Abstract
Background: Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study aims to examine the following contextual factors across four countries: knowledge, access, and use of chronic disease prevention processes.Methods: In this cross-sectional study, public health practitioners (N = 400) from Australia (n = 121), Brazil (n = 76), China (n = 102), and the United States (n = 101) completed a 26-question survey on EBCDP. One-way ANOVA and Pearson's Chi-Square tests were used to assess differences in contextual factors of interest by country.Results: Practitioners in China reported less knowledge of EBCDP processes (p < 0.001) and less use of repositories of evidence-based interventions, than those from other countries (p < 0.001). Academic journals were the most frequently used method for accessing information about evidence-based interventions across countries. When selecting interventions, Brazilian and Chinese practitioners were more likely to consider implementation ease while the Australian and United States practitioners were more likely to consider effectiveness (p < 0.001).Conclusions: These findings can help inform and improve within and across country strategies for implementing EBCDP interventions.
Highlights
Chronic diseases are an increasing threat to the health and wellbeing of individuals and communities in middle- and highincome countries [1], and pose many challenges, including reduced quality of life and productivity [2]
Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of evidence-based chronic disease prevention (EBCDP) worldwide
The 26-question survey was informed by the following: the development of a guiding framework based on previous work of the research team [27, 28]; a literature review of EBCDP measures to identify relevant questions and gaps [2, 27, 29,30,31,32,33]; and semi-structured interviews of public health practitioners working in chronic disease prevention in Australia (n = 13), Brazil (n = 9), China (n = 16), and the United States (n = 12)
Summary
Chronic diseases are an increasing threat to the health and wellbeing of individuals and communities in middle- and highincome countries [1], and pose many challenges, including reduced quality of life and productivity [2]. Similar to evidence-based medicine, evidence-based public health (EBPH), evidence-based chronic disease prevention (EBCDP) has proven to be an effective set of processes for reducing the burden of chronic disease. Studies conducted in high-income countries (e.g., Australia, Canada, and the United States) have shown that knowledge of EBCDP processes, and access to evidence-based interventions, positively influence the implementation of EBCDP [10]. More research is needed to better understand how knowledge of EBCDP processes and access to evidence-based interventions may vary across middle- and high-income countries, to inform and improve future strategies for implementing EBCDP interventions and reducing chronic diseases worldwide [11,12,13,14]. Evidence-based chronic disease prevention (EBCDP) effectively reduces incidence rates of many chronic diseases, but contextual factors influence the implementation of EBCDP worldwide. This study aims to examine the following contextual factors across four countries: knowledge, access, and use of chronic disease prevention processes
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