Evidence-Based Practice
for Public Health Project
Funded by a
CDC/ATPM Cooperative Agreement
Lamar Soutter Library
Principal Investigator: Elaine Martin, MSLS, MA
Project Coordinator: Hathy Simpson, MPH
Project Consultant: Roger Luckmann, MD, MPH
Overview
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Rationale & background of the project
Project’s goals
Process used to meet the goals
Description of the project to date
Future plans
Many EBM products have
been developed for busy
medical clinicians but few
EBPH resources are available
for public health
practitioners.
A Definition of EBM
The conscientious, explicit,
judicious use of the current
best evidence in making
decisions about the care of
individual patients.
(Ref: Sackett et al, 1996)
Definition of EBM (cont.)
EBM practice requires integrating
practitioner clinical expertise with
best evidence from systematic
research.
A Definition of EBPH
The conscientious, explicit,
judicious use of the current
best evidence in making
decisions in routine PH practice,
and in developing PH policies and
programs.
(Ref: Sackett et al, 1996)
Definition of EBPH (cont.)
EBPH practice requires integrating
practitioner expertise, accumulated
PH and basic science knowledge, and
regulatory requirements, with best
evidence from systematic research.
Spectrum of Evidence
1. Definitive clinical and epidemiologic
studies of human subjects and
populations
2. Consensus of experts based on
historical observation and
experience in human populations
3. Findings from basic science
research extrapolated to humans
Spectrum of Evidence: Clinical
and Epidemiologic Studies
1. Systematic reviews of multiple valid
intervention studies
2. One or more randomized controlled
trials or other intervention studies
3. Systematic reviews of multiple valid
observational studies or evaluations
4. One or more observational studies
or evaluations
Rationale for Evidence-Based
Practice for Public Health Project
• Increasing amount of high quality,
relevant research in PH and in disciplines
related to PH (medical, behavioral, social
sciences).
• Great need for high quality, evidencebased information by PH practitioners.
• Access to best evidence limited
Evidence-Based Practice
for PH: Key Questions
• What are the knowledge domains of PH?
• What is / Where is the relevant
“evidence” for each domain?
• What are the needs of PH practitioners
for current “evidence” in their fields?
• How can access to required current
evidence be improved?
• What model/s for information delivery
can best meet PH information needs?
Evidence-Based Practice
for PH: Methods.
• Define the knowledge domains of
public health
• Identify and assess existing sources
of EBPH content and existing means of
delivering it
• Examine, classify, evaluate existing
models for synthesizing and delivering
EBM content to medical practitioners
Evidence-Based Practice
for PH: Methods
• Identify characteristics of EBM
synthesis/delivery methods potentially
relevant to models for delivery of EBPH
content.
• Propose model/s for synthesis/delivery
of current EBPH content for selected
knowledge domains and related
practitioner groups.
Identifying the Knowledge
Domains of Public Health
• The field of public health is very
broad and diverse
• Activities range from disease
control to health care financing
Identifying the Knowledge
Domains of Public Health
• There are multiple disciplines
(knowledge domains) within
the field of public health
Public Health is Multidisciplinary
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Epidemiologists
Statisticians
Environmental Engineers
Animal Control Officers
Sanitarians
Food Scientists
Industrial Hygienists
Health Care Administrators
Health Economists
Politicians
• Social Workers
• Mental Health Workers
• Substance Abuse
Counselors
• Doctors
• Nurses
• Teachers
• Disaster Relief Workers
• Nutritionists
• Lab Technicians
What are the
Knowledge Domains
of Public Health?
Process Used to Identify
the Knowledge Domains
of Public Health
• Examined public health sources
• What “knowledge domains” or
areas of public health do these
sources include?
Public Health Sources Used to
Identify the Knowledge
Domains of Public Health
1.
