Abstract
Colorado’s adult obesity rate has more than doubled since 1995, prompting its Department of Public Health and Environment to list obesity as its top prevention priority. To initiate comprehensive and effective action, the department used a well-known evidence-based public health framework developed by Brownson and others. This article describes the tools and process developed to conduct 2 of the 7 stages in this framework that challenge public health organizations: reviewing the literature and prioritizing effective strategies from that literature. Forty-five department staff participated in an intensive literature review training to identify physical activity and nutrition strategies that effectively address obesity and worked with external stakeholders to prioritize strategies for the state. Divided into 8 multidisciplinary teams organized by the setting where public health could exert leverage, they scanned the scientific literature to identify potential strategies to implement. These teams were trained to use standardized tools to critique findings, systematically abstract key information, and classify the evidence level for each of 58 identified strategies. Next, departmental subject matter experts and representatives from local public health and nonprofit health agencies selected and applied prioritization criteria to rank the 58 strategies. A team charter, group facilitation tools, and 2 web-based surveys were used in the prioritization stage. This process offered the staff a shared experience to gain hands-on practice completing literature reviews and selecting evidence-based strategies, thereby enhancing Colorado’s obesity prevention efforts and improving public health capacity. Practitioners can use these tools and methodology to replicate this process for other health priorities.
Highlights
A scientific approach to the formulation of evidence-based public health strategies was advanced as a way to improve the performance of public health departments and make the best use of limited resources [1]
Evidence-based public health (EBPH) is defined by Kohatsu as “the process of integrating science-based interventions with community preferences to improve the health of the population” [2]
At the state and local level, trying to follow scientific approaches is often impeded by day-to-day realities of conducting public health
Summary
A scientific approach to the formulation of evidence-based public health strategies was advanced as a way to improve the performance of public health departments and make the best use of limited resources [1]. The committee designated staff leads to develop implementation teams for each priority and communicated the results to all staff members and stakeholders as the end of stage 5 and the start of stage 6 (action planning) This systematic planning process stretched over 9 months and covered 5 of the 7 stages in the evidence-based public health framework by Brownson and others [1]. At the end of the literature review trainings and discussions, the instructors collected feedback from participants using paper and pencil surveys to assess the capacity building components and the usefulness of the tools used Respondents indicated that they gained confidence in their ability to search for and obtain journal articles, use the CDPHE Digital Library, critique journal articles, rate the literature, and summarize the overall level of evidence using the tool Typology for Classifying Interventions and Strategies by Level of Scientific Evidence. Colorado’s resulting portfolio of priority obesity strategies is grounded in science, built on a foundation of broad staff and stakeholder support and expertise, and provides the greatest strategic opportunity for success
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