A Case Story: Evidence-informed decision making in public health in Canada FUSE Knowledge Exchange in Public Health Durham...
Telling the story  <ul><li>About the partners </li></ul><ul><li>Project background </li></ul><ul><li>Objectives  </li></ul...
Project Partners
Project Partners <ul><li>Region of Peel Public Health </li></ul><ul><li>West of Toronto </li></ul><ul><li>2 nd  largest pu...
Peel Public Health <ul><li>Cities of Mississauga, Brampton and Town of Caledon – population >1.25 million </li></ul><ul><l...
Baby-friendly Designation <ul><li>Baby Friendly Community Health Service - in June 2009: </li></ul><ul><ul><li>seven Point...
Health Evidence Funders
Health Evidence <ul><li>Provide and promote access to the best available evidence </li></ul><ul><ul><li>Registry </li></ul...
Health Evidence <ul><li>online registry – 2300 reviews </li></ul><ul><li>evaluated interventions </li></ul><ul><li>quality...
FormulaNOthanks.ca
Next Step?
Objective  <ul><li>Determine if the available research literature supported a claim of improved cognitive development due ...
EIDM Model National Collaborating Centre for Methods and Tools Haynes B, DiCenso, A., Ciliska D., & Guyatt, G. 2005
EIDM Process Health Evidence Support  Decision
The Question <ul><li>Is breastfeeding exclusively for 6 months associated with enhanced  cognitive development outcomes  i...
The Search  <ul><li>Database searches of Medline, Embase, CINAHL (2005-2009), searches run June 10, 2009 </li></ul><ul><li...
Findings
Findings <ul><li>4 studies moderate quality </li></ul><ul><li>6 had serious methodological flaws  </li></ul><ul><li>Good q...
Decision Factors <ul><li>Research evidence </li></ul><ul><li>Public health experience, beliefs </li></ul><ul><li>Public he...
Decision <ul><li>Concept for the ‘IQ’ poster was deferred </li></ul><ul><li>Continued with infection, weight </li></ul>✔ ✔...
Learning and Challenges <ul><li>Imperative to understand feelings and experiences of staff </li></ul><ul><li>Staff highly ...
Next Steps <ul><li>Crafting messaging to explain these findings </li></ul><ul><li>Continue to mine the literature </li></u...
Questions? …..Thank you! <ul><li>Peel Health </li></ul><ul><li>Megan Ward </li></ul><ul><li>Associate Medical Officer of H...
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A case story: EIDM in public health in Canada

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A case story: EIDM in public health in Canada

