Lifsey Sarah, Cash Amanda, Anthony Jodi, Mathis Sheryl, Silva Sandra
Altarum Institute, Washington, DC, USA
U.S. Department of Health & Human Services, Washington, DC, USA.
Health Educ Behav. 2015 Apr;42(1 Suppl):133S-140S. doi: 10.1177/1090198114568429.
Population-level interventions focused on policy, systems, and environmental change strategies are increasingly being used to affect and improve the health of populations. At the same time, emphasis on implementing evidence-based public health practices and programming is increasing, particularly at the federal level. Valuing strategies in the population health domain without the benefit of demonstrated efficacy through highly rigorous methods introduces an inherent tension between planning and acting on the best evidence available, waiting for more rigorous evidence to emerge, as well as exploring innovative ways to evaluate and model evidence-based strategies. This article describes the creation of a resource that helps public health practitioners use current evidence for strategic decision making while building the evidence base for population-level interventions. The resource addresses topics of current discussion in the field of evaluating population-level interventions, including the tension between internal and external validity, the need to include measures of health equity, and the balance between fidelity to the intervention and adaptation to the community context. The resource is intended to advance development of evidence in the field by providing practitioners, project managers, and evaluators with a practical guide for using, reviewing, and adding to the existing evidence base.
聚焦于政策、系统和环境变化策略的人群层面干预措施正越来越多地被用于影响和改善人群健康。与此同时，对实施基于证据的公共卫生实践和规划的重视也在增加，尤其是在联邦层面。在没有通过高度严格的方法证明疗效的情况下重视人群健康领域的策略，这在基于现有最佳证据进行规划和行动、等待更严格的证据出现以及探索评估和模拟基于证据的策略的创新方法之间引入了内在的矛盾。本文描述了一种资源的创建，该资源有助于公共卫生从业者利用当前证据进行战略决策，同时为人群层面的干预措施建立证据基础。该资源涉及评估人群层面干预措施领域当前讨论的主题，包括内部效度和外部效度之间的矛盾、纳入健康公平措施的必要性以及干预措施的保真度与社区背景适应性之间的平衡。该资源旨在通过为从业者、项目经理和评估人员提供使用、审查和补充现有证据基础的实用指南，推动该领域证据的发展。
