Framework use in assessing chronic disease prevention interventions

Evidence-based practices have the potential to greatly impact public health, but there is a gap between what evidence shows is effective and what is practiced. There is the need to develop an expedited method for assessing the evidence on existing practices, including policies, which address urgent public health problems. The Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention is developing a rating system to assess the extent to which existing state chronic disease prevention and health promotion policies are evidence based. A high quality evidence base includes study designs that maximize internal validity, credible sources, and evidence derived from practice, theory, and research. Evidence should show that a practice positively impacts health and is equitable, efficient, and transferable across settings. We developed an approach for assessing the evidence basis for public health interventions, based on the Conceptual Framework for Planning and Improving Evidence-Based Practices as well as additional criteria from the literature that were relevant to assessing evidence quality and public health impact. We conducted cursory literature and state law reviews to identify interventions for in-depth analysis, collected the evidence, and applied the approach to assess the strength of the evidence bases. We found interventions related to public access defibrillation, community health workers, and collaborative drug therapy management, among others. The approach was found to be effective in identifying emerging, promising, and best interventions. This presentation will describe: 1) the development of the approach; 2) the results of assessing chronic disease prevention interventions; and 3) how the approach will serve as a valuable resource for decision-makers and practitioners.