Evidence-based Health Practice Research Articles

Genomic Insights for Personalized Care: Motivating At-Risk Individuals Toward Evidence-Based Health Practices.

Lung cancer and tobacco use pose significant global health challenges, necessitating a comprehensive translational roadmap for improved prevention strategies. Polygenic risk scores (PRSs) are powerful tools for patient risk stratification but have not yet been widely used in primary care for lung cancer, particularly in diverse patient populations. We propose the GREAT care paradigm, which employs PRSs to stratify disease risk and personalize interventions. We developed PRSs using large-scale multi-ancestry genome-wide association studies and standardized PRS distributions across all ancestries. We applied our PRSs to 796 individuals from the GISC Trial, 350,154 from UK Biobank (UKBB), and 210,826 from All of Us Research Program (AoU), totaling 561,776 individuals of diverse ancestry. Significant odds ratios (ORs) for lung cancer and difficulty quitting smoking were observed in both UKBB and AoU. For lung cancer, the ORs for individuals in the highest risk group (top 20% versus bottom 20%) were 1.85 (95% CI: 1.58 - 2.18) in UKBB and 2.39 (95% CI: 1.93 - 2.97) in AoU. For difficulty quitting smoking, the ORs (top 33% versus bottom 33%) were 1.36 (95% CI: 1.32 - 1.41) in UKBB and 1.32 (95% CI: 1.28 - 1.36) in AoU. Our PRS-based intervention model leverages large-scale genetic data for robust risk assessment across populations. This model will be evaluated in two cluster-randomized clinical trials aimed at motivating health behavior changes in high-risk patients of diverse ancestry. This pioneering approach integrates genomic insights into primary care, promising improved outcomes in cancer prevention and tobacco treatment.

THE USE OF OUTCOME MEASURES IN EXERCISE PHYSIOLOGY CLINICAL PRACTICE IN AUSTRALIA

INTRODUCTION AND AIMS Outcome measure (OM) implementation in clinical settings has become a standard in allied health evidence-based practice over the last 20 years, with their use being encouraged by governing and funding bodies. This study investigated the application of standardised OMs by accredited exercise physiologists (AEPs) in Australia. This study aimed to identify commonly used OMs and explore the barriers and facilitators to OM implementation in AEP clinical practice in Australia. METHODS This study utilised a questionnaire-based, cross-sectional, descriptive design to determine the OMs used by AEPs in current clinical practice and investigated trends related to OM use within different AEP demographics and settings. Participants were also asked to identify any barriers and facilitators that affected their use of OMs in clinical practice. The OMs that were most frequently used were identified and the results analysed according to demographic variables, to determine how they influenced OM use in clinical practice. RESULTS Eighty-seven OMs were assessed, with 41% ‘never’ used by most participants. A further 48% of the OMs were identified as being underutilised with over 50% of respondents selecting ‘never’ or ‘sometimes’. Only three OMs were used frequently by most respondents. The most common barriers to OM use identified related to a lack of time, knowledge, and limited perceived value from clinicians. These reflect the barriers identified in prior research related to other allied health professions. CONCLUSIONS AEPs in Australia experience many of the same barriers to OM use as other allied health disciplines. Currently, the standardised OM resource for AEPs is outdated and underutilised in clinical practice. Updated resources for clinicians in the form of educational seminars and a searchable online database with easy access to evidence-based outcome measures are essential to the promotion of OMs to support evidence-based practice for AEPs.

Implementation fidelity, student outcomes, and cost-effectiveness of train-the-trainer strategies for Masters-level therapists in urban schools: results from a cluster randomized trial

