This webinar on evidence-informed decision-making, delivered jointly by NCCMT and NCCID, draws on the National Collaborating Centre for Methods and Tools (NCCMT) seven-step process, with reference to how methods and tools for each step can apply to infectious disease prevention.
The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.
Importance of Assessing Level of Consciousness in Medical Care | The Lifescie...
NCCMT Webinar: Infectious Disease-Focused Methods and Tools to Support Evidence-Informed Decision-Making
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Funded by the Public Health Agency of Canada | Affiliated with McMaster University
The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.
Infectious Disease-Focused
Methods and Tools to Support
Evidence-Informed Decision-Making
Susan Snelling, PhD
Senior Knowledge Translation Specialist, NCCMT
Margaret Haworth-Brockman, MSc
Senior Program Manager, NCCID
June 9, 2016
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Poll Question #1
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How many people are watching today’s
webinar with you?
a) Just me
b) 1 to 3
c) 4 to 5
d) 6 to 10
e) More than 10
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Use Q&A to post comments / questions during
the webinar
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Q&A
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Housekeeping
Experiencing feedback?
• Click Audio Broadcast at the bottom of the
Participants panel to join or leave the audio
broadcast.
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Poll Question #2
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Where are you connecting from today?
a) BC
b) AB
c) SK
d) MB
e) ON
f) QC
g) NB
h) NS
i) PEI
j) NL
k) YK
l) NWT
m) NU
n) Outside
Canada
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Outline of Today’s Webinar
• Introduction to
NCCMT and NCCID
• A model for
evidence-informed
decision making
• Steps in the process
of evidence-informed
public health
With reference to
methods & tools
relevant for infectious
diseases public
health practitioners,
including approaches
that work for social
determinants &
tuberculosis
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National Collaborating Centre for
Methods and Tools (NCCMT)
Vision
• The effectiveness and efficiency of Canada’s public
health system will be guided by the production,
sharing and use of high quality evidence.
Mission
• The NCCMT will enhance evidence-informed public
health practice and policy in Canada by providing
leadership and expertise in supporting the uptake of
what works in public health into practice.
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What is
Evidence-Informed Public Health?
… the process of distilling and disseminating
the best available evidence from research, context
and experience, and using that evidence to inform
and improve public health policy and practice.
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Poll Question #3
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What sector are you from?
a) Public Health Practitioner
b) Health Practitioner (Other)
c) Education
d) Research
e) Federal/Provincial/Territorial Government
f) Municipality
g) Non-Governmental Organization
h) Other
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NCCMT Registry of Methods and Tools
Resources to support use of research evidence in
public health
http://www.nccmt.ca/resources/registry
A free, searchable, online collection of knowledge
translation methods and tools for public health
• Summary statements
• Web links (when available) to Methods and Tools
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What are methods and tools?
A process or series
of steps to organize
a Knowledge
Translation activity
Dissemination
framework
Method
An instrument to
carry out the steps
of a Knowledge
Translation activity
Dissemination
checklist
Tool
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National Collaborating Centre for
Infectious Diseases
We help public health practitioners find,
understand and use infectious disease
research and evidence.
Integration of evidence and other information to
improve public health policy & practice
Connections & collaborations for improved
exchange
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A Model for Evidence-Informed
Decision-Making in Public Health
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Stages in the process of
Evidence-Informed Public Health
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Scenario: Setting the Stage for
Evidence Use on an Infectious Disease
• Understanding the dynamics of
TB in the inner-city &
appropriate screening
• Outreach to at-risk populations
How can the steps of Evidence-
Informed Public Health be applied
to this scenario?
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Evidence-Informed Public Health
Clearly define the question or
problem
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Define the question
PICO
P population
I intervention
C comparison
O outcome
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Define the question: Apply our scenario
PICO
P population: inner-city residents
I intervention: screening
C comparison: no intervention or usual
care
O outcome: diagnosed patients in care
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Recommended Tool: Define
Developing an Efficient Search Strategy Using
PICO
http://www.nccmt.ca/resources/search/138
Use it to develop an evidence-search question
using the PICO format.
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Stages in the process of
Evidence-Informed Public Health
Efficiently search for research
evidence
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Recommended Tool: Search
NCCMT Search Pyramids
http://www.nccmt.ca/resources/search/181
http://www.nccmt.ca/learningcentre/EN/index.php
• Pre-populated with good sites for finding
evidence in public health, and for certain specific
topics.
• Start at the top for the most synthesized
evidence.
