The evaluation of interventions in Public Health is a key element through the process of developing health policies, but it is not free of controversy. For doing this purpose it is essential the use of research outcomes, although there are sticking points related to the traditional approach of Evidence Based Medicine, dominated by the randomized clinical trial as the gold standard. Not always it is possible to develop randomized and controlled studies in Public Health (sometimes due to ethical limitations, or because of the technical impossibility for performing the trial or because conceptual incompatibility) and the interventions are mostly multifaceted, therefore, the interpretation of the results is a complex task. In other hand, the usual criteria for research appraisal underestimates systematically the observational studies which, frequently, are the indicated in Public Health scenarios. Nevertheless, a great advance has been implemented with the generation of strategies as TREND (Transparent Reporting of Evaluations with Non randomized Designs), as well as other instruments like STROBE (STrenghtening the Reporting of OBservational studies in Epidemiology) or MOOSE (Meta-analysis Of Observational Studies in Epidemiology). But regardless of the existence of more or less consolidated critical appraisal tools, we all need a solvent and rigorous way of knowing the outcomes of Public Health interventions. This would make more dynamic the review, design or planning phases, and it would contribute to facilitate the decision-making process when a well grounded knowledge be available. In this paper all the methodological process about searching evidence in Public Health interventions is reviewed, as well as the main sources providing this information, in order to facilitate this task to the Public health professionals.

BackgroundThe need of home care services is becoming an increasingly common scenario. These cares are mainly provided by the dependents’ relatives specifically, by the women part of the family. This situation might take years, decreasing the physical and psychological health of the caregiver. In Spain, the Act of Promotion of Personal Autonomy and Care for dependent persons, guarantees those dependent persons and their caregivers to have access to social services or to financial grants. The aim of this study is to Know the possible effects of the benefits provided by this Act in regards to the mental health, the quality of life and use of health services by the family caregivers assisting their relatives in situation of dependency.Methods and designA longitudinal descriptive study following-up a cohort of patients and caregivers. The study shall be carried out in Andalusia. It shall include the baseline assessment of the variables in those caregivers free from the exposure factor (reception of assistance pursuant to the Act). Following, once the benefits have been received, this cohort shall be followed-up.The study shall take three years, and the starting date for its development as well as its funding is January 2011.DiscussionThe longitudinal assessment of the rate of change of the variables studied shall allow us to know the implications which might be potentially generated as well as the natural evolution of those.

Social inequalities and health inequalities are closely related, and their reduction is the goal of international organizations and governments as well. In order to better understand the territorial distribution of social inequalities in the city of Málaga (Spain) and compare them with measured health differences, a descriptive study was done using different sources of information. Using the city's neighbourhoods as the unit of analysis, a cluster analysis was carried out based on a set of demographic, socioeconomic and standard of living indicators. This led to the configuration of six social areas within the city. In these areas, as defined by socially homogeneous criteria, diverse health indicators have been measured, leading the verification of important health differences among them. For example, clear differences in mortality rates between Area IV (socioeconomically deprived) and Area III (with a higher standard of living) are observed: the ratio between their respective "years of potential life lost" was 1.79, and between standardized mortality rates, 1.42. A similar disadvantage in low birth weight was confirmed notably so in adolescent pregnancies (five times higher). In conclusion, those areas of the city with a lower socio-economic status also had the lowest health levels.

Assessment of satisfaction with home care can be performed with the dimensions routinely used in satisfaction studies, but these should be evaluated with instruments designed ad hoc. Accessibility, communication and interpersonal relationships have a high explanatory value in satisfaction among this population.