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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