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NCCMT Webinar: Injury-Prevention-Focused Methods and Tools to Support Evidence-Informed Decision-Making

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This webinar on evidence-informed decision-making (EIDM) draws on The National Collaborating Centre for Methods and Tools (NCCMT)'s seven-step process, with reference to methods and tools for each step that are specific to injury prevention.

The National Collaborating Centre for Methods and Tools is funded by the Public Health Agency of Canada and affiliated with McMaster University. The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.

NCCMT is one of six National Collaborating Centres (NCCs) for Public Health. The Centres promote and improve the use of scientific research and other knowledge to strengthen public health practices and policies in Canada.

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NCCMT Webinar: Injury-Prevention-Focused Methods and Tools to Support Evidence-Informed Decision-Making

  1. 1. Follow us @nccmt Suivez-nous @ccnmo Funded by the Public Health Agency of Canada | Affiliated with McMaster University The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada. Injury-Prevention-Focused Methods and Tools to Support Evidence-Informed Decision-Making Susan Snelling, PhD Senior Knowledge Translation Specialist, NCCMT June 22, 2016
  2. 2. Follow us @nccmt Suivez-nous @ccnmo Poll Question #1 2 How many people are watching today’s webinar with you? a) Just me b) 1 to 3 c) 4 to 5 d) 6 to 10 e) More than 10
  3. 3. Follow us @nccmt Suivez-nous @ccnmo Housekeeping • TC line will be muted during the webinar Use Q&A to post comments / questions during the webinar • ‘Send’ questions to All (not privately to ‘Host’) Connection issues • Recommend using a wired Internet connection (vs. wireless), • WebEx 24/7 help line: 1-866-229-3239 Q&A 3
  4. 4. Follow us @nccmt Suivez-nous @ccnmo Housekeeping Experiencing feedback? • Click Audio Broadcast at the bottom of the Participants panel to join or leave the audio broadcast. 4
  5. 5. Follow us @nccmt Suivez-nous @ccnmo Availability of the Slides and Audio Recording • The PowerPoint presentation (in English and French) and English audio recording will be available at: • PowerPoint: http://www.slideshare.net/nccmt • Audio Recording: https://www.youtube.com/user/nccmt 5
  6. 6. Follow us @nccmt Suivez-nous @ccnmo 6 Outline of Today’s Webinar • Introduction to NCCMT • A model for evidence-informed decision making • Steps in the process of evidence-informed public health With reference to methods & tools relevant for injury prevention practitioners
  7. 7. Follow us @nccmt Suivez-nous @ccnmo National Collaborating Centre for Methods and Tools (NCCMT) Vision • The effectiveness and efficiency of Canada’s public health system will be guided by the production, sharing and use of high quality evidence. Mission • The NCCMT will enhance evidence-informed public health practice and policy in Canada by providing leadership and expertise in supporting the uptake of what works in public health into practice. 7
  8. 8. Follow us @nccmt Suivez-nous @ccnmo NCCMT Registry of Methods and Tools Resources to support use of research evidence in public health http://www.nccmt.ca/resources/registry A free, searchable, online collection of knowledge translation methods and tools for public health • Summary statements • Web links (when available) to Methods and Tools 8
  9. 9. NCCMT Registry of Methods and Tools for Knowledge Translation 9
  10. 10. Follow us @nccmt Suivez-nous @ccnmo What are methods and tools? A process or series of steps to organize a Knowledge Translation activity Dissemination framework Method An instrument to carry out the steps of a Knowledge Translation activity Dissemination checklist Tool 10
  11. 11. Follow us @nccmt Suivez-nous @ccnmo Evidence… of what? 11
  12. 12. Follow us @nccmt Suivez-nous @ccnmo Evidence of the Problem versus Evidence of Effective Interventions • Injury Prevention has a lot of data on the problem: rates of injury, causes, burden… • Knowing the nature and magnitude of the problem helps to focus efforts. 12
  13. 13. Follow us @nccmt Suivez-nous @ccnmo Example: www.parachutecanada.org 13 Evidence of the problem comes in reports on cost, surveillance reports…
  14. 14. Follow us @nccmt Suivez-nous @ccnmo Evidence of the Problem versus Evidence of Effective Interventions • Injury Prevention has a lot of data on the problem: rates of injury, causes, burden… • Knowing the nature and magnitude of the problem helps to focus efforts. • Knowing the problem doesn’t tell us what effective interventions are. • We also want to find the best available evidence for effective interventions. 14
  15. 15. Follow us @nccmt Suivez-nous @ccnmo A Model for Evidence-Informed Decision-Making in Public Health 15
  16. 16. Follow us @nccmt Suivez-nous @ccnmo What is Evidence-Informed Public Health? … the process of distilling and disseminating the best available evidence from research, context and experience, and using that evidence to inform and improve public health policy and practice. 16
  17. 17. Follow us @nccmt Suivez-nous @ccnmo What does it mean for an intervention to be ‘effective’? Recommended resource: http://www.nccmt.ca/resources/search/129 17 Centers for Disease Control and Prevention (2011).