BackgroundLittle is known about the effectiveness and cost-effectiveness of train-the-trainer implementation strategies in supporting mental health evidence-based practices in schools, and about the optimal level of support needed for TT strategies.MethodsThe current study is part of a larger type 2 hybrid cluster randomized controlled trial. It compares two train-the-trainer strategies, Train-the-Trainer (TT) and Train-the-Trainer plus ongoing consultation for trainers (TT +) on the delivery of a group cognitive behavioral treatment protocol for anxiety disorders. Participants were 33 therapists, 29 supervisors, and 125 students who were at risk for anxiety disorders from 22 urban schools. Implementation outcomes were implementation fidelity and treatment dosage. Student outcomes were child- and parent-reported symptoms of anxiety, child-reported symptoms of depression, and teacher-reported academic engagement. We estimated the cost of implementing the intervention in each condition and examined the probability that a support strategy for supervisors (TT vs TT +) is a good value for varying values of willingness to pay.ResultsTherapists in the TT and TT + conditions obtained similarly high implementation fidelity and students in the conditions received similar treatment dosages. A mixed effects modeling approach for student outcomes revealed time effects for symptoms of anxiety and depression reported by students, and emotional disaffection reported by teachers. There were no condition or condition × times effects. For both conditions, the time effects indicated an improvement from pre-treatment to post-treatment in symptoms of anxiety and depression and academic emotional engagement. The average cost of therapist, supervisor, and consultant time required to implement the intervention in each condition was $1002 for TT and $1431 for TT + (p = 0.01). There was a greater than 80% chance that TT was a good value compared to TT + for all values of willingness to pay per one-point improvement in anxiety scores.ConclusionsA TT implementation approach consisting of a thorough initial training workshop for therapists and supervisors as well as ongoing supervision for therapists resulted in adequate levels of fidelity and student outcomes but at a lower cost, compared to the TT + condition that also included ongoing external expert consultation for supervisors.Trial registrationClinicalTrials.gov identifier: NCT02651402.

Mis-implementation of evidence-based behavioural health practices in primary care: lessons from randomised trials in Federally Qualified Health Centers.

Implementing evidence-based practices (EBPs) within service systems is critical to population-level health improvements - but also challenging, especially for complex behavioral health interventions in low-resource settings. "Mis-implementation" refers to poor outcomes from an EBP implementation effort; mis-implementation outcomes are an important, but largely untapped, source of information about how to improve knowledge exchange. We present mis-implementation cases from three pragmatic trials of behavioral health EBPs in U.S. Federally Qualified Health Centers (FQHCs). We adapted the Consolidated Framework for Implementation Research and its Outcomes Addendum into a framework for mis-implementation and used it to structure the case summaries with information about the EBP and trial, mis-implementation outcomes, and associated determinants (barriers and facilitators). We compared the three cases to identify shared and unique mis-implementation factors. Across cases, there was limited adoption and fidelity to the interventions, which led to eventual discontinuation. Barriers contributing to mis-implementation included intervention complexity, low buy-in from overburdened providers, lack of alignment between providers and leadership, and COVID-19-related stressors. Mis-implementation occurred earlier in cases that experienced both patient- and provider-level barriers, and that were conducted during the COVID-19 pandemic. Multi-level determinants contributed to EBP mis-implementation in FQHCs, limiting the ability of these health systems to benefit from knowledge exchange. To minimize mis-implementation, knowledge exchange strategies should be designed around common, core barriers but also flexible enough to address a variety of site-specific contextual factors and should be tailored to relevant audiences such as providers, patients, and/or leadership.

Revisiting the policy ecology framework for implementation of evidence-based practices in mental health settings

BackgroundOver the past three decades, policy actors and actions have been highly influential in supporting the implementation of evidence-based practices (EBPs) in mental health settings. An early examination of these actions resulted in the Policy Ecology Framework (PEF), which was originally developed as a tactical primer for state and local mental health regulators in the field of child mental health. However, the policy landscape for implementation has evolved significantly since the original PEF was published. An interrogation of the strategies originally proposed in the PEF is necessary to provide an updated menu of strategies to improve our understanding of the mechanisms of policy action and promote system improvement.ObjectivesThis paper builds upon the original PEF to address changes in the policy landscape for the implementation of mental health EBPs between 2009 and 2022. We review the current state of policy strategies that support the implementation of EBPs in mental health care and outline key areas for policy-oriented implementation research. Our review identifies policy strategies at federal, state, agency, and organizational levels, and highlights developments in the social context in which EBPs are implemented. Furthermore, our review is organized around some key changes that occurred across each PEF domain that span organizational, agency, political, and social contexts along with subdomains within each area.DiscussionWe present an updated menu of policy strategies to support the implementation of EBPs in mental health settings. This updated menu of strategies considers the broad range of conceptual developments and changes in the policy landscape. These developments have occurred across the organizational, agency, political, and social contexts and are important for policymakers to consider in the context of supporting the implementation of EBPs.SummaryThe updated PEF expands and enhances the specification of policy levers currently available, and identifies policy targets that are underdeveloped (e.g., de-implementation and sustainment) but are becoming visible opportunities for policy to support system improvement. The updated PEF clarifies current policy efforts within the field of implementation science in health to conceptualize and better operationalize the role of policy in the implementation of EBPs.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Global Statements to Produce and Implement Evidence in the Post-COVID-19 Era Provide a Path Forward for Rehabilitation - A Joint Initiative of Cochrane Rehabilitation and the Leading Journals in the Field.

