Evidence-Based Decision Making
Evidence Based Decision-Making is a process for making decisions about a program, practice, or policy that is grounded in the best available research evidence and informed by experiential evidence from the field and relevant contextual evidence.
The process includes:
- Gathering evidence
- Interpreting evidence
- Applying what is learned from evidence
Throughout this process, it is important to make sure the program or intervention is relevant to the target population. You may need to consider adapting it for your audience.
For more information view the Evidence-Based Decision Making: The Intersection of Public Health and Health Care infographic.
Influence on Evidence-Based Decision Making
This Venn diagram shows the relationships among 5 concepts. Notice how the three circles in the middle of the graphic overlap with each other:
- Best available research evidence
- Resources, including practitioner expertise
- Population characteristics, needs, values, and preferences
The “Decision-making”circle is created in the space where the three circles overlap. This is where the most effective solutions and innovative interventions can be developed.
The group of 4 circles is surrounded by “environment and organizational context.” It’s important to also consider other factors that affect the target populations including:
- Culture, community & lifestyle
- Language & reading levels
- Access to care & transportation
Taking the information from all four circles into account can help guide your program or intervention.
Why Use Evidence-Based Decision Making?
Using evidence-based decision making increases the likelihood that interventions will be successful and make a positive impact on policy, funding, or program decisions that affect public health and health care. Using this process gives us the opportunity to invest in something that works to improve health and prevent disease or injury.
What is Evidence?
Evidence can exist in different forms, varying from objective to subjective data. To the right are examples of different types of data that are important for prevention efforts.
- Scientific Lit in Systematic Review: The Community Guide
- Scientific Lit in 1+ Peer-Reviewed Journal: County Health Rankings Smoke-free policies for outdoor areas
- Public Health Surveillance Data: YRBS or BRFSS Reports
- Program Data: Avoid Opioid SD Key Data
- Qualitative Evaluation Data: SD Cancer Whitepaper PDF & MTM Report PDF
- Media Marketing Data: Website analytics or focus group studies
- Word of Mouth: Social media trends or topics
- Personal Experience: Testimonials
Levels of Evidence
When searching for evidence-based information, select the highest level of evidence possible.
Systematic reviews, meta-analyses, and critically-appraised topics/articles are considered “filtered” because they have gone through an evaluation process.
The highest levels of evidence may not exist for every subject or question. If this is the case, move down the pyramid as you search for additional resources.
Evidence-Based Decision-Making Checklist
Using the Evidence-Based Decision Making process can help inspire questions and lead to success. See how organizations and communities have used this process to improve healthcare practices. Explore Success Stories.
Three Buckets of Health
The Centers for Disease Control (CDC) has developed a conceptual framework with 3 categories—or “buckets”—of prevention. Each one is needed to yield the most promising results for a population, regardless of whether the population is defined narrowly, (i.e. the patients in a medical practice) or broadly (i.e. the residents of a state).
This 3-part framework may be useful as a way of maximizing the likelihood that clinicians, insurers, and public health practitioners attend to traditional office-based as well as innovative clinical approaches and do not neglect the community factors that have an enormous impact on health.
Traditional Clinical Interventions
These interventions happen when health care providers are involved in routine one-to-one encounters, such as seasonal flu vaccines or colonoscopies.
Innovative Clinical Interventions
Interventions that are patient focused but have not been paid for by insurance and occur outside the health care provider’s office, such as National Diabetes Prevention Program, or community health workers who provide home-based education and remediation for families of children with asthma.
These interventions no longer focus on a single patient, rather an entire population, such as smoking ban regulations or laws, or community-wide efforts to promote healthy eating and physical activity.
Intersection of Public Health and Health Care
These activities maximize the likelihood that clinicians, insurers, and professionals who practice public health attend to traditional office based as well as innovative clinical approaches that do not neglect the community factors that impact health outcomes.
Coordinated multi-sector initiatives, guided by evidence and promoting all buckets simultaneously can result in largest gains.
