Prevention Health Policy, Systems and Analytics, Prevention Services Division, Colorado Department of Public Health and Environment, Denver, CO 80246, USA.
Prev Chronic Dis. 2013 Jul 3;10:E106. doi: 10.5888/pcd10.120275.
Colorado's adult obesity rate has more than doubled since 1995, prompting its Department of Public Health and Environment to list obesity as its top prevention priority. To initiate comprehensive and effective action, the department used a well-known evidence-based public health framework developed by Brownson and others. This article describes the tools and process developed to conduct 2 of the 7 stages in this framework that challenge public health organizations: reviewing the literature and prioritizing effective strategies from that literature. Forty-five department staff participated in an intensive literature review training to identify physical activity and nutrition strategies that effectively address obesity and worked with external stakeholders to prioritize strategies for the state. Divided into 8 multidisciplinary teams organized by the setting where public health could exert leverage, they scanned the scientific literature to identify potential strategies to implement. These teams were trained to use standardized tools to critique findings, systematically abstract key information, and classify the evidence level for each of 58 identified strategies. Next, departmental subject matter experts and representatives from local public health and nonprofit health agencies selected and applied prioritization criteria to rank the 58 strategies. A team charter, group facilitation tools, and 2 web-based surveys were used in the prioritization stage. This process offered the staff a shared experience to gain hands-on practice completing literature reviews and selecting evidence-based strategies, thereby enhancing Colorado's obesity prevention efforts and improving public health capacity. Practitioners can use these tools and methodology to replicate this process for other health priorities.
科罗拉多州的成年人肥胖率自 1995 年以来已经翻了一番还不止,这促使该州公共卫生和环境部门将肥胖问题列为首要预防重点。为了采取全面有效的行动,该部门使用了由 Brownson 等人开发的知名循证公共卫生框架。本文描述了为实施该框架中 7 个阶段中的 2 个阶段而开发的工具和流程,这 2 个阶段对公共卫生组织构成了挑战:审查文献并从文献中确定有效的策略。45 名部门工作人员参加了一次密集的文献综述培训,以确定能有效解决肥胖问题的身体活动和营养策略,并与外部利益相关者合作,为该州确定策略的优先顺序。他们分为 8 个多学科小组,这些小组由公共卫生可以施加影响力的环境组织,扫描科学文献,以确定潜在的实施策略。这些团队接受了使用标准化工具来评估发现、系统地提取关键信息以及为 58 项确定策略分类证据水平的培训。然后,部门主题专家和来自当地公共卫生及非营利卫生机构的代表选择并应用了优先排序标准,对 58 项策略进行了排名。团队章程、小组促进工具和 2 个基于网络的调查在优先排序阶段使用。这一过程为工作人员提供了一个共同的经验,使他们能够实际操作完成文献综述和选择基于证据的策略,从而加强科罗拉多州的肥胖预防工作并提高公共卫生能力。从业人员可以使用这些工具和方法来复制其他健康重点的这一过程。