PCCHD is a mid-sized health department governed by a local board of health. Initial contact was made between the director and the research team through an EBDM training. The Pueblo City–County Health Department (PCCHD), located in southeastern Colorado, was selected for this case study because of the public health director’s interest in establishing EBDM as standard practice throughout the department. This article describes an assessment of AEBPs and individual staff-member factors in a local health department involved in adopting EBDM, the activities related to promoting EBDM that took place over 1 year, and the impact of those activities on staff attitudes and perceptions toward EBDM. Organizational structures and activities associated with EBDM performance, called administrative evidence-based practices (AEBPs) (5), fall into 5 domains: workforce development, leadership, organizational culture and climate, relationships and partners, and financial characteristics of the agency (7). Other national data show the importance of agency size and make-up (ie, types of staff members and their qualifications) in EBDM (7,8). One survey of 447 state and territorial health care practitioners treating chronic disease showed that the strongest barriers to using EBDM were organizational factors (6). These include philosophical differences between practitioners and researchers lack of time, money, or incentives and insufficient organizational support (5). Research shows that EBDM practice does not happen organically (5) there are common barriers to engaging local health departments in EBDM. Public Health Accreditation Board Standard 10 requires the use and dissemination of evidence (3), which contributes to the momentum for EBDM.Īlthough the key tenets of EBDM are now well established (1,4,5), information is sparse on how to implement EBDM concepts in day-to-day public health practice. EBDM produces high-quality information on what works in populations, resulting in implementation of successful programs and policies, greater workforce productivity, and more efficient use of funding (1). EBDM is a process used to determine the best intervention for a population it is rooted in community needs, practitioner experience, and existing evidence (2). Future research may provide insight into tailoring EBDM within and across local health departments.Įvidence-based decision making (EBDM) provides a framework to address many critical challenges (eg, setting priorities, making efficient use of resources) facing the public health system (1). Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). A follow up survey was administered 1 year after the initial assessment. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Research partners engaged staff to understand factors that increase or deter its use.Ī survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners.Īdministrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs.
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