Evidence-informed decision making in public health in action

Abstract

You have been asked by your local health department to join a team looking at ways to increase physical activity in adults and children. A recent report suggests that there is an increase in overweight and obesity in the local population. Your health department includes a largely urban, socioeconomically and ethnically diverse population. As an Environmental Health Specialist, you want to see if the built environment or urban planning interventions could have an effect on rates of physical activity and, ultimately, improve the physical health of your population. Where do you begin? What is evidence-informed public health? Evidence-Informed Public Health (EIPH) is the process of distilling and disseminating the best available evidence from research, context and experience, and using that evidence to inform and improve public health practice and policy. Put simply, it means finding, using, and sharing what works in public health. The National Collaborating Centre for Methods and Tools (NCCMT) recommends a seven-step process of EIPH (NCCMT 2012). This paper will explain the steps in the process and recommend tools to help at each step. Define ''Who is my target group? What is the issue we are dealing with? What specifically are we trying to change?'' The first step of the EIPH process is to clearly define the question or problem in a searchable and answerable format. The PICO (Population, Intervention, Comparison, Outcome) format has been developed to help make the question specific and provide helpful search terms. Using this scenario, an example PICO could be: “ Population: urban community dwellers (adult and child) “ Intervention: urban planning interventions “ Comparison: usual intervention or no intervention “ Outcome: rates of physical activity Outlining the search terms using the PICO format helps you develop a focused search strategy for locating the best available research evidence.