Transcript Slide 1

Selecting
an Evidence-based Approach (EBA)
with the Best Fit
Image courtesy of Naypong at FreeDigitalPhotos.net
Where do We Stand?
Assessing
your
Community
Establishing
Goals &
Objectives;
Planning for
Evaluation
Finding
Evidence
Selecting Best
Fitting EBAs
Adapting
Implementing &
Evaluating
Session Objectives
• Describe basic principles for selecting an
approach that fits the organization and
population
• Assess the fit between approaches and the
organization and population
• Select an approach that fits the organization and
population
Refresher: Types of EBAs
• Program
o Intervention that includes instructions and specifies
materials
• Policy
o System of laws, regulatory measures, courses of
action, or funding priorities
• Strategy
o Broad recommendation
Steps for Selecting Candidate EBAs
1. Obtain information about EBAs
2. Assess fit by comparing candidate EBAs with
community assessment findings according to fit criteria
a. Basic fit
b. Detailed fit
3. Select EBA based on fit and strength of evidence
Obtain General Information about EBAs
Assessing Basic Fit
EBA 3
Community Assessment Findings
 Health goals
 Behavioral/ environmental
objectives
 Priority population
 Organization/coalition
(capacity and resources)
Compare
EBA 2
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EBA 1
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Assessing Detailed Fit
• To assess detailed fit, get EBA materials such as:
• Educational materials (e.g., handouts, booklets, etc.)
• Protocols and implementation guides
• Information from EBA website and EBA developers
• Journal articles or other literature about the EBA
Detailed Comparison of EBAs & Community
Assessment Findings
1. Health goals, behavioral and environmental
objectives
2. Determinants - objectives
3. Delivery possibilities and preferences
4. Characteristics of priority population
5. Organization/ coalition/ community context
1. Health Problem, Behavior
Compare the community assessment findings to the EBA:
• Community assessment
– Prevalence & seriousness of health problem, behaviors
– Objectives related and specific behaviors, e.g.,
1. Decide to get colorectal cancer screening
2. Choose type of screening test
3. Make appointment for screening
4. Keep appointment
• Evidence-based approach (EBA)
– Which behavioral outcomes were effectively changed?
1. Health Problem, Environment
• Community assessment, e.g.,
– Lack of available and accessible screening facilities
– Objective:
Increase availability and accessibility of screening facilities
• EBA
– Are these issues addressed by the EBA?
2. Determinants
Methods
Mild fear
arousal
Belief
selection
Persuasive
communication
Modeling
Objectives
Determinants
Awareness,
Risk perception
Beliefs
Attitudes
Self-Efficacy
Goal
Behaviors &
Environment
FOBT
Health
Reduce CRC
morbidity &
mortality
Access to
Free/low cost tests
Methods to Use to Influence Determinants
*From Bartholomew, LK, Parcel GS, Kok G, Gottlieb NH, & Fernandez ME (2011) Planning
Health Promotion Programs: An Intervention Mapping Approach. San Francisco: Jossey-Bass
3. Delivery
• Community assessment
– Capacity and resources: setting, channels,
personnel, e.g., via general-audience oriented or
ethnic-audience oriented channels; via community
health workers
• Population: which used, preferences/ attitudes?
• Capacities and resources: which channels available
• EBA
– Delivery setting, format, program deliverers, channels
used
4. Priority Population
• Community assessment
– Priority population’s
characteristics
Image courtesy of stockimages at FreeDigitalPhotos.net
• Evidence-based Approach
– Statistics*
– Pictures*
– Language*
American Cancer Society, Surveillance Research, 2013
*Kreuter M.W., Lukwago, S.N., Bucholtz, D.C., Clark, E.M., & Sanders-Thompson, V. (2003) Achieving cultural
appropriateness in health promotion programs: targeted and tailored approaches. Health Educ Behav, pp. 133146.
5. Capacity and resources
• Community assessment
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Existing programs/ facilities
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Facilitators and barriers for implementation
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Infrastructure, leadership, other roles
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Capabilities, willingness, and resource
• EBA
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What is needed for implementation?
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Which contextual factors influenced effectiveness?
Selecting an EBA
EBA Selection Tool
Activity: Comparison Tool Activity
with Nutrition Programs
Activity: Comparison Tool Activity
1. Read the case community information and the 2
EBA program descriptions individually
2. Complete the Comparison Tool in a small group
3. Discuss:
– Share what fit and didn’t fit for each program.
– Which program would you choose?
4. Share decisions and rationale with the large
group
Additional Considerations
•
What is the relevance & strength of the evidence?
•
How much certainty is there about the effectiveness
of the EBA?
•“Real world” effectiveness
vs “ideal world” efficacy
•Systematic review
vs a single program evaluation
Real World Effectiveness & RE-AIM
• REACH your intended target population
• EFFECTIVENSS or efficacy
• ADOPTION by target staff, settings, or
institutions
• IMPLEMENTATION consistency, costs and
adaptations made during delivery
• MAINTENANCE of intervention effects in
individuals and settings over time
Single Study vs.
Review of Multiple Studies
Research Tested
Intervention Programs
(RTIPS)
Community
Guide
Recommended
Strategies
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Scenario 1
Scenario 3
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Scenario 2
Scenario 4
Take-home Points: Importance of
Selecting an EBA with the Best Fit
• Refer to your community assessment when considering fit
• Select evidence-based programs, strategies and policies
that fit your
o Goals and objectives, including for determinant change
o Delivery possibilities and preferences
o Characteristics of the priority population
o Organization/coalition/community context
• Select EBAs with a stronger evidence base
Questions?