Sleep tight! Adolescent sleep quality across three distinct sleep ecologies.

Good sleep quality, associated with few arousals, no daytime sleepiness and self-satisfaction with one's sleep, is pivotal for adolescent growth, maturation, cognition and overall health. This article aims to identify what ecological factors impact adolescent sleep quality across three distinct sleep ecologies representing a gradient of dense urbanity to small, rural environments with scarce artificial lighting and no Internet. We analyze variation of sleep efficiency, a quantitative measure of sleep quality-defined as the ratio of total time spent asleep to total time dedicated to sleep-in two agricultural indigenous populations and one post-industrial group in Mexico (Campeche = 44, Puebla = 51, Mexico City = 50, respectively). Data collection included actigraphy, sleep diaries, questionnaires, interviews and ethnographic observations. We fit linear models to examine sleep efficiency variation within and between groups. We found that sleep efficiency varied significantly across sites, being highest in Mexico City (88%) and lowest in Campeche (75%). We found that variation in sleep efficiency was significantly associated with nightly exposure to light and social sleep practices. Our findings point toward contextual cost-benefits of sleep disruption in adolescence. We highlight the need to prioritize research on adolescent sleep quality across distinct developmental ecologies and its impact on health to improve adolescent wellbeing through evidence-based health practices.

Assessing the quality of research outputs in physiotherapy

Assessing the quality of research output is challenging. Systematic reviews and meta-analyses of randomized trials have a pivotal role in informing clinical practice and policy decisions, and there is a broad agreement that the method quality of primary research should be carefully assessed (Albanese et al., 2020). One of the instruments to do that is the Physiotherapy Evidence Database (PEDro) scale, specifically designed to assess the quality of methods used in clinical trials in the field of physiotherapy (Elkins et al., 2013). Its reliability in terms of ICC values ranges from 0.55 (95% confidence interval CI: 0.47–0.65) for the original scale, to 0.82 (95% CI: 0.70–0.89) for the Portuguese version (Shiwa et al., 2011). The PEDro scale consists of 11 items encompassing the domains of external validity (item 1: Eligibility criteria and source), internal validity (items 2 to 9: Random allocation; Concealed allocation; Baseline comparability; Blinding of participants; Blinding of therapists; Blinding of assessors; Adequate follow-up (>85%); and Intention-to-treat analysis), and statistical reporting (items 10 and 11: Betweengroup statistical comparisons and Reporting of point measures and measures of variability) (Cashina, McAuleya, 2020). Each item is scored as either present (1) or absent (0), leading to a maximum score of 10 (Paci, Bianchini and Baccini, 2022). A trial is considered of moderate to high quality if it scores at least 6 of 10 (Paci, Bianchini and Baccini, 2022). The purpose of the PEDro score is to help researchers identify trials that have good internal validity (items 2–9) and that report enough data to make their results interpretable (items 10 and 11) (Moseleya et al., 2020). Interpreting these items correctly is critical to high-quality, evidence-based health practice. Unlike PEDro, however, the Cochrane Collaboration distinguishes between the methodological quality of a study and the risk of bias: a study of high quality can still be at high risk of bias (Higgins et al., 2011). The Cochrane risk of bias (RoB) tool focuses on the internal validity of trials and assesses six domains of bias: selection bias, performance bias, detection bias, attrition bias, reporting bias, and other bias (Higgins et al., 2011). These two tools can complement each other for an even better quality assessment of physiotherapy research and help disseminate and make transparent and available research output, encouraging interdisciplinary research along the way.

