NCCMT Webinar: Injury-Prevention-Focused Methods and Tools to Support Evidence-Informed...
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Transcript of NCCMT Webinar: Injury-Prevention-Focused Methods and Tools to Support Evidence-Informed...
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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
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Poll Question #1
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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
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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’)
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Q&A
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Housekeeping
Experiencing feedback?
• Click Audio Broadcast at the bottom of the
Participants panel to join or leave the audio
broadcast.
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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
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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
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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.
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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
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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
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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.
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Example: www.parachutecanada.org
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Evidence of the
problem comes in
reports on cost,
surveillance
reports…
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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.
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A Model for Evidence-Informed
Decision-Making in Public Health
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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.
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What does it mean for an intervention
to be ‘effective’?
Recommended resource:
http://www.nccmt.ca/resources/search/129
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Centers for Disease
Control and
Prevention (2011).
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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?
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Evidence-Informed Public Health
Clearly define the question or
problem
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Frameworks can help:
BEEEACH Model of Categories and
Settings of Interventions
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Define the question
PICO
P population
I intervention
C comparison
O outcome
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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
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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.
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Stages in the process of
Evidence-Informed Public Health
Efficiently search for research
evidence
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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
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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
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Evidence-Informed Public Health
Critically and efficiently appraise
the research methods
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Recommended Tools: Appraise
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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
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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.
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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
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Evidence-Informed Public Health
Interpret information;
understand how to prioritize
conflicting results
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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.
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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).
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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
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Evidence-Informed Public Health
Adapt the information
to the local community
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A Model for Evidence-Informed
Decision-Making in Public Health
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Recommended Tools: Adapt - Applicability and Transferability of Evidence
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http://www.nccmt.ca/resources/search/227
http://www.nccmt.ca/resources/search/24
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Online Learning Module Assessing the Applicability and Transferability
of Evidence
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Tips for “Adapt”
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• 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?
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Evidence-Informed Public Health
Decide whether
(and plan how) to implement
the change in practice or policy
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https://www.mcmasteroptimalaging.org/
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Which is more likely to meet the need:
Communicating evidence to partners and community members
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http://www.nccmt.ca/resources/search/81
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Recommended Tool: Implement
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Evidence-Informed Public Health
Assess the effectiveness
of the change in
practice or policy
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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.
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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.
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Poll Question #2
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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
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Recommended tool: Evidence-
Informed Decision Making Checklist http://www.nccmt.ca/resources/search/237
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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.
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Poll Question #3
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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
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• Use Q&A to post comments
and/or questions
• ‘Send’ questions to All (not
privately to ‘Host’)
Q&A
Your Comments/Questions
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Poll Question #4
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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
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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
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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
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For more information about the
National Collaborating Centre
for Methods and Tools:
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NCCMT website www.nccmt.ca
Contact: [email protected]