Defining the spectrum of evidence for policy, system and environmental change strategies: Forum for feedback

Background: Decision-makers and practitioners need a clear, easy-to-understand framework to identify promising and effective policy, system and environmental (PSE) strategies that are most likely to make meaningful and lasting changes in their communities, states, and regions. The U.S. Department of Health and Human Services (HHS) has commissioned an expert panel of researchers, policy makers, and community and state practitioners to define this evidence spectrum for PSE strategies. Methods: A review of grey, extant, and published literature on tools and methods related to assessing evidence for PSE was conducted and turned into a brief report. Panelists will have reached agreement on PSE definitions, defined the evidence-based spectrum, develop guidelines for quality assessment and inclusion criteria, and developed a protocol to examine the evidence. Results: The defined evidence spectrum will go beyond the typical evidence-based reviews of assessing the relationship of a specific program intervention to health outcomes. In addition to identifying useful health outcomes, the Panel will also consider the inclusion of intermediate or proximal outcomes and critically examine community processes and engagement. In addition, the quality assessment will consider methodologies beyond replicated, randomized control trials. The panelists' draft spectrum will be completed by September 2013. HHS staff and key panel members will present their process and the resulting spectrum, and participant input will be sought using participatory techniques. Discussion: Participating audience members will be asked to have an open discussion about how the spectrum can be a meaningful tool for examining the evidence for PSE for the public health community.