The concept of integration in mixed methods research: a step-by-step guide using an example study in physiotherapy

ABSTRACT Background Integration is a unique attribute of Mixed Methods Research (MMR). However, some MMR studies, published in the field of physiotherapy and other allied health professions, have illustrated a lack of understanding of the concept of integration. Aims The purpose of this paper is to provide guidance for integrating elements of mixed methods research in order to effectively support evidence-based practice in health. Methods The concept of integration of findings is explained with reference to the author’s recent PhD study, which used a mixed methods exploratory sequential design. This article describes how the author used a narrative joint display to integrate findings from both the qualitative and survey phases of the study. Then, a step-by-step approach is introduced to guide the interpretation and integration of the findings. Results This four-step approach demonstrates integration of the two different datasets: Creating a joint display, linking activity, establishing relationships, and interpreting and reporting. Tables and Figures are used to support detailed description and illustration of the integration process. Discussion A joint display provides a visual representation of how the qualitative and quantitative findings in a MMR study can be integrated. In this way, interpretation of the data drawn from this process extend beyond the individual findings of each study component to facilitate a greater understanding of complex health care issues.

Development and evaluation of a remote training strategy for the implementation of mental health evidence-based practices in rural schools: pilot study protocol

BackgroundAn increasing number of schools in rural settings are implementing multi-tier positive behavioral interventions and supports (PBIS) to address school-climate problems. PBIS can be used to provide the framework for the implementation of evidence-based practices (EBPs) to address children’s mental health concerns. Given the large service disparities for children in rural areas, offering EBPs through PBIS can improve access and lead to better long-term outcomes. A key challenge is that school personnel need technical assistance in order to implement EBPs with fidelity and clinical effectiveness. Providing ongoing on-site support is not feasible or sustainable in the majority of rural schools, due to their remote physical location. For this reason, remote training technology has been recommended for providing technical assistance to behavioral health staff (BHS) in under-served rural communities.ObjectivesThe purpose of this study is to use the user-centered design, guided by an iterative process (rapid prototyping), to develop and evaluate the appropriateness, feasibility, acceptability, usability, and preliminary student outcomes of two online training strategies for the implementation of EBPs at PBIS Tier 2.MethodsThe study will employ a pragmatic design comprised of a mixed-methods approach for the development of the training platform, and a hybrid type 2, pilot randomized controlled trial to examine the implementation and student outcomes of two training strategies: Remote Video vs. Remote Video plus Coaching.DiscussionThere is a clear need for well-designed remote training studies focused on training in non-traditional settings. Given the lack of well-trained mental health professionals in rural settings and the stark disparities in access to services, the development and pilot-testing of a remote training strategy for BHS in under-served rural schools could have a significant public health impact.Ethics and disseminationThe project was reviewed and approved by the institutional review board. Results will be submitted to ClinicalTrials.gov and disseminated to community partners and participants, peer-reviewed journals, and academic conferences.Trial registrationClinicialTrials.gov, NCT05034198 and NCT05039164

Sustainment Rates and Factors for Multidimensional Family Therapy in Europe and North America

This retrospective non-experimental study examined the short-term (2-year) and longer-term (5-year and 8-year) sustainment of 137 programs in Europe and North America implementing a single evidence-based practice (EBP), Multidimensional Family Therapy (MDFT). MDFT implementation and sustainment is based on the Stages of Implementation (SIC) model outlined by Saldana and colleagues. The study had two primary objectives: (1) to examine short-term and longer-term sustainment rates of MDFT in Europe and North America, and (2) to explore potential factors that may be associated with sustainment of MDFT in particular, and the potential implications for behavioral health EBPs more generally. Results show that 90% of MDFT programs were sustained for at least 2 years, 87% of the programs sustained for at least 5 years, and 70% for at least 8 years. These findings compare favorably with the previous research on implementing and sustaining evidence-based practices. The findings support the growing consensus that not only start-up funding but also ongoing financing either through governments or third-party payors may be essential for longer-term sustainability of EBPs in both Europe and North America. This study also highlights the potential value of multi-site program networks. Future research directions are suggested, such as examination of the potential importance of the quality and nature of the EBP itself, adaptability to different organizations and clients, and providing high-quality structured and empowering training and quality assurance to sustain evidence-based behavioral health interventions. These programmatic and clinician-level factors are critical areas for further investigation into the sustainment of EBPs.