  18. 18. Follow us @nccmt Suivez-nous @ccnmo Strength of evidence and Effectiveness 18
  19. 19. Follow us @nccmt Suivez-nous @ccnmo Stages in the process of Evidence-Informed Public Health 19
  20. 20. Follow us @nccmt Suivez-nous @ccnmo Scenario: Setting the Stage for Evidence Use in Injury Prevention • Falls prevention for seniors living at home • Opportunity to offer some programming in partnership with several stakeholders How can the steps of Evidence- Informed Public Health be applied to this scenario? 20
  21. 21. Follow us @nccmt Suivez-nous @ccnmo 21 Evidence-Informed Public Health Clearly define the question or problem
  22. 22. Follow us @nccmt Suivez-nous @ccnmo Frameworks can help: BEEEACH Model of Categories and Settings of Interventions 22
  23. 23. Follow us @nccmt Suivez-nous @ccnmo Define the question PICO P population I intervention C comparison O outcome 23
  24. 24. Follow us @nccmt Suivez-nous @ccnmo Define the question: Apply our scenario PICO P population: community-dwelling seniors I intervention: [we’ll leave unspecified] C comparison: no intervention or usual care O outcome: prevention of falls 24
  25. 25. Follow us @nccmt Suivez-nous @ccnmo Recommended Tool: Define Developing an Efficient Search Strategy Using PICO http://www.nccmt.ca/resources/search/138 Use it to develop an evidence-search question using the PICO format. 25
  26. 26. Follow us @nccmt Suivez-nous @ccnmo 26
  27. 27. Follow us @nccmt Suivez-nous @ccnmo 27 Stages in the process of Evidence-Informed Public Health Efficiently search for research evidence
  28. 28. Follow us @nccmt Suivez-nous @ccnmo Recommended Tool: Search NCCMT Search Pyramids http://www.nccmt.ca/resources/search/181 http://www.nccmt.ca/learningcentre/EN/index.php • Pre-populated with good sites for finding evidence in public health, and for certain specific topics. • Start at the top for the most synthesized evidence. • Saves time • Systematic approach to searching 28
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  30. 30. Follow us @nccmt Suivez-nous @ccnmo 30 Recommended Tool: Search
  31. 31. National Guideline Clearinghouse 31
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  33. 33. 33 Recommended Tool: Search www.healthevidence.org
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  42. 42. Follow us @nccmt Suivez-nous @ccnmo Tips for “Search” • Choose the highest possible level on the Pyramid • Pre-appraised sources make your search more efficient • NCCMT online module on Searching through Learning Centre 42
  43. 43. Follow us @nccmt Suivez-nous @ccnmo 43 Evidence-Informed Public Health Critically and efficiently appraise the research methods
  44. 44. Follow us @nccmt Suivez-nous @ccnmo Recommended Tools: Appraise 44 Critically Appraising Practice Guidelines: The AGREE II Instrument http://www.nccmt.ca/registry/view/eng/100 Tools to Assess the Methodological Quality of Systematic Reviews: AMSTAR http://www.nccmt.ca/registry/view/eng/97 Critical Appraisal Skills Programme: Checklists http://www.nccmt.ca/resources/search/87
