Training needs and supports for evidence-based decision making among the public health workforce in the United States

Abstract

BackgroundPreparing the public health workforce to practice evidence-based decision making (EBDM) is necessary to effectively impact health outcomes. Few studies report on training needs in EBDM at the national level in the United States. We report competency gaps to practice EBDM based on four U.S. national surveys we conducted with the state and local public health workforce between 2008 and 2013.MethodsWe compared self-reported data from four U.S. national online surveys on EBDM conducted between 2008 and 2013. Participants rated the importance of each EBDM competency then rated how available the competency is to them when needed on a Likert scale. We calculated a gap score by subtracting availability scores from importance scores. We compared mean gaps across surveys and utilized independent samples t tests and Cohen’s d values to compare state level gaps. In addition, participants in the 2013 state health department survey selected and ranked three items that “would most encourage you to utilize EBDM in your work” and items that “would be most useful to you in applying EBDM in your work”. We calculated the percentage of participants who ranked each item among their top three.ResultsThe largest competency gaps were consistent across all four surveys: economic evaluation, communicating research to policymakers, evaluation designs, and adapting interventions. Participants from the 2013 state level survey reported significantly larger mean importance and availability scores (p <0.001, d =1.00, and p <0.001, d = .78 respectively) and smaller mean gaps (p <0.01, d = .19) compared to the 2008 survey. Participants most often selected “leaders prioritizing EBDM” (67.9%) among top ways to encourage EBDM use. “EBDM training for specific areas” was most commonly ranked as important in applying EBDM (64.3%).ConclusionPerceived importance and availability of EBDM competencies may be increasing as supports for EBDM continue to grow through trends in funding, training, and resources. However, more capacity building is needed overall, with specific attention to the largest competency gaps. More work with public health departments to both situate trainings to boost competency in these areas and continued improvements for organizational practices (leadership prioritization) are possible next steps to sustain EBDM efforts.

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

“…A summary of four US surveys of state and local public health practitioners identified three skills where the gaps in capacity are largest between importance and availability: economic evaluation, communicating research to policymakers, and adapting interventions from one setting or population to another (103). The shortage of economic data has also been observed in England (115).…”

Mixed Picture of Readiness for Adoption of Evidence‐Based Prevention Programs in Communities: Exploratory Surveys of State Program Delivery Systems

“…Finally, there were several interrelated reasons for surveying representatives from the Departments of Education and Public Health, in addition to Extension. Although a national survey assessing training needs of the public health workforce concerning evidenced-based decision making recently has been conducted (Jacob et al 2014), other relevant types of readiness assessments were not found. Most importantly, the design for the PROSPER Partnership Model entails active collaboration of Extension systems with DOEs and DPHs, as potential supporters of EBP delivery.…”

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