Finding and using evidence: an illustration of the process

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Anonymous
2011-02-23
I’m not sure who would be the best target audience. For example, the summary statement highlighted that programs should focus on reducing transmission from children and that hand washing may be a means of doing this. However, the summary points out that this finding is only “broadly supported by studies with higher risk of bias.”

So would the best audience be the general public? or school-aged children? And is a hand washing program the best intervention to implement? What would you advise?
 
Ciliska, Donna
2011-03-01
If you go back to the PICO for the scenario, we had originally identified the community at large (all ages) as the target population.

Keeping this in mind, another way to interpret the recommendations is to think in terms of the best use of resources during the time of a flu outbreak. Given that resources are limited, what are the best ways to prevent the spread of respiratory viruses? This may help you to think about how to adapt these recommendations.
 
Anonymous
2011-03-07
OK, that helps. I think the key message is that during a flu outbreak, hand washing (with or without antiseptic) is effective and, for those working in a clinical setting, the use of masks (not necessarily N95), gloves and gowns together with hand washing is a must. I think we could easily integrate these recommendations in our pandemic plans, including our communication campaign.
 
Ciliska, Donna
2011-03-10
A useful tool to consider how you might adapt recommendations from research is the Applicability and Transferability tool. Public health decision-makers can use this tool to help determine whether a policy or program is relevant or feasible. Using this tool, you will consider how the research evidence fits with other factors such as political will, community acceptability, existing resources, etc.

For example, you may want to consider what resources you have available to you in order to implement a communication campaign (e.g., who could be a champion to deliver the message? What would be the costs?).

After reviewing the tool, how applicable and transferable do you think a communication campaign would be?
 
Anonymous
2011-03-15
It could be feasible to incorporate these messages into our “Prevent the Spread of Flu” communication campaign. We have been running this campaign annually during flu season. Our MOH supports the initiative and has agreed to be the spokesperson for our radio ads. We could update our messaging this year that frequent hand washing with or without antiseptic is effective.

In terms of transferability, I believe there is a real need (based on local surveillance data) and, if implemented as planned (e.g., radio, newspaper ads, flyers in clinics and hospitals), it would adequately “cover” the entire community.
 
Ciliska, Donna
2011-03-17
You’re on the right track! Now that you have considered the applicability of the intervention, it’s good to think about the actual implementation. At this step, the decision maker will consider some of the potential facilitators and barriers to implementing a program or change in practice. Consider questions like what are the components of the intervention? Who is the intended audience? Who will implement the intervention? How will it be implemented?

It would also be worthwhile to include some steps in your plan to evaluate the effectiveness of your campaign.
 
Anonymous
2011-03-21
Evaluation would definitely be an important part of the implementation plan. We evaluate our communication campaign each year (e.g., overall reach, requests for information, website traffic, etc.). This year we could consider measuring if the campaign led to changes in behavior (e.g., increased hand washing) and if it triggered local clinics to stock up on gloves, simple masks and gowns. Perhaps we could even see if there is a change in surveillance data for incidence of flu, or days absent from school, or work absenteeism?

What do you think?
 
Ciliska, Donna
2011-03-24
Excellent! We have now worked through all of the seven steps of the evidence-informed public health “wheel”. I hope you found this process to be helpful and perhaps applicable to other decisions you may be faced with. Feel free to report back on how the campaign went and any lessons from evaluation.
 
Anonymous
2011-03-28
Thanks Donna. Has anyone else in the network implemented a campaign like this? It would be great to learn about other examples.