Improving public health practice

This week, you begin development of your Scholar-Practitioner Project-Public Health
Leadership Theory. In order to achieve success in this program and as a future leader in
public health, developing your skills for effectively assessing current literature and
evaluating problems is critical. One of the goals of the Scholar-Practitioner Project is to
help you develop such skills.
For this Project Assignment, think about common trends in public health leadership, or
critical areas of need for leadership in the field. Prepare a literature review of scholarly
articles related to your topic. This review should contain a minimum of 10 peer-reviewed
or scholarly resources. Additionally, based on your conducted review of the current
literature, create a problem statement that addresses identified gaps while incorporating
implications for positive social change. Located within the Learning Resources for the
week, you may find the information from Walden’s Online Writing Center helpful for your
completion of the assignment.
Literature Review and Problem Statement (5 pages):
� Literature Review to include:
A synthesis of the literature of at least 10 peer-reviewed, scholarly resources
A description of theoretical gaps in the research
� Problem Statement to include:
� An explanation of the specific problem that addresses identified gaps within the
� An explanation of how your problem statement incorporates implications for positive
social change

Scholar-Practitioner Project Assignment

Evidence-based decision making for improving public health practice: a literature review
Public health practice and research are credited with numerous notable achievements.
This also includes a majority of the thirty-year life expectancy gain in the US over the twentieth
century. A greater portion of this increase is attributable to the provision of safe food and water,
sewage disposal and treatment, tobacco cessation and use prevention, injury prevention,
infectious disease control through immunization, as well as population-based interventions
(Kohatsu, Robinson & Torner, 2004).
Regardless of these achievements, there are numerous additional chances for bettering the
public health practice. So as to achieve national and state objectives for improved population
health, there should be widespread evidence-based strategies’ adoption (O’Neall & Brownson,


2005). More focus on EBPH (evidence-based public health) has immense indirect and direct
benefits, including accessibility to higher and more quality information on the most effective
strategies, increased workforce productivity, as well as efficient private and public resources’
Brownson et al. (2012) note there is a need for particular concepts that can be essential in
achieving a real evidence-based approach as far as the public health practice is concerned. The
first is scientific information on policies and program that have higher chances of promoting
health. This indicates the need for evaluation research aimed at generating sound evidence.
Brownson, Fielding and Maylahn (2009), asserts that there are a wide array of efficient
interventions that are currently available from a number of sources including the Guide to
Clinical Preventive Services, Guide to Community Preventive Services, National Registry of
Evidence-based Programs and Practices, and Cancer Control PLANET. Second, translating
science into practice requires evidence-based interventions’ information from peer reviewed
literature to account for the particular real-world environments’ realities. To achieve this, as
noted by Baker et al. (2009), there is a need for processes resulting to evidence-based decision
making to be powerfully explicit. This should also include using transdisciplinary approaches
towards problem solving. Third, wide-scale interventions’ dissemination should take place more
consistently at the local, state, and federal levels. It is important if these interventions have
proven effectiveness (Koo & Miner, 2010).
Formal discourse regarding the scope and nature of EBPH came about fifteen years ago.
Kohatsu and colleagues widened earlier EBPH definitions to include the community members’
perspectives, while promoting a wholly population-centered strategy. Hence, ‘evidence-based
public health involves the process of integrating science-based interventions with community