• Saves time
• Systematic approach to searching
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Tips for “Search”
• Choose the highest possible level on the Pyramid
• Pre-appraised sources make your search more
efficient
• NCCMT online module on Searching through
Learning Centre
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Evidence-Informed Public Health
Critically and efficiently appraise
the research methods
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Recommended Tools: Appraise
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Critically Appraising Practice
Guidelines: The AGREE II
Instrument
http://www.nccmt.ca/registry/view/eng/100
Tools to Assess the Methodological
Quality of Systematic Reviews:
AMSTAR
http://www.nccmt.ca/registry/view/eng/97
Critical Appraisal Skills Programme:
Checklists
http://www.nccmt.ca/resources/search/87
Considering Sex and Gender in
Research and Practice
http://sgba-resource.ca/en/
http://pwhce.ca/risingToTheChallenge.htm
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Tips for “Appraise”
• Appraise is a filtering step, looking for sources
of bias
• Answers the question: is this research/review of
good enough quality that I should read further?
• All research has flaws! But some flaws are
more serious than others.
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Additional Resources
• Refer to NCCMT’s online learning modules for
additional practice:
http://www.nccmt.ca/professional-development/modules
• Week-long course at McMaster University: “What
is Evidence-Informed Decision Making (EIDM)?”
http://ccebn.mcmaster.ca/workshop
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Evidence-Informed Public Health
Interpret information;
understand how to prioritize
conflicting results
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Recommended Tool: Synthesize
Briefing Note: Decisions, Rationale and Key Findings
Summary
http://www.nccmt.ca/resources/search/137
Use it to create briefing notes to inform decision-
makers. Use ‘actionable messages’ to inform program
and policy development.
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Tips for “Synthesize”
• Bring good quality evidence together to
determine results and implications
• If results ‘conflict’, prefer sources that are
highest quality, most recent, most relevant to
your question
• Identify actionable findings that can guide
decisions
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Evidence-Informed Public Health
Adapt the information
to the local community
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A Model for Evidence-Informed
Decision-Making in Public Health
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43. Recommended Tools: Adapt
- Applicability and Transferability of Evidence
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http://www.nccmt.ca/resources/search/227
http://www.nccmt.ca/resources/search/24
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Online Learning Module
Assessing the Applicability and Transferability
of Evidence
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Tips for “Adapt”
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• In developing a local approach, consider:
• Research evidence
• Stakeholder perspectives
• Media coverage – what’s going on in community
• Political context
• Local and regional data reports
• Financial and human resources
• How can you adapt potential interventions to be
appropriate for your community?
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Evidence-Informed Public Health
Decide whether
(and plan how) to implement
the change in practice or policy
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Evidence-Informed Public Health
Assess the effectiveness
of the change in
practice or policy
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Recommended Tool: Evaluate
Improving Future Decisions: Optimizing the
Decision Process from Lessons Learned
http://www.nccmt.ca/resources/search/194
Use it to evaluate your use of evidence in
making decisions.
A reflective practice tool.
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Tips for “Evaluate”
Determine how effective you were at using an
evidence-informed approach:
• What process did you follow?
• What can you learn from your process?
• How could you improve your use of evidence?
• How will you know if people are using the
evidence? Have they changed their practice?
• Was the intervention adapted effectively at your
local level?
You may need to gather baseline data before you start
if you want to assess change.
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Stages in the process of
Evidence-Informed Public Health
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Poll Question #4
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How familiar are you with the methods
and tools described today?
a) I am not familiar with any of the
methods/tools
b) I have heard of one or more of the
methods/tools
c) I have used one or more of the methods/tools
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Recommended tool: Evidence-
Informed Decision Making Checklist
http://www.nccmt.ca/resources/search/237
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EIDM Phases & Steps
File Path / Link to
Saved Location on:
(insert name of your
network here)
1. Define question
Was a clear answerable search question developed?
What was the question?
P
I
C
O
2. Search for relevant evidence
Was a comprehensive search strategy employed to find the best available evidence to
address this question?
PICO search terms table (See: Developing an Efficient Search Strategy Using PICO)
Years searched:
Pyramid results (See: Levels & Sources of Public Health Evidence)
Search results (See: Keeping Track of Search Results: A Flowchart)
References saved in reference management software database (e.g. Reference Manager / RefWorks)
What relevance criteria were used to determine evidence for quality assessment:
Primary
Titles and abstracts as found in reference management database
Save as separate reference management database.
Secondary
Relevance assessment of full document versions
Save as separate reference management database.
How many papers remained following relevance assessment(s)? (See: Flowchart, above)
3. Appraise
Was quality assessment conducted on relevant evidence?
How many papers remained after quality assessment? (See: Flowchart, above)
4. Synthesize
What were the results of the review of the evidence?
What were the actionable messages from the evidence?
