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Enhancing Evidence-based Information Access to Inform

Public Health Practice

Modeling Public Health Information Needs and Accessing Requirements

December 14, 2005

conducted by:University of Massachusetts Medical School Library

funded by:Center for Disease Control and Prevention

Association of Teachers of Preventive MedicineProject TS-0734

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Project Staff & ResourcesPrincipal Investigator:

•Elaine Martin, DA

Project Coordinator:•E. Hatheway Simpson, MPH

Consultants:

•Nancy La Pelle, PhD

•Roger Luckmann, MDEvidence-Based Practice for Public Health Project Website: http://library.umassmed.edu/ebpph

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Outline

• Project Background & Purpose• Qualitative Study Findings Part 1: Information

Needs Continuum Model• Existing Public Health (PH) Information

Resource Examples • Qualitative Study Findings Part 2:Information

Accessing Requirements Not Fully Addressed• Hypothetical Integrative Model Based on

Findings

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Project Background• Evidence can be applied to solve public health

problems if readily accessible• Many barriers identified by other researchers

including limited:– Encouragement to seek it– Awareness of what is available– Access to computers/internet– Accessing skills– Time to search– Ability to appraise credibility & availability of

systematic reviews– Access to required information beyond

biomedical field

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Project Purpose

• Build on and integrate findings from related studies & review of existing resources

• Use qualitative method to identify information needs to inform PH practices

• Use findings to inform development of integrative models of PH information and accessing needs

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EBPPH Research ProcessStep 1 - Identify existing resources and features

Step 2 - Interview BCDCparticipants

Step 3 - Focus group with BCDC participants

Step 4 - Interview CHP participants

Step 5 - Develop hypothetical model system

Step 6 - Focus group with CHP participants

Step 7 - Revise hypothetical model

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Qualitative Study DetailSample:

• Two groups: Communicable Disease Control & Community Health Promotion

• 19 State level PH professionals with strongest info accessing needs

Data Collection & Analysis:• Taped/transcribed key informant interviews • Taped/transcribed follow-up focus groups• Thematic analysis of all data; comparison across

groups• Model development & review with informants

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Focus of Individual Interviews

• Type of work tasks performed requiring access to critical external information?

• Current used and preferred info sources (online and offline)?

• Preferred format for research reports (abstracts, full text, reviews/commentaries)?

• Current barriers to information access?

• Desired enhancements for access?

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Individual Interview Findings Related to Context

• All DPH staff have PCs, access to internet

• Large sophisticated DPH website

• Multiple DPH sites and more than one library site

• Urgency of information need differs widely

• Electronic information access differs widely

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Findings: Information Needs Continuum Model Emerged

Publis

hed

rese

arch

repo

rts

and

met

a-an

alys

es

Formal Research Support for Information

Emer

ging h

ealth

ris

ks a

nd pre

ventiv

e

b

ehav

iors

Em

ergi

ng p

ract

ices

Wel

l-kno

wn

dise

ase

r

efer

ence

info

Evide

nce-

base

d

g

uide

lines

Minimum Maximum

Examples:SARS, new STD, TB, Effective Immunizationhealth risks venues CVD interventions Clinical standards

Typical Access Mechanisms:Automatic Colleagues, Web Journal Websitesnotification conferences, sites search

listserves engines

Eva

luat

ed p

ract

ices

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Current PH Information Resource Types Reviewed in Focus Groups

Providing electronic access to:

1. Research Reports:• Simple or preformulated searches of

research report collections• Alerts & archiving• Summaries/commentaries/critiques

2. Systematic reviews and other evidence-based resources

3. Comprehensive knowledge sources

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http://www.pubmed.gov

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http://phpartners.org/hp

14www.safetylit.org

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http://www.jwatch.org/

http://www.harcourt-international.com/journals/ebhc

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http://www.thecommunityguide.org

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http://www.uptodate.com/

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Information Accessing or Formatting Features

Website Examples of Specific Features Reviewed with Informants

Keywords for searching published literature for articles of interest

PubMed

Pre-formulated search or screening filters

• Partners in Information Access for the PH Workforce

• PubMed Clinical Queries

Automatic notification (alert systems and topical listservs)

•SafetyLit •AJPH Online Subscriber Help & Services •TB-UpDate from the CDC

Abstracts, summaries and expert commentaries

•Journal Watch •Evidence-Based HealthCare and PH

Systematic reviews Cochrane Systematic Reviews

Evidence-based guidelines Guide to Community Preventive Services

Comprehensive knowledge collection •UpToDate•CDC website

Within article indexing UpToDate

Archiving of information sought SafetyLit

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Focus Group Findings Regarding Accessing Needs

1. One portal searching access

2. Access to consistent information for all diseases/populations and from diverse disciplines of interest to PH professionals beyond PubMed scope

3. Better access to relevant and credible “grey literature” as well as systematic reviews and full text

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Focus Group Findings Regarding Accessing Needs

4. Credibility of information systematically reviewed

5. Training on how to access information electronically

6. Mediated searching=article retrieval services

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PH Evidence-Based

Information Access Website

User-selectedfilters & pre-formulated

searchcriteria Review

System

Automatic notification of newly availablerequested filtered

information

PH InformationAccess Model

•Journal articles•Systematic reviews•Practice Guidelines•Best Practices•Relevant “grey literature”

Newly published

information in diverse

disciplinesof interest

Customizeduser database

of accessedinformation

Credibleindexed

info