This webinar on evidence-informed decision-making (EIDM) draws on The National Collaborating Centre for Methods and Tools (NCCMT)'s seven-step process, with reference to methods and tools for each step that are specific to mental health practice.
The National Collaborating Centre for Methods and Tools (NCCMT) is one of six National Collaborating Centres for Public Health in the country with a collective mandate to strengthen public health in Canada. Visit the NCCMT website (www.nccmt.ca) or contact nccmt@mcmaster.ca for more information.
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NCCMT Webinar: Mental Health-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.
Mental Health-Focused
Methods and Tools to Support
Evidence-Informed Decision-Making
Susan Snelling, PhD
Senior Knowledge Translation Specialist
March 29, 2016
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Poll Question #1
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webinar with you?
a) Just me
b) 2 to 3
c) 4 to 5
d) More than 5
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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
• A model for
evidence-informed
decision making
• Steps in the process
of evidence-informed
public health
With reference to
methods and tools
relevant for mental
health
practitioners that
can be found in
the NCCMT
Registry of
Methods and
Tools
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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) Mental Health Practitioner
c) Health Practitioner (Other)
d) Education
e) Research
f) Federal/Provincial/Territorial Government
g) Municipality
h) Non-Governmental Organization
i) 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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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
• Working with homeless populations who
experience mental illness
• Interested in structural or social interventions to
improve health
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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Defining a Population Mental Health
Framework for Public Health
http://www.ncchpp.ca/docs/2014_SanteMentale_EN.pdf
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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: homeless; high risk
I intervention: structural or social
C comparison: not specified
O outcome: change in health
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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
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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/index.php#main2.html
• Pre-populated with good sites for finding mental
health-related evidence.
• 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
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Critically and efficiently appraise
the research methods
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Recommended Tools: Appraise
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
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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)?”
May 2 – May 6, 2016
• http://ccebn.mcmaster.ca/workshop
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Evidence-Informed Public Health
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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
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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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47. 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
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Decide whether
(and plan how) to implement
the change in practice or policy
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Recommended Method:
Innovation to Implementation:
A Mental Health Commission
of Canada Knowledge
Translation Guide
http://www.nccmt.ca/resources/search/212
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Steps in MHCC ‘Innovation to
Implementation’ Model
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Evidence-Informed Public Health
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Assess the effectiveness
of the change in
practice or policy
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Recommended Method: Evaluation
Approach in MHCC ‘Innovation to
Implementation’ Model
http://www.nccmt.ca/resources/search/212
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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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In your experience, which step in
Evidence-Informed Public Health is the
most challenging to do well?
a) Define
b) Search
c) Appraise
d) Synthesize
e) Adapt
f) Implement
g) Evaluate
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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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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_8GM
lC5h5KveWRTf
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Join NCCMT for our next webinar
NCCMT Spotlight on Methods & Tools: A Tool for
Sharing Best Practices
PRESENTER: Lisa Mwaikambo, Program Officer II,
Knowledge for Health (K4Health)
Johns Hopkins Bloomberg School of Public Health
DATE: Wednesday, March 30, 2016
TIME: 1:00-2:30 pm
https://health-evidence.webex.com/health-
evidence/onstage/g.php?MTID=e43dee34d0b5945ed41deccb
15ac8a0fb
Interested in sharing best practices within your organization?
Not exactly sure what is a best practice within your
organization? Unsure how to share best practices internally
throughout your organization? Join us for a webinar on the
Tool for Sharing Best Practices.
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For more information about the
National Collaborating Centre
for Methods and Tools:
NCCMT website www.nccmt.ca
Contact: nccmt@mcmaster.ca
6464
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.
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.
Will develop further
Can help to have a framework to help define the kind of evidence you are searching for.
This framework is drawn from a Report from our colleagues at NCCHPP.
Worth noting in this framework that in terms of outcomes, you could look at mental disorder indicators and mental health indicators. This framework is presented as part of a paper looking at the two-continuum model of mental health, which present the perspective that mental health and mental disorder can co-exist – it’s possible to have various states of mental disorder and also experience varying levels of mental health. I won’t go into the two continuum model in detail, but as a scenario to follow through this webinar, I am going to posit that I am interested in finding and using research evidence that speaks to interventions to improve health among a homeless population that experiences mental illness.
Or if a qualitative question, Population and Situation (P and S)
-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
Not a method or tool, but another source where you may find evidence related to mental health interventions
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?
-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.
thank you for attending today’s workshop
For more information about the NCCMT or to access any of the resources noted in these slides, please consult the NCCMT website or contact the Centre directly.