1. Public Health Information on the Web
HealthLINE
Texas Woman’s University T. Boone Pickens Institute of Health Sciences
January 17, 2013
The Agenda for the class opens with the usual welcome and introductions.
Depending on the audience, you might ask the attendees to volunteer what role they have with Public Health.
Also, the NN/LM Mission is “to advance the progress of medicine and improve the public health.”

2. Agenda Overview - What is public health?
Health promotion and education
Evidence-based practice
Statistics and Data Sets
Keeping Up
Exercises
This current version of the PH on the Web class was adapted from a full 8-hour version of the class. It is based on the concept of modules—4 in total with lots of time for practice with the resources using exercises in 3 of the sections.

3. What is Public Health? MISSION:
improve/promote physical and mental health
prevent disease, injury and disability (Association of Schools of Public Health)
VISION: Healthy People in Healthy Communities
Prevent disease and promote health – logo developed by NACCHO (Natl. Assoc. of City & County Health Officials) to provide a sense of unity and common purpose to public health departments.

4. What is Public Health? http://generationpublichealth.org
These photos illustrate several of the initiatives that Public Health is concerned with. Remember: Healthy People in Healthy Communities!
This video “Healthiest Nation in One Generation” was developed by APHA in for Public Health Week. It provides an excellent overview of some of the topics Public Health encompasses.

5. 20th Century’s Ten Great Public Health Achievements in the U.S.
Vaccination
Motor vehicle safety
Control of infectious diseases
Safer workplaces
Safer and healthier foods
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
Healthier mothers and babies
Decline in deaths from coronary heart disease and stroke
Reference:
Public Health is credited with adding 25 years to the life expectancy of people in the U.S. in the 20th century.
“Global health” and public health are virtually interchangeable. Both view health in terms of physical, mental, and social well-being.

6. Partners in Information Access for the Public Health Workforce
Collaboration of U.S. government agencies, public health organizations and health science libraries.
Mission: Helping the public health workforce find and use information effectively to improve and protect the public’s health.
This may be the most important slide in the PPT and the most important information in the class. Partners in Information Access for the Public Health Workforce (or PHPartners) began as a result of a conference sponsored by the Public Health Service at NLM in A name change and website redesign occurred in 2003.
There is no physical entity “PHPartners”. The website in an information portal created as a collaboration to meet the above mission.

7. Partners in Information Access for the Public Health Workforce
Agency for Healthcare Research and Quality (AHRQ)
American Public Health Association (APHA)
Association of Schools of Public Health (ASPH)
Association of State and Territorial Health Officials (ASTHO)
Centers for Disease Control and Prevention (CDC)
Health Resources and Services Administration (HRSA)
Medical Library Association (MLA)
National Agricultural Library
National Association of County and City Health Officials (NACCHO)
National Association of Local Boards of Health (NALBOH)
National Library of Medicine (NLM)
National Network of Libraries of Medicine (NN/LM)
Public Health Foundation (PHF)
Society for Public Health Education (SOPHE)
This collaboration of U.S. government agencies, public health organizations and health science libraries “partner” to provide the information to the PH workforce.
A variety of resources are needed for PH information.

8. Core Functions and Essential Services
This graphic provides one way of illustrating the core functions and services of Public Health.
“Inform, educate, and empower”: viewed as one of the 10 essential services of Public Health per DHHS.
10 essential services

9. Health Promotion & Education
Resources for health educators and health promotion specialists.
Putting good information in the hands of those who need it.
An informed public is a healthy public.
These points are a reflection of the vision statement of PH: Healthy People in Healthy Communities.
Show this heading as a Main Topic Page in PHPartners.

10. Health Promotion & Education
MedlinePlus
Health Topics
Frequently Requested Topics
Multiple Languages (now 49!)
Health and Wellness
Demographic Groups
Health News
Drugs & Supplements
Videos & Cool Tools
For those in the “know” about M+….what would you stress with the Public Health workforce? Use this question as a discussion point rather than focusing on training in M+; i.e., “what would you want them to know”?

11. Health Promotion and Education
Agency for Healthcare Research and Quality (AHRQ)
Sections useful for health educators and Public Health Preparedness
American Public Health Association (APHA)
“Healthy You”
Free health fact sheets on a variety of topics
Get Ready Campaign and National Public
Health Week

12. Health Promotion & Education
Centers for Disease Control and Prevention (CDC)
A – Z Index
For Specific Groups: State, Tribal, Local & Territorial Public Health Professionals Gateway
New Health Literacy website:
Food and Drug Administration (FDA)
A to Z Subject Index
FDA For You: For Consumers & Patients, For Health Professionals
CDC: Show various categories, A-Z index, and specific groups heading. Use West Nile Virus as example and/or show what comes up in this heading.
FDA A-Z Index different from CDC. Not just for food and drugs; FDA assumes safety of drugs, medical devices, foods, and cosmetics.
Example to show: “microwave ovens”
For Consumers & Patients includes “Health Educators and Students”

13. Health Promotion & Education
Healthy Roads Media
Health information in many languages and multiple formats
Refugee Health Information Network (RHIN)
Health and cultural information for refugees and health providers
RHIN: an NLM resource which is a national collaborative partnership that has created a database of quality, multi-lingual resources, specifically relevant to resettled refugees and asylees (from website), but relevant because of the multi-language and cultural materials.

14. Exercises Part 1

15. Evidence-Based Practice
The second module or section of the class is on Evidence-Based Practice.
I have this example of a 7th-grade science fair project because in some ways, EBP is like a “grown-up” science fair project. That is, the scientific evidence is gathered and used to support a case for a particular program or to support decisions made in public health.