  1. 1. A Case Story: Evidence-informed decision making in public health in Canada FUSE Knowledge Exchange in Public Health Durham University, UK April 12, 2011 Health Evidence Peel Public Health Maureen Dobbins PhD Megan Ward MD, MHSc, CCFP, FRCPC Lori Greco MHSc Beverly Bryant Kara DeCorby MSc
  2. 2. Telling the story <ul><li>About the partners </li></ul><ul><li>Project background </li></ul><ul><li>Objectives </li></ul><ul><li>Methods </li></ul><ul><li>Results </li></ul><ul><li>Learning </li></ul>
  3. 3. Project Partners
  4. 4. Project Partners <ul><li>Region of Peel Public Health </li></ul><ul><li>West of Toronto </li></ul><ul><li>2 nd largest public health unit in the Province of Ontario </li></ul><ul><li>Health Evidence </li></ul><ul><li>Based at McMaster University </li></ul><ul><li>Dedicated to a public health system informed by the best-available evidence </li></ul>
  5. 5. Peel Public Health <ul><li>Cities of Mississauga, Brampton and Town of Caledon – population >1.25 million </li></ul><ul><li>Higher proportion of children, young families and immigrants than rest of Ontario </li></ul>
  6. 6. Baby-friendly Designation <ul><li>Baby Friendly Community Health Service - in June 2009: </li></ul><ul><ul><li>seven Point Plan outcome criteria were met; 5 years to achieve </li></ul></ul><ul><ul><li>awarded by the Breastfeeding Committee for Canada, the national authority for WHO/UNICEF </li></ul></ul><ul><ul><li>Baby-friendly Initiative </li></ul></ul>
  7. 7. Health Evidence Funders
  8. 8. Health Evidence <ul><li>Provide and promote access to the best available evidence </li></ul><ul><ul><li>Registry </li></ul></ul><ul><ul><li>Literature searches & summaries </li></ul></ul><ul><ul><li>Facilitated evidence reviews </li></ul></ul><ul><li>Provide knowledge‐brokering services </li></ul><ul><ul><li>Customized EIDM training </li></ul></ul><ul><ul><li>Mentoring and Knowledge Brokering </li></ul></ul>
  9. 9. Health Evidence <ul><li>online registry – 2300 reviews </li></ul><ul><li>evaluated interventions </li></ul><ul><li>quality-assessed </li></ul><ul><li>searchable by commonly-used public health terms </li></ul><ul><li>two page summaries </li></ul><ul><li>updated quarterly </li></ul>
  10. 10. FormulaNOthanks.ca
  11. 11. Next Step?
  12. 12. Objective <ul><li>Determine if the available research literature supported a claim of improved cognitive development due to breastfeeding. </li></ul>
  13. 13. EIDM Model National Collaborating Centre for Methods and Tools Haynes B, DiCenso, A., Ciliska D., & Guyatt, G. 2005
  14. 14. EIDM Process Health Evidence Support Decision
  15. 15. The Question <ul><li>Is breastfeeding exclusively for 6 months associated with enhanced cognitive development outcomes in children when compared with formula feeding ? </li></ul>
  16. 16. The Search <ul><li>Database searches of Medline, Embase, CINAHL (2005-2009), searches run June 10, 2009 </li></ul><ul><li>Search terms were limited to results relating to humans, and English language </li></ul>
  17. 17. Findings
  18. 18. Findings <ul><li>4 studies moderate quality </li></ul><ul><li>6 had serious methodological flaws </li></ul><ul><li>Good quality evidence suggested: </li></ul><ul><ul><li>- No relationship between breastfeeding and cognitive development when you control for maternal characteristics including IQ, socio-environmental factors </li></ul></ul>
  19. 19. Decision Factors <ul><li>Research evidence </li></ul><ul><li>Public health experience, beliefs </li></ul><ul><li>Public health credibility </li></ul><ul><li>Audience assessment </li></ul>context
  20. 20. Decision <ul><li>Concept for the ‘IQ’ poster was deferred </li></ul><ul><li>Continued with infection, weight </li></ul>✔ ✔ ✗ ✗
  21. 21. Learning and Challenges <ul><li>Imperative to understand feelings and experiences of staff </li></ul><ul><li>Staff highly value tacit knowledge and experience </li></ul><ul><li>Inconsistent valuing of research </li></ul><ul><li>Research is evolving </li></ul>
  22. 22. Next Steps <ul><li>Crafting messaging to explain these findings </li></ul><ul><li>Continue to mine the literature </li></ul><ul><li>For Clients: create web pages with information about findings in language that is suitable to all literacy levels and add to the FormulaNOthanks.ca website </li></ul><ul><li>For Staff: Ongoing EIDM training, organizational supports and opportunities </li></ul>
  23. 23. Questions? …..Thank you! <ul><li>Peel Health </li></ul><ul><li>Megan Ward </li></ul><ul><li>Associate Medical Officer of Health </li></ul><ul><li>[email_address] </li></ul><ul><li>Beverley Bryant </li></ul><ul><li>Manager of Education and Research </li></ul><ul><li>[email_address] </li></ul><ul><li>Health Evidence </li></ul><ul><ul><li>Maureen Dobbins </li></ul></ul><ul><ul><li>Director </li></ul></ul><ul><ul><li>[email_address] </li></ul></ul><ul><ul><li>Lori Greco </li></ul></ul><ul><ul><li>Knowledge Broker, </li></ul></ul><ul><ul><li>[email_address] ca </li></ul></ul>

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