Behavioral Health Workforce Development in the era of COVID-19: Examples From a State-Funded Intermediary Organization.

Intermediary and purveyor organizations (IPOs) play a key role in disseminating and implementing behavioral health evidence-based practices. The COVID-19 pandemic created a time of crisis and disruption to behavioral health care delivery. Using the conceptual framework of basic, targeted, and intensive technical assistance (TA) from the Training and Technology Transfer Centers, case studies are used to describe how programs at The Center for Practice Innovations a state funded-intermediary organization, adapted its training and technical assistance to be delivered entirely remotely, to include content related to COVID-19 and to provide guidance on telehealth-based behavioral health care.

Costing of a Multiple Family Group Strengthening Intervention (SMART Africa) to Improve Child and Adolescent Behavioral Health in Uganda.

Reliable cost estimates are key to assessing the feasibility, affordability, and cost-effectiveness of interventions. We estimated the economic costs of a multiple family group (MFG) intervention-child and adolescent mental health evidence-based practices (CAMH-EBP) implemented under the SMART Africa study, seeking to improve family functioning and reduce child and adolescent behavior problems-delivered through task-shifting by community health workers (CHWs) or parent peers (PPs) in school settings in Uganda. This prospective microcosting analysis was conducted from a provider perspective as part of a three-armed randomized controlled trial of the MFG intervention involving 2,391 participants aged 8-13 years and their caregivers in 26 primary schools. Activity-specific costs were estimated and summed, and divided by actual participant numbers in each study arm to conservatively calculate total per-child costs by arm. Total per-child costs of the MFG-PP and MFG-CHW arms were estimated at US$346 and US$328, respectively. The higher per-child cost of the MFG-PP arm was driven by lower than anticipated attendance by participants recruited to this arm. Personnel costs were the key cost driver, accounting for approximately 70% of total costs because of intensive supervision and support provided to MFG facilitators and intervention quality assurance efforts. This is the first study estimating the economic costs of an evidence-based MFG intervention provided through task-shifting strategies in a low-resource setting. Compared with the costs of other family-based interventions ranging between US$500 and US$900 in similar settings, the MFG intervention had a lower per-participant cost; however, few comparisons are available in the literature. More costing studies on CAMH-EBPs in low-resource settings are needed.

Design and validity of an instrument to assess healthcare professionals’ perceptions, behaviour, self-efficacy and attitudes towards evidence-based health practice: I-SABE

ObjectivesTo develop and validate an instrument to measure Brazilian healthcare professionals’ perceptions, behaviour, self-efficacy and attitudes towards evidence-based health practice.DesignValidation of an instrument using the Delphi method to ensure content...

How Effective Are School Professionals at Identifying Students Who Might Benefit From Cognitive Behavioral Therapy? Baseline Data From the Adaptive School-Based Implementation of Cognitive Behavioral Therapy Trial

School professionals (SPs) are increasingly tasked with providing mental health treatment for students. Successful implementation of school-based mental health evidence-based practices (EBPs) can reduce students’ depression and anxiety, but requires identification of appropriate students to benefit from these interventions. We examined the ability of SPs to identify students appropriate for cognitive behavioral therapy (CBT), using baseline data collected from a large-scale implementation trial. One hundred sixty-nine SPs from 94 Michigan high schools were asked to identify up to 10 students whom they believed could benefit from CBT. Identified students were asked to complete a baseline survey. We examined the proportion of consented students who screened positive for depression or anxiety, based on the Patient Health Questionnaire modified for teens and the Generalized Anxiety Disorder questionnaire, overall and by key school- and SP-level factors. Of the 1,347 students identified by 149 SPs, 899 students completed the survey. Of those students, 87% exhibited any depression or anxiety symptoms (score of five or higher) and 66% showed moderate/severe symptoms (score of ten or higher). Per SP, the proportion of consented students who screened positive for any depression or anxiety symptoms was, on average, 0.88. The effectiveness of SPs’ student identification did not vary significantly by school-specific role, prior CBT training, or geography. Results suggest that SPs can effectively identify students appropriate for CBT given minimal training and resources, an important first step in increasing student access to school-based mental healthcare.

