seeks to improve health care by basing practice on demonstrated causal linkages between treatment and effects, and through the development of standardized practices that can be disseminated across a wide variety of health care institutions. Evidence-based practice is now being explicitly applied to public health as seen in the development of community health practice guidelines and national public health performance standards. However, implementation of evidence based practice even in medicine has been problematic, and there are reasons to expect that this will also be true in public health. Through a systematic review of the public health literature and through field observations, this paper demonstrates that at each level of public health practice, from the federal government to grassroots community organizations, gaps exist between the evidence needed for planning and the quality of evidence that is available. Furthermore, the nature of information used for planning varies greatly across different levels of practice, making it difficult for evaluations to provide the evidence needed for all settings. Finally, even when appropriate data are available, the nature of community health programs may preclude the adoption of standardized practices when they fail to consider the social and political context of practice. Recommendations are made for changing evaluation practice to help improve the quality of available evidence, and for how barriers to implementation of evidence-based practice in community health may be addressed.
Learning Objectives: 1. Participants will be able to distinguish different sources of information used for community health program planning. 2. Participants will be able to identify how different levels of public health organizations have different information needs for strategic planning. 3. Participants will be able to articulate how differing information needs present difficulties for evaluations. 4. Participants will be able to identify barriers to the implementation of evidence-based practice in community health.
Keywords: Evidence Based Practice, Evaluation
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.