Adapt a Program, Practice, or Policy to Fit a Population
Balance between the implementation of a program, practice, or policy as it was designed, and relevance to the priority population is critical. Changes may have to be made to increase fit or compatibility with the priority population. When adapting or making changes, it is important to be mindful of the elements responsible for positive results in the original program, practice, or policy to ensure they are retained.
To avoid misaligning the program, practice, or policy with the needs of the priority population, refer to the following tools and resources:
- Considerations When Adapting a Program: Rural Health Information Hub—Rural Community Health Toolkit designed to support rural communities to develop a community health program.
- Program Practice or Policy Fit and Adaptation Assessment: Association of State and Territorial Health Officials—Policy planning tools for State Health Officials to assess readiness to advance evidence-based public health policies.
- Program Practice or Policy Comparison Tool: Association of State and Territorial Health Officials—Policy planning tools for State Health Officials to assess readiness to advance evidence-based public health policies.
- Program Practice or Policy Adaptation Guidance Tool: Association of State and Territorial Health Officials—Policy planning tools for State Health Officials to assess readiness to advance evidence-based public health policies.
- Assessing and Finding Evidence
- Adapt Interventions to Fit Your Population
- Data Analysis, Dissemination, and Evaluation
- Understanding and Addressing Cultural Competency and Humility to Improve Health Equity
- Public Health 3.0 and Evidence-Based Decision-Making Tools
Use these resources and tools to make evidence-based decision making accessible and realistic:
Evidence-Based Practices & Programs
- Association of State and Territorial Health Officials: Access information on how to implement evidence-based public health, as well as tools for state and territorial health officials, and key initiatives in evidence-based public health.
- Best Practices: Public health programs, interventions, and policies that have been evaluated, shown to be successful, and have the potential to be adapted and transformed by others working in the same field.
- Evidence-Based Guidelines: provide summaries of evidence and recommendations for practice from government agencies, professional organizations, and convening expert panels.
- Global Health Cost-Effectiveness Analysis (GH CEA) Registry: A database of cost-effectiveness analysis studies that evaluate a variety of health interventions worldwide.
- Grey Literature: Information produced outside of traditional publishing and distribution channels e.g., conference abstracts, presentations.
- National Institutes of Health: Access federal resources that can help identify evidence-based disease prevention approaches that have the potential to impact public health.
- Pre-Formulated and Filtered Searches of Published Studies: Specialized searches of PubMed/MEDLINE on specific public health topics or limited to studies that correspond to a specific research category.
- Prevention Research Center in St. Louis Prevention Research Center: The purpose of this site is to provide public health professionals and decision-makers with resources and tools to make evidence-based public health practice accessible and realistic.
- Public Health Databases and Resources: Resource lists are a combination of resources highlighted and used in EBPH trainings as well as resources identified as often used by public health professionals.
- Surveillance Data: The collection, analysis, and use of data to target public health prevention.
- Systematic Reviews: Systematic reviews and meta-analyses of the literature that use specific methods and criteria to locate, appraise, and synthesize the evidence from research studies.
- University of Massachusetts: Access free online evidence-based public health (EBPH) resources, knowledge domains of public health, and public health journals and databases.
- Evidence Based Practice Tutorial: Duke University Medical Center Library & Archives. Access training for any health care practitioner or student on the principles of evidenced-based practice.
- Evidence-based Public Health Training: Colorado School of Pubic Health offers online training on core concepts regarding evidence-based public health.
- Northwest Center for Public Health Practice: Access a wide variety of training opportunities for public health professionals.
- Region V Public Health Training Center: Access a wide variety of training to support public health practices.
- TRAIN: A national learning network that provides quality training opportunities for professionals who protect and improve the public’s health.
- Toolkits and Resources: LEAD Public Health (Workforce Development Training, Enhancing Leadership/Developing Skills, Organizational Culture, Relationships and Partnerships, Financial Practices, General Resources).
- Winnable Battles and The Community Guide: Association of State and Territorial Health Officials – A crosswalk between the CDC Winnable Battles and Community Guide Task Force recommendations.