Healthy People 2020 calls for the various sectors in public health to “to strengthen policies and improve practices that are driven by the best available evidence and knowledge.” Applying an evidence-based approach to the work of public health is essential to meeting health goals and sustaining valuable resources. Describe the key elements of evidence-based public health (EBPH) and how they can be applied in public health.

Evidence-based public health (EBPH) is a systematic approach that incorporates the best available evidence, public health data, and community input to inform decision-making and improve population health outcomes. While evidence-based medicine has long been recognized and utilized in healthcare settings, the application of an evidence-based approach to public health is a relatively recent development. This approach emphasizes the use of scientific evidence and rigorous evaluation to guide public health interventions and policies.

The key elements of EBPH can be categorized into five interrelated steps: formulating the question, identifying relevant evidence, appraising the evidence, applying the evidence to practice, and evaluating the outcomes (Brownson, Fielding, & Maylahn, 2009). Let’s explore each step in detail:

1. Formulating the question: The first step in EBPH involves clearly defining the public health issue or problem and formulating a focused question. The question should be specific, measurable, achievable, relevant, and time-bound (SMART). It should also consider the population of interest, the intervention or exposure, the comparison, and the outcomes (known as PICO) to ensure a clear and targeted approach to evidence synthesis.

2. Identifying relevant evidence: Once the question is formulated, the next step is to systematically search and review the relevant literature and other sources of evidence to find studies that address the question. This includes conducting comprehensive searches of research databases, grey literature, and consulting experts in the field. The goal is to identify high-quality studies and evidence that can address the question at hand.

3. Appraising the evidence: After identifying relevant evidence, the next step is to critically appraise the quality and relevance of the studies. This entails assessing the internal and external validity of the research, examining the study design, sample size, methods of data collection and analysis, and potential sources of bias. Appraising the evidence helps determine the strength and trustworthiness of the findings.

4. Applying the evidence to practice: Once the evidence is appraised, the next step is to translate it into practice. This involves considering the context, feasibility, acceptability, and potential impact of the interventions or policies supported by the evidence. It also requires engaging key stakeholders, such as policymakers, community members, and practitioners, to ensure the relevance and effectiveness of the interventions in the specific setting.

5. Evaluating the outcomes: The final step in EBPH is evaluating the outcomes of the implemented interventions or policies. This involves monitoring and measuring the impact of the interventions on the target population’s health outcomes and assessing whether the desired changes have occurred. Evaluation helps determine whether the evidence-based interventions are achieving the intended goals and informs future decision-making and program improvement.

In public health practice, EBPH can be applied across various domains, including health promotion and disease prevention, health policy development, and program planning and evaluation. For example, in the field of health promotion, EBPH can guide the selection and implementation of evidence-based interventions to address health behaviors, such as smoking cessation or physical activity promotion. In health policy development, EBPH can inform the creation of policies and regulations that are grounded in evidence, such as implementing comprehensive tobacco control measures based on evidence of their effectiveness. In program planning and evaluation, EBPH can guide the design and evaluation of public health programs to ensure their impact and sustainability.

Overall, the application of an evidence-based approach in public health is crucial for promoting effective and efficient interventions and policies. By incorporating the best available evidence, public health data, and community input, EBPH enables informed decision-making and maximizes the potential for improving population health outcomes. It provides a systematic and rigorous framework that fosters accountability, transparency, and the optimal use of limited resources in public health practice.