  45. 45. Follow us @nccmt Suivez-nous @ccnmo Tips for “Appraise” • Appraise is a filtering step, looking for sources of bias • Answers the question: is this research/review of good enough quality that I should read further? • All research has flaws! But some flaws are more serious than others. 45
  46. 46. Follow us @nccmt Suivez-nous @ccnmo Additional Resources • Refer to NCCMT’s online learning modules for additional practice: http://www.nccmt.ca/professional-development/modules • Week-long course at McMaster University: “What is Evidence-Informed Decision Making (EIDM)?” http://ccebn.mcmaster.ca/workshop 46
  47. 47. Follow us @nccmt Suivez-nous @ccnmo 47 Evidence-Informed Public Health Interpret information; understand how to prioritize conflicting results
  48. 48. Follow us @nccmt Suivez-nous @ccnmo Recommended Tool: Synthesize Briefing Note: Decisions, Rationale and Key Findings Summary http://www.nccmt.ca/resources/search/137 Use it to create briefing notes to inform decision- makers. Use ‘actionable messages’ to inform program and policy development. 48
  49. 49. Follow us @nccmt Suivez-nous @ccnmo Summarize Key Findings from Stubbs • exercise reduces falls (including the rate, risk, and odds of falling), with 13/14 pooled analyses (93%) from 7 meta-analyses demonstrating a significant reduction. • multifactorial interventions reduce falls (5/6, 83% reported significant reduction). • conflicting evidence regarding the influence of vitamin D supplementation (7/12, 58.3% reported significant reduction). 49
  50. 50. Follow us @nccmt Suivez-nous @ccnmo Bringing it all together…back to the framework! 50
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  52. 52. Follow us @nccmt Suivez-nous @ccnmo Tips for “Synthesize” • Bring good quality evidence together to determine results and implications • If results ‘conflict’, prefer sources that are highest quality, most recent, most relevant to your question • Identify actionable findings that can guide decisions 52
  53. 53. Follow us @nccmt Suivez-nous @ccnmo 53 Evidence-Informed Public Health Adapt the information to the local community
  54. 54. Follow us @nccmt Suivez-nous @ccnmo A Model for Evidence-Informed Decision-Making in Public Health 54
  55. 55. Recommended Tools: Adapt - Applicability and Transferability of Evidence 55 http://www.nccmt.ca/resources/search/227 http://www.nccmt.ca/resources/search/24
  56. 56. Follow us @nccmt Suivez-nous @ccnmo Online Learning Module Assessing the Applicability and Transferability of Evidence 56
  57. 57. Follow us @nccmt Suivez-nous @ccnmo Tips for “Adapt” 57 • In developing a local approach, consider: • Research evidence • Stakeholder perspectives • Media coverage – what’s going on in community • Political context • Local and regional data reports • Financial and human resources • How can you adapt potential interventions to be appropriate for your community?
