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循证公共卫生:公共卫生实践的一个基本概念。

Evidence-based public health: a fundamental concept for public health practice.

作者信息

Brownson Ross C, Fielding Jonathan E, Maylahn Christopher M

机构信息

Prevention Research Center, St. Louis, Missouri 63110, USA.

出版信息

Annu Rev Public Health. 2009;30:175-201. doi: 10.1146/annurev.publhealth.031308.100134.

Abstract

Despite the many accomplishments of public health, a greater attention to evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about a decade ago. Key components of EBPH include making decisions on the basis of the best available scientific evidence, using data and information systems systematically, applying program-planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Three types of evidence have been presented on the causes of diseases and the magnitude of risk factors, the relative impact of specific interventions, and how and under which contextual conditions interventions were implemented. Analytic tools (e.g., systematic reviews, economic evaluation) can be useful in accelerating the uptake of EBPH. Challenges and opportunities (e.g., political issues, training needs) for disseminating EBPH are reviewed. The concepts of EBPH outlined in this article hold promise to better bridge evidence and practice.

摘要

尽管公共卫生取得了诸多成就,但仍有必要更加关注循证方法。本文回顾了循证公共卫生(EBPH)的概念,关于这一概念的正式讨论大约始于十年前。循证公共卫生的关键要素包括基于可得的最佳科学证据做出决策、系统地使用数据和信息系统、应用项目规划框架、让社区参与决策、进行合理评估以及传播所学知识。已呈现了三类证据,分别是关于疾病病因和风险因素程度的证据、特定干预措施的相对影响的证据,以及干预措施如何实施以及在何种背景条件下实施的证据。分析工具(如系统评价、经济评估)有助于加速循证公共卫生的应用。本文还探讨了传播循证公共卫生所面临的挑战与机遇(如政治问题、培训需求)。本文所概述的循证公共卫生概念有望更好地弥合证据与实践之间的差距。

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