Study protocol: cluster randomized trial of consultation strategies for the sustainment of mental health interventions in under-resourced urban schools: rationale, design, and methods

BackgroundThe school is a key setting for the provision of mental health services to children, particularly those underserved through traditional service delivery systems. School-wide Positive Behavioral Interventions and Supports (PBIS) is a tiered approach to service delivery based on the public health model that schools use to implement universal (Tier 1) supports to improve school climate and safety. As our prior research has demonstrated, PBIS is a useful vehicle for implementing mental and behavioral health evidence-based practices (EBPs) at Tier 2 for children with, or at risk for, mental health disorders. Very little research has been conducted regarding the use of mental health EBPs at Tier 2 or how to sustain implementation in schools.Methods/designThe main aim of the study is to compare fidelity, penetration, cost-effectiveness, and student outcomes of Tier 2 mental health interventions across 2 sustainment approaches for school implementers in 12 K-8 schools. The study uses a 2-arm, cluster randomized controlled trial design. The two arms are: (a) Preparing for Sustainment (PS)—a consultation strategy implemented by school district coaches who receive support from external consultants, and (b) Sustainment as Usual (SAU)—a consultation strategy implemented by school district coaches alone. Participants will be 60 implementers and 360 students at risk for externalizing and anxiety disorders. The interventions implemented by school personnel are: Coping Power Program (CPP) for externalizing disorders, CBT for Anxiety Treatment in Schools (CATS) for anxiety disorders, and Check-in/Check-out (CICO) for externalizing and internalizing disorders. The Interactive Systems Framework (ISF) for Dissemination and Implementation guides the training and support procedures for implementers.DiscussionWe expect that this study will result in a feasible, effective, and cost-effective strategy for sustaining mental health EBPs that is embedded within a multi-tiered system of support. Results from this study conducted in a large urban school district would likely generalize to other large, urban districts and have an impact on population-level child mental health.Trial registration ClinicalTrials.gov identifier number NCT04869657. Registered May 3, 2021.

Integrative Health Care: Definition and examples of implementation in Oncology in France

Integrative health is the combined use of conventional medicine, complementary medicine and lifestyle medicine. It is the result of the coordination of patient-centred, science and evidence-based health practices, delivered by a multidisciplinary team. Its objective is to enable the return or the maintenance of health in an optimal well-being. Its originality lies in the inclusion of the patients and their own representations of care in the overall management of their health. As a result of a strong demand from patients but also from caregivers, this North American concept is gradually being established in France. Since December 2019, the Strasbourg Saint Vincent de Paul Hospital Group has opened an Outpatients unit for Integrative care. Initially created in Aix-en-Provence in 2010, there are now 7 Resource centres which offer Well Being care and a Personalised Therapeutic Accompaniment Program. In Dunkirk, the Flanders House of Supportive Care (Maison des Soins de Support des Flandres) has been in operation since 2017. In Paris, since 2018, the Rafaël Institute offers 9000 integrated treatments per year. All these treatments are free of charge for the patient. In treating the whole person, understanding the needs and values of each patient, by looking after the quality of life as much as seeking to cure, integrative health care makes it possible for caregivers to link the treatment goals with good and new practices for and with the patient.

Perceptions, experiences, and attitudes of health care professionals regarding the role of librarians in fostering evidence-based health practice: a systematic review protocol.

The objective of this systematic review is to explore perceptions, experiences, and attitudes of health care professionals in teaching hospitals, academic health science centers, and health care professional colleges regarding the role of librarians in fostering the production of evidence-based research. Evidence-based health practice entails the use of the best research evidence, combined with knowledge and information gained through professional expertise as a practicing clinician, and consideration of patients' concerns and preferences to make the best possible decision for the care provided to those patients. With their extensive skills in literature searching, librarians and other information professionals contribute to the process of evidence-based health practice by locating and retrieving the most relevant information for clinical practice. Despite the importance of librarians in evidence-based health practice, little attention has been paid to the perceptions and attitudes of health care professionals toward the involvement of librarians in fostering evidence-based research and their participation in other evidence-based health practice activities. The population of interest is health care professionals working in teaching hospitals, academic health science centers, and health care professional colleges who make clinical decisions based on evidence, clinical judgments, and patient values. The following databases will be searched from database inception till June 2021 for published and unpublished studies: CINAHL, PsycINFO, AMED, Academic Search Premier, Scopus, LISTA, MEDLINE, POPLINE, and OpenGrey. Studies published in English will be considered for review. The selected studies will be critically assessed for methodological quality by two independent reviewers. PROSPERO CRD42019136749.