16. Evidence-Based Practice
Collection of scientific evidence to support decisions in public health.
Why is it important?
Allocation of resources
Return on investment
For every $1 spent on smoking cessation programs, you save $1.50 in reduction of health care costs
This example shows how a particular problem prompted funding and a project designed to directly impact the solution.
Evidence-based practice is a “collection of scientific evidence to support decisions in public health.”
It is particularly important in the decision making process because of the determination of allocation of limited resources (esp. $s) and return on investment.
Refer to APHA handout infographic: Funding public health protects our communities and kids, saves lives … and saves money (may print for class materials, but comes out quite small and may be too hard to read)
Example:
“City Initiative Brings Fresh Produce
to Houston’s ‘Food Deserts’”

17. Evidence-Based Public Health
“the development, implementation, and evaluation of effective programs and policies in public health through application of principles of scientific reasoning, including systematic uses of data and information systems, and appropriate use of behavioral science theory and program planning models.”
Source: Brownson, Ross C., Elizabeth A. Baker, Terry L. Leet, and Kathleen N. Gillespie, Editors. Evidence-Based Public Health. New York: Oxford University Press, 2003.
Here is a more sophisticated definition of Evidence-Based Practice, particularly as it applies to the realm of Public Health.

18. PHPartners.org Literature and Guidelines PubMed
More than 20 million citations for biomedical articles
“Research is Just a Click Away…”
Individual Journal Titles
Newsletters
Agency Reports
Let’s go back to the PHPartners site to see some places to look for this scientific evidence. Literature & Guidelines is the second Main Topic Page.
Many of you are expert searches in this realm, but you may not be aware of SEQs or Structured Evidence Queries.

19. Evidence-Based Public Health
Healthy People 2020 Structured Evidence Queries
Guide to Community Preventive Services
Summaries of population-based interventions
CDC and U.S. Dept. of Health & Human Services
SEQs: Use “Food Safety” Topic Area for examples of how searches are conducted.
Also refer to handout in packet on SEQs.
The Community Guide is a resource for evidence-based Task Force recommendations and findings about what works to improve public health.
CDC programs contribute subject matter experts other agencies and organizations contribute their expertise. Provides evidence without having to do full searches.

20. Evidence-Based Public Health
NACCHO Model Practices Database
National Association of County & City Health Officials
National Guideline Clearinghouse (AHRQ)
Guidelines with recommendations, strategies, etc.
NACCHO Model Practices Database is an online, searchable collection of innovative best practices across public health areas. Since 2003, these practices demonstrate how local health departments and their community partners can effectively collaborate to address local public health concerns. Now also includes several interactive features.
A resource to: get and idea, give an idea, try an idea, evaluate an idea, reference an idea.
NGC is a public resource for evidence-based clinical practice guidelines. Based more on clinical practice which may have public health implications and applications. Derived from MeSH terms.

21. Exercises, Part 2

22. Break!!

23. Statistics & Data Sets
Caveat: statistics are collected to meet the needs of the collector!
Organizational perspective and bias
Biases can determine what data are collected, how they are collected and outcomes that are reported
Data: raw numbers; must be processed to be of practical use
Statistics: analyzed raw data in a meaningful format

24. To count … or not to count
“Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted.”
--Albert Einstein

25. Key Features of Health Statistics
Population based
Measure a wide range of health indicators
Often collected and analyzed over a period of time
Include different types of data
Vital (birth, death, marriage, divorce)
Morbidity & mortality
Use and cost of health care
Epidemiology

26. How is the data gathered?

27. Uses of Data and Statistics
Measure wide range of health indicators
Assess costs of health care
Identify needed prevention targets for outcomes (e.g. Healthy People 2020)
Evaluate effectiveness of public health programs

28. Health Data Tools & Statistics
PHPartners.org
Gateway to a wealth of statistics sites and data sets
CDC Data and Statistics
CDC is the best in the world for data & statistics
National Center for Health Statistics (NCHS)
PHPartners again has a Main Topic Page on Health Data Tools and Statistics.
CDC provides a wealth of information with relevant statistics. NCHS sets standards and provides basis for other groups to gather statistics.

29. Health Data Tools & Statistics
FastStats A – Z
Quick access to topics relevant to public health
A to Z listing
BRFSS (Behavioral Risk Factor Surveillance System)
World’s largest telephone survey (both landlines and cell phones)
Tracks health risks in the U.S.
WISQARS (Web-based Injury Statistics Query and Reporting Systems)
Information on fatal and non-fatal injuries
We will talk about 3 resources which provide “big picture” statistics in different realms; i.e., focus on national-level statistics, although state level data may also be available.

30. Health Data Tools & Statistics
State Health Facts Online (Kaiser Family Foundation)
Allows comparison on a state level
County Health Rankings
Provides snapshot of a county’s overall health
These resources provide statistics at the state and county level and also allow cross-comparison between states and counties.

31. Exercises, Part 3

32. Keeping Up and Staying Informed
Staying informed is a professional responsibility.
Being informed is important at every level.
Efficient strategies provide the most value (relevant items) while expending the least amount of time.
It’s easy to become overwhelmed!

33. Why is it important? Ever-increasing amounts of information
New legislation
New guidelines
Funding

34. Strategies Email lists and RSS feeds Tables of contents of journals
Automatic update searches (e.g. My NCBI)
Social media (Twitter, Facebook, blogs)
Joining or following organizations (APHA, NACCHO, SOPHE)
Not all information is available electronically

35. Thank you!
Cheryl Rowan, Consumer Health Coordinator National Network of Libraries of Medicine, South Central Region
South Central Region

36. Closing thoughts….
“Clean water and health care and school and food and tin roofs and cement floors, all of these things should constitute a set of basics that people must have as birthrights.”
~Paul Farmer, Mountains Beyond Mountains,
founder, Partners in Health