Civic education translates research evidence about topics of social importance for broad public audiences, with increased understanding and meaningful action of the desired outcomes. For the Sake of All is an example of civic education on the social determinants of health and health disparities situated in the local context of St. Louis, Missouri. This article describes the research translation, community engagement, strategic communication, and approach to policy that characterized this project. It presents data highlighting racial disparities in health, educational, and economic outcomes, along with policy and programmatic recommendations. Engagement and implementation strategies are described within the context of the events in Ferguson.
The research community faces a growing need to deliver useful data and actionable evidence to support health systems and policymakers on ways to optimize the health of populations. Translating science into policy has not been the traditional strong suit of investigators, who typically view a journal publication as the endpoint of their work. They are less accustomed to seeing their data as an input to the work of communities and policymakers to improve population health. This article offers four suggestions as potential solutions: (1) shaping a research portfolio around user needs, (2) understanding the decision-making environment, (3) engaging stakeholders, and (4) strategic communication.
OBJECTIVESWe examined the perceived importance of scientific resources for decision-making among local health department (LHD) practitioners in the United States.METHODSWe used data from LHD practitioners (n = 849). Respondents ranked important decision-making resources, methods for learning about public health research, and academic journal use. We calculated descriptive statistics and used logistic regression to measure associations of individual and LHD characteristics with importance of scientific resources.RESULTSSystematic reviews of scientific literature (24.7%) were most frequently ranked as important among scientific resources, followed by scientific reports (15.9%), general literature review articles (6.5%), and 1 or a few scientific studies (4.8%). Graduate-level education (adjusted odds ratios [AORs] = 1.7-3.5), larger LHD size (AORs = 2.0-3.5), and leadership support (AOR = 1.6; 95% confidence interval = 1.1, 2.3) were associated with a higher ranking of importance of scientific resources.CONCLUSIONSGraduate training, larger LHD size, and leadership that supports a culture of evidence-based decision-making may increase the likelihood of practitioners viewing scientific resources as important. Targeting communication channels that practitioners view as important can also guide research dissemination strategies.
Evidence based public health (EBPH) in local health departments (LHDs) is a process that involves translating the best available scientific evidence into practice. However, EBPH and implementation of evidence based programs and policies in LHDs are not widespread. This report outlines the patterns and predictors of the use of administrative evidence based practices (A-EBPs) in a national sample of LHD directors. LHDs can improve performance, prepare for accreditation and ultimately improve community health by utilizing an administrative evidence based process.
Among the challenges facing research translation-the effort to move evidence into policy and practice-is that key questions chosen by investigators and funders may not always align with the information priorities of decision makers, nor are the findings always presented in a form that is useful for or relevant to the decisions at hand. This disconnect is a problem particularly for population health, where the change agents who can make the biggest difference in improving health behaviors and social and environmental conditions are generally nonscientists outside of the health professions. To persuade an audience that does not read scientific journals, strong science may not be enough to elicit change. Achieving influence in population health often requires four ingredients for success: research that is responsive to user needs, an understanding of the decision-making environment, effective stakeholder engagement, and strategic communication. This article reviews the principles and provides examples from a national and local initiative.
Objectives. There are sparse data showing the extent to which the process of evidence-based public health is occurring among local health departments (LHDs). The study objective was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance) in a representative sample of LHDs. Methods. A cross-sectional study of 517 LHD directors was conducted. The questions on administrative evidence-based practices included 19 items based on a recent literature review (five domains: workforce development, leadership, organizational climate/culture, relationships/partnerships, financial processes). Results. There was a wide range in attainment of administrative evidence-based practices; mean values were lowest for organizational climate/culture (49.9%) and highest for relationships/partnerships (77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted odds ratios (aORs) ranging from 4.4 to 7.5) and state governance structure (aOR=3.1). Conclusion. The current data and the existing literature suggest considerable room for improvement in administrative evidence-based practices.
Background: Preparing the public health workforce to practice evidence-based decision making (EBDM) is necessary to effectively impact health outcomes. Few studies report on training needs in EBDM at the national level in the United States. We report competency gaps to practice EBDM based on four U.S. national surveys we conducted with the state and local public health workforce between 2008 and 2013.Methods: We compared self-reported data from four U.S. national online surveys on EBDM conducted between 2008 and 2013. Participants rated the importance of each EBDM competency then rated how available the competency is to them when needed on a Likert scale. We calculated a gap score by subtracting availability scores from importance scores. We compared mean gaps across surveys and utilized independent samples t tests and Cohen's d values to compare state level gaps. In addition, participants in the 2013 state health department survey selected and ranked three items that "would most encourage you to utilize EBDM in your work" and items that "would be most useful to you in applying EBDM in your work". We calculated the percentage of participants who ranked each item among their top three.Results: The largest competency gaps were consistent across all four surveys: economic evaluation, communicating research to policymakers, evaluation designs, and adapting interventions. Participants from the 2013 state level survey reported significantly larger mean importance and availability scores (p < 0.001, d = 1.00, and p < 0.001, d = .78 respectively) and smaller mean gaps (p < 0.01, d = .19) compared to the 2008 survey. Participants most often selected "leaders prioritizing EBDM" (67.9%) among top ways to encourage EBDM use. "EBDM training for specific areas" was most commonly ranked as important in applying EBDM (64.3%).Conclusion: Perceived importance and availability of EBDM competencies may be increasing as supports for EBDM continue to grow through trends in funding, training, and resources. However, more capacity building is needed overall, with specific attention to the largest competency gaps. More work with public health departments to both situate trainings to boost competency in these areas and continued improvements for organizational practices (leadership prioritization) are possible next steps to sustain EBDM efforts.