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:

  1. Gathering evidence
  2. Interpreting evidence
  3. 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

Evidence-Based Decision Making Venn Diagram
Domains that influence evidence-based decision making. Source: Satterfield JM et al (2).

This Venn diagram shows the relationships among 5 concepts. Notice how the three circles in the middle of the graphic overlap with each other:

  1. Best available research evidence
  2. Resources, including practitioner expertise
  3. 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:

  1. Culture, community & lifestyle
  2. Language & reading levels
  3. 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.

Objective

subjective

Levels of Evidence

When searching for evidence-based information, select the highest level of evidence possible.

TRIP Database Pyramid
EBM Pyramid and EBM Page Generator, Copyright 2006-2014 Trustees of Dartmouth College and Yale University. All Rights Reserved. Produced by Jan Glover, David Izzo, Karen Odato and Lei Wang.

TRIP Database

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

Once an issue has been identified through data collection and a needs assessment, use a Checklist to help you make strong evidence-based decisions that allow you to more easily inform and implement changes. 

Download our Evidence-Based Decision Making Checklist to get started.

Success Stories

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.

Buckets of 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.

Idea Starter

Idea starter: Check the information on the SD Diabetes website which includes information on clinical interventions.

Community-Wide Interventions

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.

Explore Icon

Explore: Visit the BeFreeSD and HealthySD websites for information on community-wide interventions.

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.

Reference Best Practices Icon

Reference Best Practices: The Best Practices Guide for Cardiovascular Disease Prevention describes and summarizes scientific evidence behind 8 effective strategies for lowering high blood pressure and cholesterol levels that can be implemented in health care systems that involve community-clinical links.

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:

Good Example Icon

Good Example: The Canli Coalition of the Cheyenne River Sioux Tribe is one of only three Tribes in the US to have passed a comprehensive indoor smoke-free air policy. They developed a framework, embedded cultural lifeways, and adapted a toolkit to help reduce health inequities of Native people.

Trainings

Resources

Training participants and viewers will need to have, or create, a TRAIN account in order to access the recordings. If you experience issues with the TRAIN platform, please email .

Use these resources and tools to make evidence-based decision making accessible and realistic:

Evidence-Based Practices & Programs

Training

Tools

  • 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 GuideAssociation of State and Territorial Health Officials – A crosswalk between the CDC Winnable Battles and Community Guide Task Force recommendations.