preferences to improve the health of populations’ (419). An agreement emerged that combining
scientific evidence, context, and resources was essential in decision making.
Dodson, Baker and Brownson (2010) noted that there exists four overlapping EBPH user
groups. These are all essential in promoting leadership in the EBPH leadership area. The first
group is the public health practitioners possessing managerial and executive roles and with the
desire of knowing the quality and scope of evidence for the alternative strategies, for instance,
policies and programs. The second group of users is the policy makers at the international,
national, state, regional, and local levels. This group is normally required to make macro-level
decisions regarding public resources allocation for which they are the acknowledged stewards.
The 3 rd group comprises of stakeholders that are usually affected by interventions under
consideration (Koo & Miner, 2010). This constitutes of the voting public and interest groups that
are created to oppose or support particular policies, for example abortion legality, fluoridation of
community water supplies, and if adults should be given handgun licenses in case they pass the
background checks. Finally, there is the group of researchers who deal with issues on the
population health. An example is researchers who deal with the evaluation of particular
programs’ or policies’ impacts. Both use and develop evidence for answering the research
questions (Glanz & Bishop, 2010).
Previous researches establish that while these audiences are receiving and generating
evidence in a number of forms, there are several significant concerns that arise;

  1. The size of public health challenges.
  2. If there are efficient interventions through which the problems can be addressed.
    The information on particular interventions and local context that can be useful in
    deciding its potent utilization in the present situation (Glanz & Bishop, 2010).


  1. Whether the policy or program is worth venturing into. This should involve considering
    the alternatives and deciding if they are worth. In addition, there is a need to assess if the
    policy or program will offer desirable return on investment measure through health
    impacts and monetary terms.
    Brownson et al. (2012) asserts that for there to be EBPH leadership, it is worth being familiar
    with the principal features of the evidence-based decision making. In other words, considering a
    number of common, overarching features of a program that is evidence- based in the public
    health practice is worth. Baker et al. (2009) goes on to describe some of the key attributes of
    EBPH as outlined; first is the utilization of information and data systems systematically. Second
    is making decisions that are founded on the most appropriate accessible peer-reviewed evidence
    that is both qualitative and quantitative research. Third, utilizing program planning frameworks,
    whose foundation is usually in the behavioral science theory. The fourth characteristic is
    engaging the community during decision making and assessment. Fifth is conducting sound
    evaluation (Kohatsu, Robinson & Torner, 2004). Sixth, dissemination of all that principal
    decision makers and stakeholders have learned, and finally, synthesizing effective
    communication, scientific skills, political acumen during decision making, and commonsense.
    These characteristics should be incorporated in all programs aimed at improving EBPH in the
    According to Brownson, Fielding and Maylahn (2009), although the formal EBPH
    concept is relatively novel, the skills that underlie this are not. For instance, scientific literature
    review for evidence as well as evaluating program interventions are skills usually taught in
    public health graduate programs as well as other academic disciplines. In addition, they are vital
    building blocks in the practice of public health. Dodson, Baker and Brownson (2010) argue that


competencies for extremely efficient public health practice are currently more vivid. Addressing
these crucial EBPH competencies requires the development of training programs in the US for
state health agencies’ public health professionals, community-based organizations, local health
departments, as well as the development and implementation of similar programs in other areas.
Furthermore, there is an emergence of core competencies’ set. Executing and developing
core competencies can actually be supported through administrative evidence-practices. These
focus on practices and conditions at the agency level, which have higher chances of improving
public health practice’ decision making (Jacobs et al., 2010). The administrative practices engage
five major domains, which should also be considered for effective leadership in EPBH; financial
processes, partnerships and relationships, organizational culture and climate, leadership, and
workforce development.
Implementing EBPH successfully in the public health is acknowledged as both an art and
science. The science constitutes of policy, behavioral, and epidemiologic research showing the
scope and size of public health challenges as well as identifying interventions that can be most
effective in solving the challenges (O’Neall & Brownson, 2005).On the other hand, the decision
making art involves being aware of what information is crucial to certain stakeholders at the
proper time. Dissimilar to solving mathematics problems, crucial decisions as far as public health
is concerned should balance art and science (Jacobs et al., 2010). This is founded on the fact that
evidence-based decision making basically involves the selection of an alternative from a set
made of numerous rational choices. There are several implications for practitioners. The
application of the EBPH concepts discussed herein can go a long way in improving decision
making and public health practice (O’Neall & Brownson, 2005).



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 helath practice. Annu Rev Public Health, 30: 175- 201.
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.
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

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