The Second Consensus Conference on Stroke Management took place from 22 to 24 March 2006 in Helsingborg, Sweden. The meeting was arranged by the International Stroke Society, endorsed by the European Stroke Council and International Stroke Society, and co-sponsored by the WHO Regional Office for Europe. It was arranged in collaboration with the European Region of the World Confederation for Physical Therapy and the European Association of Neuroscience Nurses. The patients’ organization Stroke Alliance for Europe also participated. The meeting adopted the Helsingborg Declaration 2006 on European Stroke Strategies, a statement of the overall aims and goals of five aspects of stroke management (organization of stroke services, management of acute stroke, prevention, rehabilitation, evaluation of stroke outcome and quality assessment) to be achieved by 2015.
The control of noncommunicable diseases (NCDs) was addressed by the declaration of the 66th UN General Assembly followed by the World Health Organisation’s NCD 2020 Action Plan. There is a clear need to better apply evidence in public health settings to tackle both behaviour-related factors and the underlying social and economic conditions. This article describes concepts of evidence based public health and outlines a set of actions that are essential for a successful global NCD prevention. The authors describe the importance of knowledge translation with the goal of increasing the effectiveness of public health services, replying on both quantitative and qualitative evidence. In particular, the role of capacity building is highlighted because it is fundamental to progress in controlling NCDs. Important challenges for capacity building include the need to bridge diverse disciplines, build the evidence base across countries, and the lack of formal training in public health sciences. As brief case examples, several successful capacity building efforts are highlighted to address challenges and further evidence-based decision making. The need for a more comprehensive public health approach, addressing social, environmental and cultural conditions, has led to a whole-of government and whole-of society strategies that are now on the agenda due to efforts such as the WHO's NCD 2020 Action Plan and the Health 2020 European Policy Framework. These efforts need research to generate evidence in new areas (e.g., equity, sustainability), training to build public health capacity, and a continuous process of improvement and knowledge generation and translation.
Too often, public health decisions are based on short-term demands rather than long-term research and objectives. Policies and programmes are sometimes developed around anecdotal evidence. The Evidence-Based Public Health (EBPH) programme trains public health practitioners to use a comprehensive, scientific approach when developing and evaluating chronic disease programmes. Begun in 2002, the EBPH programme is an international collaboration. The course is organized in seven parts to teach skills in: 1) assessing a community's needs; 2) quantifying the issue; 3) developing a concise statement of the issue; 4) determining what is known about the issue by reviewing the scientific literature; 5) developing and prioritizing programme and policy options; 6) developing an action plan and implementing interventions; and 7) evaluating the programme or policy. The course takes an applied approach and emphasizes information that is readily available to busy practitioners, relying on experiential learning and includes lectures, practice exercises, and case studies. It focuses n using evidence-based tools and encourages participants to add to the evidence base in areas where intervention knowledge is sparse. Through this training programme, we educated practitioners from 38 countries in 4 continents. This article describes the evolution of the parent course and describes experiences implementing the course in the Russian Federation, Lithuania, and Chile. Lessons learned from replication of the course include the need to build a "critical mass" of public health officials trained in EBPH within each country and the importance of international, collaborative networks. Scientific and technologic advances provide unprecedented opportunities for public health professionals to enhance the practice of EBPH. To take full advantage of new technology and tools and to combat new health challenges, public health practitioners must continually improve their skills.
Objective: Since 2002, a course entitled ‘Evidence-Based Public Health (EBPH): A Course in Noncommunicable Disease (NCD) Prevention’ has been taught annually in Europe as a collaboration between the Prevention Research Center in St Louis and other international organizations. The core purpose of this training is to strengthen the capacity of public health professionals, in order to apply and adapt evidence-based programmes in NCD prevention. The purpose of the present study is to assess the effectiveness of this EBPH course, in order to inform and improve future EBPH trainings. Methods: A total of 208 individuals participated in the European EBPH course between 2007 and 2016. Of these, 86 (41%) completed an online survey. Outcomes measured include frequency of use of EBPH skills/materials/resources, benefits of using EBPH and barriers to using EBPH. Analysis was performed to see if time since taking the course affected EBPH effectiveness. Participants were then stratified by frequency of EBPH use (low v. high) and asked to participate in in-depth telephone interviews to further examine the long-term impact of the course ( n = 11 (6 low use, 5 high use)). Findings: The most commonly reported benefits among participants included: acquiring knowledge about a new subject (95%), seeing applications for this knowledge in their own work (84%), and becoming a better leader to promote evidence-based decision-making (82%). Additionally, not having enough funding for continued training in EBPH (44%), co-workers not having EBPH training (33%) and not having enough time to implement EBPH approaches (30%) were the most commonly reported barriers to using EBPH. Interviews indicated that work-place and leadership support were important in facilitating the use of EBPH. Conclusion: Although the EBPH course effectively benefits participants, barriers remain towards widely implementing evidence-based approaches. Reaching and communicating with those in leadership roles may facilitate the growth of EBPH across countries.
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