Public health
accreditation criteria
2. Chapters from an
academic public health
reference book
3. Collection categories of
the American Journal
of Public Health
4. Public health
occupational categories
5. Massachusetts
Department of Public
Health
6. American Public Health
Association (APHA)
Public Health Sources Used to
Identify the Knowledge
Domains of Public Health
7. Healthy People 2010
national health
objectives
8. Public health guidelines
from The Guide to
Community Preventive
Services
9. Ten essential services of
public health from the
Public Health Functions
Working Group
10. Library indexes: NLM
journal subject headings
& MeSH; public health
subject headings from
the Library of Congress
Example of a Public Health Knowledge Domain:
Environmental Health
Proposed
Knowledge
Domain of
Public Health
Environmental
Health
Toxicology
Hazardous
Materials
Ecology
Environmental
Microbiology
Environmental
Monitoring
Environmental
Epidemiology
Industrial & Land
Pollution
Accreditation
Maxcy-Rosenau- American Journal
Criteria, Council Last Public Health of Public Health,
on Education for
& Preventive
Collection
Public Health,
Medicine
Categories
Knowledge Areas
Chapters
Environmental
Environmental
Environment
Health Sciences
Health
Biological Factors Toxicology
Physical Factors
Chemical Factors
The Public Health
Work Force,
Enumeration 2000
Occupational
Categories
Environmental
Engineer
Environmental
Engineer
Technician
Chemical
Engineer
Testing
Technician
Environmental
Scientist &
Specialist
Environmentalist
Environmental
Science &
Protection
Technician
Environmental
Health Specialist
Soil & Plant
Scientist
Hazardous
Materials Specialist
Toxicologist
Massachusetts
Dept. of Public
Health,
Bureaus &
Programs
Environmental
Health
Assessment
Community
Assessment
Program
Environmental
Health Education
Program
Environmental
Epidemiology
Program
Environmental
Toxicology
Program
American Public
Health People
Health
2010,
Association,
Focus Areas &
Sections & Special  Leading Health
Interest Groups
Indicators
Environment
Environmental
Health
Toxics & Waste
Infrastructure &
Surveillance
Environmental
Quality
The Guide to
Community
Preventive
Services,
Topics
Public Health
Functions
Working Group,
Essential Public
Health Services
Diagnose and
Investigate
Health Problems
Enforce Laws and
Regulations
Follow-up of
Hazards &
Exposure-related
Diseases
Toxicology
 Pesticides
 Poisoning
 Xenobiotics
Environmental
Medicine
Environmental
Health
 Environmental
Toxicology
 Environmentally
Induced Diseases
Environmental
Microbiology
Environmental
 Air Microbiology
Engineering
 Food
 Environmental
Microbiology
Monitoring
 Soil Microbiology  Environmental
 Water
Testing
Microbiology
Disorders of
Environmental
Origin
Air Pollution
Outdoor Air
Enforcement of
Engineer,
Technician
Air Pollution
Specialist
Quality
Clean Air
Standards
Housing & Health
Environmental
Health
 Ecology
 Pollution
Environmental
Health
Library of
Congress
Subject Headings
Environmental
Monitoring
Pollution
- Housing &
Health
- Buildings &
Health
- Lead Poisoning
- Asbestos
- Radon in Homes
Public Health
NLM,
Medical Subject
Headings
Environmental
Pollution
Outdoor Air
 Indoor Pollution
NLM,
Journal Subject
Headings
Indoor
Air Quality
Childhood Lead
Poisoning
Prevention Program
Healthy Homes &
Healthy
Communities
- Indoor Allergens
- Office Building
Air Quality
- Radon in Homes
- Lead-based
Paint
- Substandard
Housing
Air Pollution
Air Pollution
Air Pollution,
Indoor
 Housing &
Housing
Asbestos
Abatement
Health
Lead Abatement
We Identified 17 (with their subdomains)
Public Health Knowledge Domains
• Epidemiology (6)
• Biostatistics (6)
• Vital Statistics &
Surveillance (7)
• Environmental Health (13)
• Occupational Health (3)
• Health Services
Administration (15)
• Social & Behavioral Sciences
(8)
• Health Promotion & Education
(4)
• Community Health (18)
(includes Maternal & Child
Health)
• Public Health Nursing (3)
• Disaster Control &
Emergency Services (4)
• Communicable Diseases
(16)
• HIV/AIDS (4)
• Chronic &
Noncommunicable Diseases
& Conditions (18)
• Public Health Laboratory
Sciences (5)
• Public Health Informatics
(5)
• Global, International
Health
The Next Step in the Process:
What is the literature
associated with the identified
knowledge domains of public
health?
–Identify public health journals
Process Used to Identify
Public Health Journals
• Used ISI’s Journal Citation Reports to identify
top public health journals by impact factor
• Created a list of public health journals using
three sources:
1. CDC Information Center: list of the most
frequently requested journals
2. Healthy People 2010 Information Access
Project: list of the most frequently cited journals
from formulated search strategies
3. Journals identified through the MLA’s Core
Public Health Journal Project
Public Health Journals
Identified
1. List of the top 25 journals by impact
factor in the subject category: “Public,
Environmental, and Occupational Health”
2. List of 698 public health journals
– Available online?
– Free or by subscription only?
– If free: Internet link (URL)?
The Next Step
What public health literature is
associated for the identified
knowledge domains of public health?
– Match journal titles with knowledge
domains
Example of a Public Health
Knowledge Domain:
Maternal and Child Health
Public Health Knowledge Domain:
Maternal and Child Health
Some associated journals:
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Maternal and Child Health Journal
American Journal of Obstetrics and Gynecology
Paediatric and Perinatal Epidemiology
Archives of Disease in Childhood
Archives of Pediatrics and Adolescent Medicine
Child Abuse and Neglect
Child: Care, Health and Development
The Future of Children
Journal of Child and Family Studies
Pediatrics International
Accomplishments To Date
• Identified the knowledge domains
of public health
• Identified public health journals
• Created project website
• In progress: Match identified
knowledge domains with public
health journals
The Project’s Website
http://library.umassmed.edu/ebpph
Future Goals for the Next Year
• Determine the information needs of
public health workers vs. clinical
workers.
• Identify the characteristics of clinical
EBM products.
• Can any of the characteristics be
applied to a model for evidence-based
public health?
• What is our definition of evidencebased public health?
Future Goals for the Next Year
Continued
• Would public health workers use the
product?
• What features would public health
workers want?
• Choose sample public health knowledge
domains to test evidence-based
model(s) for public health practice.
Evidence-Based Practice
for Public Health Project
Personnel
Principal Investigator: Elaine Martin, MSLS, MA
Project Coordinator: Hathy Simpson, MPH
Project Consultant: Roger Luckmann, MD, MPH
Project Consultant: Sharon Telleen, PhD
Technical Advisor: Jocelyn Rankin, PhD