1. 1 Finding and Selecting Evidence- Based Programs: Introduction

2.  Know where to:  Find evidence-based resources on strategies, programs & policies  Look for information when existing resources lack suitable approaches  Gain hands-on experience using RTIPs, The Community Guide, and Canadian Best Practices Portal for Health Promotion and Disease Prevention- three widely-used resources for finding evidence-based strategies and programs 2

3.  Know how to use: ◦ Evidence-based recommendations ◦ Strategies with “Insufficient Evidence”  Describe basic principles for selecting an approach that fits your organization and target population  Assess the fit between potential approaches, your organization and target population  Select an approach that fits your organization and target population 3

4.  Consider the characteristics of the organization or setting  Consider the goals, objectives and target community for your proposed program, policy or strategy  Then, select evidence-based options to match those goals, objectives, and community 4

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6. 6 Goals and objectives help to:  Narrow program scope  Avoid straying from the needs assessment data  Direct your search for evidence-based programs

7. 7 Goals:  The “grand reason” for engaging in your public health effort  Lengthy time period  State the desired end result of the program

8.  The goal for the program is based on: ◦ Location ◦ Health issue ◦ Population  Goal: Reduce cervical cancer mortality among Mexican American women, ages 18-65, in East Los Angeles. 8

9. 9 Objectives:  Much more specific than goals. They state how the goals will be achieved in a certain timeframe.  Objectives should be SMART: S —Specific M —Measurable A —Achievable R —Realistic T —Time-framed

10.  Program priorities: ◦ Raise awareness about cervical cancer screening ◦ Instruct women about when to first get a Pap test and how often ◦ Mention the link between HPV and cervical cancer 10

11.  Our SMART objectives are: ◦ Objective 1: Increase the number of women who receive Pap test screening by 20 percent during the life of the program ◦ Objective 2: Find out about the cervical cancer screening behaviors of this group of women in East Los Angeles ◦ Objective 3: Increase the number of Mexican American women who can state that HPV is linked with cervical cancer by 20 percent 11

12. 12  REMEMBER: Goals and objectives WILL evolve as you develop your strategy or program!

13. Now you are ready to look for Evidence-Based Programs, policies or strategies to match your goals, objectives, and community. 13

14.  Strategies are the methods you might use to address a health issue.  Programs include one or more strategies used together to design an intervention.

15. Environment Behavioral and Educational Policy 15

16.  “Collectively accepted or adopted laws, regulations, and rules that guide the behavior of individuals and societies.” (Brownson R.C. et al., 2003) 16

17.  Focus on influencing change in the broader regulations, ordinances, rule enforcement, and decisions on resource distribution that may affect the contributing factors to the health problem ◦ worksite health plans ◦ patient navigation services ◦ patient reminders with electronic medical records 17 Source: U.S. Department of Health and Human Services. (2003). Planned Approach to Community Health: Guide for the Local Coordinator.

18.  Focus on changes that alter the physical or social environment. Small media (educational posters in offices) Mass media (billboards, commercials) Walking trails 18 Source: U.S. Department of Health and Human Services. (2003). Planned Approach to Community Health: Guide for the Local Coordinator.

19.  Focus on changing the awareness, knowledge, attitudes, and behaviors of community members. ◦ Group education ◦ One-on-one education ◦ Client reminders 19 Source: U.S. Department of Health and Human Services. (2003). Planned Approach to Community Health: Guide for the Local Coordinator.

20.  Can you think of a strategy that might influence both policy and the environment?  What about a strategy that influences behavior and policy? 20

21.  Will depend on which evidence-based program you select  Answers to these questions will help identify strategies: ◦ What specific behaviors do I want my audience to acquire or enhance? ◦ What information or skills do they need to learn to act in a new way? ◦ What resources do I need to carry out the program? ◦ What methods would best help me meet my objectives? 21

22. 22 Image from http://www.balancedweightmanagement.com

23.  A Systematic Review provides a summary of individual research studies that have investigated a phenomenon or question. This scientific technique uses explicit criteria for retrieval, assessment, and synthesis of evidence from individual studies and other research methods. (Forrest & Miller, 2002)  Statistical methods (meta-analysis) may or may not be used to analyze and summarize the results of the included studies. 23 Source: www.cebm.net/index.aspx?o=2148

24.  Skim the systematic review to find research articles that outline relevant interventions/programs. 24

25.  Where do I find evidence-based strategies and programs that fit my needs?  What do I do if there’s no clear-cut strategy/program that fits my situation? 25

26.  The Community Guide to Preventive Services  http://www.thecommunityguide.org/ http://www.thecommunityguide.org/  Strategies for health promotion/disease prevention  The Guide to Clinical Preventive Services  http://www.uspreventiveservicestaskforce.org/reco mmendations.htm http://www.uspreventiveservicestaskforce.org/reco mmendations.htm  Strategies for secondary prevention 26