Responding to the Call through Translating Science into Impact: Building an Evidence-Based Approaches to Effectively Curb Public Health Emergencies [Covid-19 Crisis

COVID-19 demonstrated a global catastrophe that touched everybody, including the scientific community. As we respond and recover rapidly from this pandemic, there is an opportunity to guarantee that the fabric of our society includes sustainability, fairness, and care. However, approaches to environmental health attempt to decrease the populations burden of COVID-19, toward saving patients from becoming ill along with preserving the allocation of clinical resources and public safety standards. This paper explores environmental and public health evidence-based practices toward responding to Covid-19. A literature review tried to do a deep dive through the use of various search engines such as Mendeley, Research Gate, CAB Abstract, Google Scholar, Summon, PubMed, Scopus, Hinari, Dimension, OARE Abstract, SSRN, Academia search strategy toward retrieving research publications, “grey literature” as well as reports from expert working groups. To achieve enhanced population health, it is recommended to adopt widespread evidence-based strategies, particularly in this uncertain time. As only together can evidence-informed decision-making (EIDM) can become a reality which include effective policies and practices, transparency and accountability of decisions, and equity outcomes; these are all more relevant in resource-constrained contexts, such as Nigeria. Effective and ethical EIDM though requires the production as well as use of high-quality evidence that are timely, appropriate and structured. One way to do so is through co-production. Co-production (or co-creation or co-design) of environmental/public health evidence considered as a key tool for addressing complex global crises such as the high risk of severe COVID-19 in different nations. A significant evidence-based component of environmental/public health (EBEPH) consist of decisions making based on best accessible, evidence that is peer-reviewed; using data as well as systematic information systems; community engagement in policy making; conducting sound evaluation; do a thorough program-planning frameworks; as well as disseminating what is being learned. As researchers, scientists, statisticians, journal editors, practitioners, as well as decision makers strive to improve population health, having a natural tendency toward scrutinizing the scientific literature aimed at novel research findings serving as the foundation for intervention as well as prevention programs. The main inspiration behind conducting research ought to be toward stimulating and collaborating appropriately on public/environmental health action. Hence, there is need for a “Plan B” of effective behavioural, environmental, social as well as systems interventions (BESSI) toward reducing transmission.

Experiences with using a mobile application for learning evidence-based practice in health and social care education: An interpretive descriptive study.

Health and social care students are expected to apply evidence-based practice (EBP). An innovative mobile application, EBPsteps, was developed to support learning EBP. The aim of this study was to explore health and social care students' experiences of learning about EBP using the mobile application EBPsteps during their clinical placements. An interpretive description approach guided the exploration of student experiences. Four focus groups were conducted with a convenience sample of students from three undergraduate degree programs: occupational therapy, physical therapy, and social education. The constant comparison method was used to categorize and compare the qualitative data. Three integrated themes were generated: "triggers for EBP", "barriers to EBP", and "design matters". Information needs, academic requirements, and encouragement from clinical instructors triggered the students to use EBPsteps. Lack of EBP knowledge, lack of academic demand, and lack of emphasis on EBP in clinical placement were barriers to using EBPsteps. Design issues mattered, as use of the app was motivated by design features such as the opportunity to practice EBP in one place and taking notes in a digital notebook. The use of the app was hindered by anticipation that the use of phones during clinical placements would be viewed negatively by others and by specific design features, such as unfamiliar icons. The students perceived the EBPsteps app as a relevant tool for learning EBP, although they also suggested specific changes to the design of the app. Requirements must be embedded in the curriculum to ensure that the app is used. Our findings bring important information to developing and implementing mobile applications as a teaching method in health and social care educations.