Resources from blog moved to web page

Well, I was having a hard time finding some of the resources I'd linked to from the blog. And if I'm having a hard time, I figured anyone taking part in the workshop was having an even harder time! So I wised up and moved things to a web page. Where did everything go?
http://www.sph.uth.tmc.edu/charting/handouts/ebph_handouts/ebph_workshop.htm

I'm going to maintain the blog, just in a slightly different way. I'd like to add more EBPH newsy links to the site, stuff not necessarily related to my workshops. We'll see. I'm kind of busy, it gets hard to look for things.

But, here's a thought-- I may just try looking for something public health related, something topical, and ask for comments. Dunno. What do you think? How do you think this blog can be best utilized?

More about the week 4 workshop

The first few weeks of this 4-week workshop provided an overview to the EBPH 6-step process (O'Neall, M. A., & Brownson, R. C. (2005). Teaching evidence-based public health to public health practitioners. Annals of Epidemiology, 15(7), 540-544. ).

We spent one week on data gathering and one week exploring literature databases. During the last session, I covered resources with a consumer-health bent. I did that because so many PH workers are in clinics, work with clinic staff, put on health fairs, or need to design programs for the public.

However, now that the data is gathered and the literature has been researched, it's time to review the last 3 steps of the EBPH process:

4.Develop program or policy options
5.Create an implementation plan
6.Evaluate the program or policy

I don't have anything new for steps 4 or 5-- put those health theories to work and revise your logic models. But, the evaluation part has been in the back of my mind. I see this as something that can really make or break a program. After all, you can put together the best intervention ever seen but if you don't have the data to support it you won't get refunded!

So here are a few links to evaluating your programs.

CDC Evaluation Working Group: Framework for Program Evaluation

WK Kellogg Foundation Evaluation Handbook

Association for Community Health Improvement: Outcomes Measurements

The latter item is a meta-site-- it points to bunches of other resources. I don't normally like to do that, but they've pulled together a great list of outcomes measurements.

I want to give a big THANK YOU to my Tuesday group. They were great-- stuck with me through these 4 weeks. We had a hurricane last week (well, sort of-- we thought we were going to have a hurricane!) but other than that they were here for each class, asked questions, made comments-- I really had a good time. I hope they did as well.

Questions or comments to this or any post can be published through the blog or sent to me directly from the Ask-A-Librarian link in the upper left corner of the blog.

Last week of workshops!

Hi all,

My first group is almost finished with the 4-week session. I have had so much fun! I have 2 more classes-- today and Thursday. Same topic-- additional resources. Yeah, not much of a name but that's what we're covering.

What are the resources?

◦MedlinePlus (NLM)
◦ToxMap (Texas) (NLM)
◦Household Products Database (NLM)
◦Partners in Information Access for the Public Health Workforce

Why these?

MedlinePlus is *the* best source for consumer health information. If you're working in a clinic or you have practitioners who work in clinics, you can point your patients and their families to MedlinePlus. Excellent prescription drug information, great links to handouts, and lots of pointers to *local* resources. The last item refers to the Go Local project sponsored by the National Library of Medicine. Local health sciences libraries have joined in on the project and created awesome directories of services.

ToxMap is one of my favorite NLM projects. If you want to see where the big polluters are, go to ToxMap. If you want to know the health effects of the pollution around you, go to ToxMap. If you want to see the historical trends of the polluters around you, go to ToxMap.

Another favorite site of mine is the Household Products Database. You can look up products by name brand, by ingredient, or by manufacturer. You can even look up products by health effect. Try it-- go to the link above and look up "asthma".

Lastly, the Partners in Information Access for the Public Health Workforce site is an attempt (and a very well done attempt at that!) to link the PH workforce to key resources that they may find useful in their positions. Training, conferences, health education/promotion resources, data, grants-- you name it and if it's of benefit to PH, it's there.

That's all for now. Recordings for the presentations will be posted later.

Week 2: Data Sources recordings

Well, week 2 of the EBPH webinars has just come to a close. What a great group! Thanks for the questions. I've got some research to do (dang, homework!!!). Actually, the homework is pretty interesting.

For example, the Youth Risk Behavioral Surveillance System has data for Texas and Texas minus the Houston Independent School Districts. Why? And is the data for the HISD available separately? It turns out it is!! There is a page for local data with a link to Houston data.

Want to know more? The recordings are available online now from the two sessions if you'd like to take a listen. While I have the same agenda for both sessions, there will be a few unique tidbits in each session. For example, during the Thursday session we looked at pregnancy data from VitalWeb. Way cool, if you ask me.

Tuesday Data Sources recording
Thursday Data Sources recording

The sessions did refer to a couple of handouts (Census data, birth data, death data) so I wanted to be sure to include the link to those.

Lastly, thank you to the participants of these sessions who give me feedback, let me know when I can't be heard or the screen can't be seen! I've made some changes in how I do things to try and improve my performance; the feedback is absolutely essential! And thank you for questions! Keep them coming.

