Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments
Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments
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DOI：
10.1007/s10900-018-0494-0
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发表时间：
2018-10-01
影响因子：
5.9
通讯作者：
Brownson, Ross C.
中科院分区：
文献类型：
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作者：
Allen, Peg;Jacob, Rebekah R.;Brownson, Ross C.
循证公共卫生（EBPH）实践，也称为循证公共卫生，可以改善人群健康，减少人群疾病负担。组织结构和程序可以促进公共卫生机构中的EBPH能力建设。这项研究涉及51个结构化访谈的领导人和项目经理在12个国家卫生部门慢性病预防单位，以确定因素，促进EBPH的实施。去识别访谈的逐字记录在NVIVO定性软件中进行一致编码。编码文本的内容分析被用来确定主题和说明性的报价。主持人的主题包括慢性病预防单位和部门内的领导支持，单位流程，以加强跨计划领域的信息共享和合格人员的招聘和保留，培训和技术援助，以建立技能，并有能力提供支持外部合作伙伴。慢性病预防领导者对EBPH过程的角色建模和对工作人员的期望，以证明拟议的计划和方法是领导支持的关键方面。领导人保护工作人员的时间，以确定和消化证据，解决欧洲公共卫生局缺乏时间的共同障碍。资金不确定性或预算削减、对厄立特里亚公共卫生局缺乏政治意愿以及工作人员更替仍然是挑战。总之，领导支持是EBPH能力建设和实践的关键促进因素。公共卫生机构中具有权威和技能的科和司领导人可以制定管理做法，帮助工作人员学习和应用EBPH流程，并与合作伙伴一起传播EBPH。
Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.