5. Adapt.
NCCMT’s Applicability and Transferability tool;
AHRQ’s Will It Work Here? A Decisionmaker's Guide to Adopting Innovations
6. Implement.
7. Evaluate.
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Poll Question #5
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To what extent will the methods or tools
described today be useful in your
practice?
a) Very useful
b) Somewhat useful
c) Not at all useful
d) Don’t know
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• Use Q&A to post comments
and/or questions
• ‘Send’ questions to All (not
privately to ‘Host’)
Q&A
Your Comments/Questions
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Poll Question #6
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What are your next steps? (Check all that
apply)
a) Access a method/tool referenced in the
presentation
b) Read an NCCMT summary about a
method/tool described today
c) Consider using the methods/tools in
practice
d) Tell a colleague about the methods/tools
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Availability of the Slides and Audio
Recording
• The PowerPoint presentation (in English and
French) and English audio recording will be
available at:
• PowerPoint: http://www.slideshare.net/nccmt
• Audio Recording:
https://www.youtube.com/user/nccmt
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Your Feedback is Important
Please take a few minutes to share your thoughts
on today’s webinar.
https://nccmt.co1.qualtrics.com/SE/?SID=SV_8vlZ
Fs7Dme2pwm9
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Join NCCMT for our next webinar
Topic-Specific Methods and Tools to Support Evidence-Informed
Decision-Making: Resources for Practitioners Working in Injury
Prevention
PRESENTER: Susan Snelling, Senior Knowledge Translation
Specialist, NCCMT
DATE: Wednesday, June 22 2016
TIME: 1:00-2:30 pm
https://health-evidence.webex.com/health-
evidence/onstage/g.php?MTID=e5709e2b84fb3c8d00298494
074d1b533
Do you work in the injury prevention field?
Join us for a webinar to learn about a process for evidence-
informed decision-making, and methods and tools that are
specific to injury prevention. Remember to share information
about this webinar with your colleagues who work in the injury
prevention field!
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For more information about the
National Collaborating Centre
for Methods and Tools:
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NCCMT website www.nccmt.ca
Contact: nccmt@mcmaster.ca
For more information about the
National Collaborating Centre
for Infectious Diseases:
www.nccid.ca
nccid@umanitoba.ca
Notas del editor
EIPH provides a systematic approach to incorporate research evidence in program and policy decisions.
EIPH is defined as the process of distilling and disseminating the best available evidence from research, context and experience, and using that evidence to inform and improve public health policy and practice.
Put simply, it means finding, using and sharing what works in public health.
Removed Mental Health Practitioner that had been (b)
Where would you go to find resources to help you use research in your work?
Within the Registry of Methods and Tools, we have mapped out which methods and tools could help you with each step of the wheel.
-the Registry is a collection of KT resources which are relevant for public health
=the purpose of the Registry is to make KT resources more accessible
-we do this by:
-by identifying and filtering knowledge translation resources that are relevant to public health, and
-by creating summary statements of those resources to save time for practitioners
-our summary statements contains web-links to methods and tools, in addition to supplemental resources that you may find helpful in using the resource
-here’s a screenshot of the Registry
- visitors can access a number of user stories about how people have used methods and tools in their work, recent updates and new resources which have been added, and browse resources in the Registry
So why is there a distinction between methods and tools? Why is it important that there is a difference?
-methods can help you to organize the approach that you use to accomplish a task through a process or series of steps
-sometimes methods can help you to learn about a particular aspect of KT and how you think about it
-for example, you may want to learn about knowledge management and a method would be a good place to start
-tools provide a way to do a task, whether it is critical appraisal of evidence or adapting evidence to your setting
-tools can include workplans, instruments, checklists, some sort of tangible product
=the value add of having both methods and tools is that you can use both together to accomplish a task – for example, you may access a method on stakeholder engagement to learn why you need to reach out to your stakeholders during your project and what you hope to achieve in doing so
-a tool on stakeholder engagement would help your group identify and document the steps you’ve taken in the process
-the EIPH wheel illustrates the steps involved in evidence-informed practice
-the wheel is a guide for practitioners and decision makers to determine how to address a particular issue by systematically incorporating research evidence in the decision making process
-there are 7 steps in the EIPH process that starts with
clearly defining the problem,
Searching the research literature
Appraising the evidence you find
Synthesizing or summarizing the research on your issue
Adapting and interpreting the findings to your local context
Implementing the evidence or appropriate intervention
Evaluating your implementation efforts.
Or if a qualitative question, Population and Situation (P and S)
I added screening as the interventions since identification on its own is not an intervention. OK?
-posted on the Registry of Methods and Tools
gives useful prompts to help you come up with a searchable question
And other pyramid topics
Free access; Need to log-in
As noted under syntheses, HE is a good source for systematic reviews of research evidence related to public health
Second is from CRICH- an adaptation with additional health equity content – so might be very relevant for our evidence-informed decisions related to improving health in homeless populations
Determine whether to reduce or drop services currently being offered?
What would this process look like for emerging infections where there is not a lot of research evidence?
thank you for attending today’s workshop
For more information about the NCCMT, NCCID or to access any of the resources noted in these slides, please consult the NCCMT and NCCID websites or contact the Centres directly.