27.  Research Tested Intervention Programs (Chronic Disease/Cancer Prevention) ◦ http://rtips.cancer.gov/rtips http://rtips.cancer.gov/rtips ◦ Evidence-based programs for health promotion/disease prevention  Cancer Control PLANET (NCI) ◦ http://cancercontrolplanet.cancer.gov/ http://cancercontrolplanet.cancer.gov/ ◦ Topic-based compendium of evidence-based strategies and programs (links Community Guide to R-TIPs)  National Registry of Evidence-based Programs and Practices (NREPP) (substance abuse & mental health) ◦ http://www.nrepp.samhsa.gov/ http://www.nrepp.samhsa.gov/ ◦ Evidence-based programs to mitigate substance abuse/mental health issues 27

28.  Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention  http://cbpp-pcpe.phac-aspc.gc.ca/ http://cbpp-pcpe.phac-aspc.gc.ca/  Strategies and programs for health promotion/disease prevention 28

29.  PubMed  http://www.ncbi.nlm.nih.gov/pubmed/ http://www.ncbi.nlm.nih.gov/pubmed/  US Nat’l Library of Medicine database of peer- reviewed articles  Cochrane Collaboration  http://www.cochrane.org http://www.cochrane.org  Cochrane Summaries provide systematic reviews of available evidence 29

30.  The Community Guide ◦ http://www.thecommunityguide.org http://www.thecommunityguide.org  The Cochrane Collaboration ◦ http://www.cochrane.org http://www.cochrane.org  The Guide to Clinical Preventive Services ◦ http://www.uspreventiveservicestaskforce.org/recommend ations.htm http://www.uspreventiveservicestaskforce.org/recommend ations.htm  Cancer Control P.L.A.N.E.T. ◦ http://cancercontrolplanet.cancer.gov http://cancercontrolplanet.cancer.gov  Other library or online databases ◦ (e.g. PubMed or googlescholar) 30

31. What do I do when there are no evidence-based recommendations (systematic reviews) or packaged interventions that match my community assessment, goals, and organizational capacity? 31

32.  What does the research evidence suggest are the best strategies for addressing the problem in populations and settings similar to ours? 32

33. PubMedPubMed is a service of the US National Library of Medicine® that:  Provides free access to MEDLINE®, the NLM® database of indexed citations and abstracts to medical, nursing, dental, veterinary, health care, and preclinical sciences journal articlesMEDLINE®  Includes additional selected life sciences journals not in MEDLINE  Adds new citations Tuesday through Saturday  Was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) as part of the Entrez retrieval systemNational Center for Biotechnology Information (NCBI)National Library of Medicine (NLM)Entrez retrieval system http://www.ncbi.nlm.nih.gov/pubmed/ 33 Source: http://www.nlm.nih.gov/services/pubmed.htmlhttp://www.nlm.nih.gov/services/pubmed.html

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35.  Databases: ◦ Provide the ability to focus search by subject area, not just keyword (MeSH search in PubMed, for example) ◦ Sorting/searching is more advanced ◦ Other databases: Educational Resource Inforamtion Center, FirstSearch, EBSCO, Academic Search Premier (see “Handout #2: Finding Alternative Sources for EBPs)  Google Scholar: ◦ Can’t search by subject as easily/precisely ◦ Sorting/searching is less advanced 35 Source: http://www.library.illinois.edu/ugl/howdoi/use_google_s cholar.html http://www.library.illinois.edu/ugl/howdoi/use_google_s cholar.html

36.  Whenever you can, speak with the team that developed the program or product in which you are interested. ◦ They can share information about the program that may be helpful ◦ They may answer questions about implementation or adaptation ◦ Look for program websites to find materials and program contacts 36

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40.  Goal: improve teen mental health in Los Angeles County  Objective: decrease % of teens at risk for depression in Los Angeles County by 10%, from 23.1% to 20.8%, by 2024 40

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43.  Working in groups of 2-3 people, find one related programs/policies/interventions from each the following sources: ◦ SAMHSA’s National Registry of Evidence-based Programs & Practices (NREPP): http://www.nrepp.samhsa.gov/http://www.nrepp.samhsa.gov/ ◦ The Canadian Best Practices Portal: http://cbpp- pcpe.phac-aspc.gc.ca/http://cbpp- pcpe.phac-aspc.gc.ca/ ◦ PubMed (using the MeSH subject headings search): http://www.ncbi.nlm.nih.gov/mesh http://www.ncbi.nlm.nih.gov/mesh 43

44.  What did you find?  Were there programs that easily fit your goals/objectives? 44

45. QUESTIONS? 45

46.  Work in groups of 2-3 and decide on a topic issue to focus on. 1.Draft 1 goal and 2 objectives, using local/nat’l data sources. 2.Use The Community Guide or another systematic reviewer to find strategies you might want to consider. 3.Use RTIPs or another database to find at least 2 programs to consider for program implementation. 4.Choose 1 program and explain why you chose that program over the others. 46

47. Wednesday, September 10th: Introduction to Evidence-Based Programs & Community Assessments, Planning for Evaluation Wednesday, September 24th: Finding & Selecting the Right Evidence-Based Program Wednesday, October 15th: Adapting and Implementing Evidence-Based Programs Wednesday, October 29th: Understanding Whether or Not Your Program Worked – and Why