Lecture Notes: Evidence-Informed Decision-Making in Public Health (EIDM)

Overview

• EIDM: A model for using research evidence to inform practice and policy decisions in public health.
• Features five overlapping ovals, illustrating the complexity and diversity of public health decision-making.
• Sources of Evidence:
  • Research evidence
  • Community health issues & local context
  • Community & political preferences
  • Public health resources
  • Public health expertise

Model Details

• Four Background Ovals: Represent different sources of evidence:
  • Research Evidence: Data from studies and research.
  • Community Health Issues & Local Context: Specific health challenges and local conditions.
  • Community & Political Preferences: Public opinion and political climate.
  • Public Health Resources: Availability of necessary resources.
• Foreground Oval: Public health expertise needed to integrate evidence.
• Oval Sizes: Indicate equal influence, though actual influence may vary.
• Flexibility: Importance of evidence sources can differ based on settings and circumstances.

Application Example

• Scenario: National report shows variation in respiratory symptoms & public transport usage across Canada.
• Evidence Gathering for a specific community:
  • Research: Investigate links between car emissions and respiratory symptoms.
  • Community Context: Low public transit usage but also lower emissions and symptoms than average.
  • Political Preferences: Residents fear noise, politicians reluctant to raise taxes.
  • Resources: High cost of modifying infrastructure.
• Conclusion: Prioritize community and political preferences over research and resources.
  • Decision: No change to transit strategy due to local conditions.

Alternative Regional Application

• Different Community Scenario:
  • High vehicle emissions & symptoms, low transit usage.
  • Political support for transit, funding options explored.
  • Research supports the link, costs attainable.
• Decision: Implement strategies to encourage public transit.

Key Takeaways

• Complexity: Public health decision-making is intricate, influenced by various evidence sources.
• Adaptability: EIDM allows for tailored decisions based on unique regional circumstances.
• Practice: Using the EIDM model effectively requires practice, but becomes intuitive.
• Consistency with Variability: Even with consistent research evidence, decisions vary based on evidence weighting and regional specifics.