Next week, we'll look at research databases (i.e. journals articles and such) so we gonna have some fun! Hope you're looking forward to it as much as I am....

Determinants of health

During both webinars, I mentioned a couple of articles I'd read related to determinants of health. These particular articles were meaningful to me for different reasons. I wanted to share the citations with you so you can judge for yourself!



As I was developing CHARTing Health Information for Texas, I needed a framework for organizing the determinants of health. Someone referred me to this article:


Hillemeier,M.M.; Lynch,J.; Harper,S.; Casper,M. Measuring contextual characteristics for community health. Health Serv.Res. 38, (6 Pt 2), 1645-1717, 2003.
http://dx.doi.org/10.1111/j.1475-6773.2003.00198.x

and it made so much sense to me! Their schema really helped me pull together all of the links I had into a cohesive format. At least, it was cohesive for me!

Another article I mentioned was one about the importance of African-American males completing high school to greatly reduce the risk of them entering the criminal justice system. I'm not wording it very well so here's the 1st sentence from the author's abstract, "This paper analyzes the relationship between levels of educational attainment and outcomes for African American males, in particular the likelihood of conflict with the criminal justice system. "

Here's the citation:
African-American Males: Education or Incarceration. By: Green, Robert L.. 1991 34 pp. (ED346184)

Lastly, I mentioned an analysis of research on various social determinants of health to determine if there was one determinant more influential than any others. According to this author, it's education! I still need to find the article but as soon as I do, I will post the citation here.

Happy weekend!

Xtreme logic models!

During the Thursday session, I mentioned a book by some fo the faculty here at the UTSPH. It's called "Planning HealthPromotion Programs : Intervention Mapping, 2nd Edition" by L. Kay Bartholomew, Guy S. Parcel, Gerjo Kok, and Nell H. Gottlieb. The title of the first edition was just plain "Intervention Mapping".

I'm really simplifying it by calling intervention mapping an "Xtreme logic model". Basically, they describe a systematic approach to intervention mapping using behavioral theories, data, and research to guide the processes. It's an amazing book and well worth the $$ spent on it.

In addition, they've made available an online resource:
http://www.sph.uth.tmc.edu/chppr/interventionmapping/

Lastly, Dr. Bartholomew offers a short course (face to face) a couple of times each year. I believe the next course is coming up soon!

NEW SHORT COURSE: Intervention Mapping: Developing and evaluating theory- and evidence-based programs for health education and health promotion(August 2008 and April 2009)

Webinars have started!

I've finally begun a series of webinars on evidence-based public health and I am pretty darn excited! The first group met Tuesday (we will meet for 3 more Tuesdays); I have another group meeting today. Each session is 2 hours long. Oh, and so I don't forget:

This project has been funded in part with Federal funds from the National Library of Medicine National lnstitutes of Health, Department of Health and Human Services, under Contract No NO1-LM-6-3505.

I was able to hire 2 awesome interns this semester, one from the University of North Texas and one from Texas Woman's University. Both are studying to be librarians (I'd written a stipend into my project to pay for library school students to work with me.)

And now, I'm going to be really brave and post a link to the recording:
Week 1: EBPH Workshop Agenda and Course Overview (Tuesday recording)
Week 1: EBPH Workshop Agenda and Course Overview (Thursday recording)

It's long-- 90 minutes or so. Next week will be 120 minutes.

That's it, I guess. I have another session this afternoon so I better make sure I'm ready!

July workshops starting!

If you're taking the webinars starting in July, welcome!



I taught a 3-hour version of this workshop at TPHA in San Antonio (2008). We really rushed through everything-- speed of light. This will a little more leisurely but there is still quite a bit to cover.



We will start with this post:

http://ebph.blogspot.com/2008/02/welcome-to-evidence-based-public-health.html



and work our way through the resources. I've set the archives to show oldest first which means you'll see them in the order of the class.

I encourage you to review the blog, post comments, suggestions, and questions. If there is a site I need to add, tell me!

Post TPHA workshop thoughts

I want to thank the people who attended the TPHA pre-conference workshop. I had fun and I hope you did as well. Not to say I wasn't dog tired afterwards, but I did have fun. I hope you did as well.

There was quite a bit covered in the workshop and we had to rush through some of the tasks. But I hope you look at the handouts as I walk you through the tasks, screen by screen. I have lots of pretty pictures in my handouts!

Lastly, there is a link to Ask a Librarian on the EBPH page that I hope you will use. Ask me questions! I want to know what kind of data you are looking for, what your projects are, and what evidence you need. It will help me prepare for the future (my selfish motive!) plus I want to make certain you have the tools you need at your disposal to be as successful as possible when creating and implementing programs.

I'd also be interested in any successes you might have had as a result of using some of the resources we covered in the workshop. Did your program get funded? Were you able to come up with new community partners? What have you learned about one of your communities using the Census that maybe surprised you and resulted in some changes in your programs? I'd love to know and, if you don't mind, share with others.

Happy Friday!