  58. 58. Follow us @nccmt Suivez-nous @ccnmo 58 Evidence-Informed Public Health Decide whether (and plan how) to implement the change in practice or policy
  59. 59. Follow us @nccmt Suivez-nous @ccnmo https://www.mcmasteroptimalaging.org/ 59 Which is more likely to meet the need: Communicating evidence to partners and community members
  60. 60. Follow us @nccmt Suivez-nous @ccnmo http://www.nccmt.ca/resources/search/81 60 Recommended Tool: Implement
  61. 61. Follow us @nccmt Suivez-nous @ccnmo 61 Evidence-Informed Public Health Assess the effectiveness of the change in practice or policy
  62. 62. Follow us @nccmt Suivez-nous @ccnmo Recommended Tool: Evaluate Improving Future Decisions: Optimizing the Decision Process from Lessons Learned http://www.nccmt.ca/resources/search/194 Use it to evaluate your use of evidence in making decisions. A reflective practice tool. 62
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  64. 64. Follow us @nccmt Suivez-nous @ccnmo Tips for “Evaluate” Determine how effective you were at using an evidence-informed approach: • What process did you follow? • What can you learn from your process? • How could you improve your use of evidence? • How will you know if people are using the evidence? Have they changed their practice? • Was the intervention adapted effectively at your local level? You may need to gather baseline data before you start if you want to assess change. 64
  65. 65. Follow us @nccmt Suivez-nous @ccnmo Stages in the process of Evidence-Informed Public Health 65
  66. 66. Follow us @nccmt Suivez-nous @ccnmo Poll Question #2 66 How familiar are you with the methods and tools described today? a) I am not familiar with any of the methods/tools b) I have heard of one or more of the methods/tools c) I have used one or more of the methods/tools
  67. 67. Follow us @nccmt Suivez-nous @ccnmo Recommended tool: Evidence- Informed Decision Making Checklist http://www.nccmt.ca/resources/search/237 67  EIDM Phases & Steps File Path / Link to Saved Location on: (insert name of your network here)  1. Define question  Was a clear answerable search question developed? What was the question? P I C O  2. Search for relevant evidence  Was a comprehensive search strategy employed to find the best available evidence to address this question? PICO search terms table (See: Developing an Efficient Search Strategy Using PICO)  Years searched: Pyramid results (See: Levels & Sources of Public Health Evidence) Search results (See: Keeping Track of Search Results: A Flowchart) References saved in reference management software database (e.g. Reference Manager / RefWorks) What relevance criteria were used to determine evidence for quality assessment: Primary Titles and abstracts as found in reference management database  Save as separate reference management database. Secondary Relevance assessment of full document versions  Save as separate reference management database. How many papers remained following relevance assessment(s)? (See: Flowchart, above)  3. Appraise  Was quality assessment conducted on relevant evidence? How many papers remained after quality assessment? (See: Flowchart, above)  4. Synthesize  What were the results of the review of the evidence? What were the actionable messages from the evidence?  5. Adapt.  NCCMT’s Applicability and Transferability tool;  AHRQ’s Will It Work Here? A Decisionmaker's Guide to Adopting Innovations  6. Implement.  7. Evaluate.
  68. 68. Follow us @nccmt Suivez-nous @ccnmo Poll Question #3 68 To what extent will the methods or tools described today be useful in your practice? a) Very useful b) Somewhat useful c) Not at all useful d) Don’t know
  69. 69. Follow us @nccmt Suivez-nous @ccnmo • Use Q&A to post comments and/or questions • ‘Send’ questions to All (not privately to ‘Host’) Q&A Your Comments/Questions 69
  70. 70. Follow us @nccmt Suivez-nous @ccnmo Poll Question #4 70 What are your next steps? (Check all that apply) a) Access a method/tool referenced in the presentation b) Read an NCCMT summary about a method/tool described today c) Consider using the methods/tools in practice d) Tell a colleague about the methods/tools
  71. 71. Follow us @nccmt Suivez-nous @ccnmo Availability of the Slides and Audio Recording • The PowerPoint presentation (in English and French) and English audio recording will be available at: • PowerPoint: http://www.slideshare.net/nccmt • Audio Recording: https://www.youtube.com/user/nccmt 71
  72. 72. Follow us @nccmt Suivez-nous @ccnmo Your Feedback is Important Please take a few minutes to share your thoughts on today’s webinar. https://nccmt.co1.qualtrics.com/SE/?SID=SV_9EIx wibAzI4IgcJ 72
  73. 73. Follow us @nccmt Suivez-nous @ccnmo For more information about the National Collaborating Centre for Methods and Tools: 73 NCCMT website www.nccmt.ca Contact: nccmt@mcmaster.ca

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