What is EvidenceBased Public Health Ross C Brownson

What is Evidence-Based Public Health? Ross C. Brownson Saint Louis University School of Public Health May 14, 2007 Council for Training in Evidence-Based Behavioral Practice

“Public health workers… deserve to get somewhere by design, not just by perseverance. ” Mc. Kinlay and Marceau

What is “Evidence”? Scientific literature in systematic reviews l Scientific literature in one or more journal articles l Public health surveillance data l Program/policy evaluations l Qualitative data l Objective – Community members – Other stakeholders Media/marketing data l Word of mouth l Personal experience l Subjective

Key Issues/Controversies § How do we address the variability in training in public health practice? § Only 22% of local public health leaders have graduate degrees in public health § How do we balance disciplinary skills (epidemiology, behavioral science) with cross-cutting skills (management, leadership)? § What should be the role of community involvement in shaping public health research & practice? § What constitutes acceptable evidence?

The effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials…. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute. Smith and Pell, BMJ, 2004

Key Issues/Controversies § Who should be trained? § Related organizational challenges § What is the “horizon” for success? § When we have evidence-based guidelines (e. g. , the Community Guide), how do we ensure implementation?

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