Scholar-Practitioner Project: Visual Representation of Public Health Leadership Theory
Visual representation
So as to improve the public health practice, evidence-based decision making is extremely important. In this regard, there is a need to formulate a future leadership theory detailing the policies and programs that are scientific and have high chances of being effective. This is also putting into consideration the fact that the evidence base accessible to public health practitioners is expanding continually (Glanz & Bishop, 2010). The theory on evidence-based public health will involve integrating science-based interventions with the community preferences with the intention of improving population health. The process of evidence-based decision making in public health leadership will encompass components such as practitioner expertise in addition to other available resources; best available and accessible research evidence; and the preferences, values, needs, and characteristics of all who will be influenced by the intervention (O’Neall & Brownson, 2005).
Evidence-based decision making is very essential in public health (Jacobs et al., 2010). Generally, the process of making decisions in public health is very complex as a result of group decision making as well as complex inputs. Another fact is that public health evidence normally derives from quasi-experimental and cross-sectional studies as opposed to randomized controlled trials that are considered the ‘gold standard’ in clinical medicine (Dreisinger et al., 2008). On the same note, interventions in public health are seldom single interventions that involve large-scale policy and environmental changes for addressing the needs as well as balancing the preferences of diverse, often large groups of people (Dodson, Baker & Brownson, 2010).
There is a keen need to consider that public health workforce’s formal training is very different from training in medicine as well as other clinical disciplines. Regardless of the fact that disciplines such as health education and epidemiology are very vital, very few public health workers possess formal training in these areas (Kohatsu, Robinson & Torner, 2004).
In the visual representation, it is very evident that there is a dire need for a multidisciplinary approach. If a public health professional takes this approach, there are high chances of the interventions being effective. Considering that there are high heterogeneity levels, it is very important and as indicated in the virtual representation, multiple perspectives should be considered during the decision-making process. Despite the immense efficiencies and benefits linked to evidence-based policies or programs, a majority of the public health interventions are implemented founded on media or political pressures, how it has always been done in the past, or anecdotal evidence. Hence, as indicated in the virtual representation, there is a need to address issues such as skilled personnel, lack of funding, time, and incentives. It is important that when being implemented on a large-scale, evidence-based public health (EBPH) not only needs a workforce that can implement and comprehends EBPH efficiently. In addition, it is important to have sustained support from policy makers, practitioners, and health department leaders.
Such a leadership theory in public health is driven by the call for practitioners to be keen on EBPH concepts in their practice as the US settles on a ten-year national agenda for objectives and goals on health that encompasses the Healthy People 2020 initiative (Koo & Miner, 2010). It is worth pointing out that the mission of this initiative is founded on a multisectoral action, ‘to improve practices and strengthen policies that are guided by the best accessible knowledge and evidence’ (Centers for Disease Control and Prevention, 1999).
So as to achieve the EBPH in relation to the components in the virtual representation, there is a need for information dissemination; conducting sound evaluation; application of program planning frameworks that are founded on health behavior theory; decisions that are founded on the best accessible peer-reviewed evidence (both qualitative and quantitative), using information and data systems systematically, and involving the community in decision-making and assessment (Brownson et al., 2012).
Evidently, public health practitioners have a huge scientific evidence volume at their fingertips. Implementing this evidence can assist practitioners in meeting the demands for systematic approaches aimed at solving public health problems, which would yield measurable outcomes. There is a need for practitioners to have support, knowledge, skills, and time for implementing evidence-based programs and policies. There are many tools that can be very effective in incorporating the best available strategies and evidence into their work (Brownson, Fielding & Maylahn, 2009). Immense improvements in population health can be achieved if the tools are applied in relation to the local context, are evaluated rigorously, and shared with practitioners, researchers, as well as other stakeholders.
Following all kinds of evaluations, it is important that practitioners do not overlook disseminating the findings. On the contrary, they should share it with decision makers, stakeholders, as well as community members. More significantly, the people who participate in data collection should not be left out in the dissemination of findings since they have the ability of making vital use of evaluation findings. Dissemination can take the form of oral presentations, written reports, academic journal publications, or placing the information on websites and newsletters (Brownson et al., 2012).
It is important to note that not all health issues, settings, and populations are represented with evidence-based systematic reviews and guidelines. In addition, there are many kinds of evidences including qualitative research, cohort studies, and randomized controlled trials.
References
Baker, E. A., Brownson, R. C., Dreisinger, M., McIntosh, L. D., & Karamehic-Muratovic, A. (2009). Examining the role of training in evidence-based public health: a qualitative study. Health Promot Pract; 10(3):342-8.
Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health, 30:175-201.
Brownson, R.C., Allen, P., Duggan, K., Stamatakis, K. A., & Erwin, P. C. (2012). Fostering more- effective public health by identifying administrative evidence-based practices: a review of the literature. Am J Prev Med, 43(3): 309- 19.
Brownson, R.C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health, 30: 175- 201.
Centers for Disease Control and Prevention. (1999). Framework for program evaluation in public health. MMWR Recomm Rep; (48 RR-11):1-40.
Dodson, E. A., Baker, E. A., & Brownson, R. C. (2010). Use of evidence-based interventions in state health departments: a qualitative assessment of barriers and solutions. J Public Health Manag Pract; 16(6):E9-15.
Dreisinger, M., Leet, T.L., Baker, E.A., Gillespie, K.N,. Haas, B., & Brownson, R.C. (2008). Improving the public health workforce: evaluation of a training course to enhance evidence-based decision making. J Public Health Manag Pract, 14(2):138-43.
Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in the development and implementation of public health interventions. Annu Rev Public Health; 31:399-418.
Jacobs, J. A., Dodson, E. A., Baker, E. A., Deshpande, A. D., & Brownson, R. C. (2010). Barriers to evidence-based decision making in public health: a national survey of chronic disease practitioners. Public Health Rep; 125(5):736-42.
Kohatsu, N. D., Robinson, J. G., & Torner, J. C. (2004). Evidence-based public health: an evolving concept. Am J Prev Med., 27(5): 417- 21.
Koo, D., & Miner, K. (2010). Outcome-based workforce development and education in public health. Annu Rev Public Health, 31: 253- 69.
O’Neall, M. A., & Brownson, R. C. (2005). Teaching evidence-based public health to public health practitioners. Ann Epidemiol;15(7):540-4.