Logic models to the rescue

So far, I've written about theory, health data, research literature-- many of the pieces needed to conduct research but nothing on how to put it together. Well, I'm not really an expert in that arena, but I can offer some suggestions of resource to use from those who are.

First-- what is a logic model?
According to one of those tutorials listed below, a logic model is: "A pictorial diagram that shows the relationship between your program components and activities and desired health outcomes. A logic model is a planning tool that might describe your entire program or a particular program objective or initiative."

If you've not used them before, your really need to take a look. Logic models can help you avoid missing important components as you do your program planning. Of course, once you do your logic model, keep it out where you can see it! I don't think I've ever seen that written anywhere, but too often we create these things and then put them away after we've gotten the funding or convinced the boss that we *do* know what we're doing!

So, on to the resources:

Logic Models: The Basics (Centers for Disease Control & Prevention)
http://apps.nccd.cdc.gov/dashoet/logic_model_1/menu.html

Logic Models 2: Constructing a Logic Model (Centers for Disease Control & Prevention)
http://apps.nccd.cdc.gov/dashoet/logic_model_2/index.html

W.F. Kellogg Foundation Logic Model Development Guide
http://www.wkkf.org/Pubs/Tools/Evaluation/Pub3669.pdf

Remember that creating a logic model doesn't have to be a solitary event. Invite your co-workers or anyone else who will be a part of this project from the get-go to work on it with you.

Just remember:
Common sense, however it tries, cannot avoid being surprised from time to time. ~Bertrand Russell

TexShare databases for research

Here in Texas, we have one of the most amazing cost-sharing, economy-of-scale programs I have ever seen called TexShare. Every single person in Texas has access to incredibly fine quality online databases through their public library!

I work at a university (one that is part of the University of Texas System, no less!) so we have primo access to online databases and journals. But not everyone has that luxury-- not everyone is part of a mammoth university system. But you do most likely have a public library in your community.

You will need to go to your library (and, again, I'm talking about Texas; I don't know about other states). If you've never visited your library or you're not sure which branch is closest to you, you can find a list of libraries at the TexShare Public Library site:
http://www.texshare.edu/generalinfo/about/programspub.html

A list of databases that are part of the 2008 agreement can be found at:
http://www.texshare.edu/programs/academicdb/licenseagreementsfy2008.html

"Only librarians like to search; everyone else likes to find." Roy Tennant [librarian]

Community Based Participatory Research

Kohatsu, Robinson, and Torner make the point that evidence-based public health must involve the community stakeholders (Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: An evolving concept. Am J Prev Med. 2004 Dec;27(5):417-21.) But how?

Community-based participatory research is one way:

http://www.ahrq.gov/research/cbprrole.htm

Through CBPR, community members aren't just subjects, they're partners. After all, who knows better what's happening in a neighborhood than the community?

Of course, there can be problems with CBPR. Your agenda may not be their agenda. Or is it?.....

Let's say you know there is a major obesity/diabetes problem in one of the neighborhoods. You set up town hall meetings with organizers and community members and all they want to talk about are the broken lights and bad sidewalks in the neighborhood. And some of the streets don't even have sidewalks. And the park is completely unsafe as it's used for prostitution and drug dealing.

What does any of this have to do with obesity and diabetes? That's what you planned on talking about, not the neighborhood!

Well, guess what-- it has everything to do with obesity and diabetes! The outdoor environment plays a major role in the ability of people to go out and exercise. If it's unsafe and unattractive, why will they go outside? So what can you do to improve the immediate environment? That issue may have to be tackled before you can implement a "10,000 steps a day" program, right?

So, does CBPR work? Take a look at an evidence report published by the Agency for Healthcare Research and Quality:
http://www.ahrq.gov/downloads/pub/evidence/pdf/cbpr/cbpr.pdf
Chapter 3 and 4 are results and discussion respectively.

Consider looking at some of the studies included to see if maybe they might provide some insight to how you can incorporate CBPR into your next project.

And the moral is, we all have to learn to play nice!

Links to Handouts

I've been madly developing handouts for the EBPH workshop to be held at the Texas Public Health Association 2008 Annual Conference in bee-yoo-tee-ful San Antonio TX. If you've never been, you need to go.

The handouts are slowly being added to the CHARTing Health Information Web site. If you're like to see what's there, go to:
http://www.sph.uth.tmc.edu/charting/handouts/ebph_handouts/ebph_workshop.htm

Happy browsing!

Have theory will travel

Tonight I learned a valuable lesson while working on a survey. I don't have to come up with all of it on my own! Someone else has probably come up with something *similar*-- doesn't have to be exactly what I'm doing but close enough. I can look at their theory and see if it truly fits with what I want (after deciding as to whether it was the appropriate theory to apply). I can then use it to figure out the path to take.

What theories/models are out there that help explain health behaviors? How about the Transtheoretical Model and Stages of Changes? Theory of Reasoned Action and Theory of Planned Behavior? Social Cognitive Theory? Health Belief Model?

If you'd like to see how you can utilize them to help you plan your health promotion programs, take a look at Theory at a Glance: A Guide for Health Promotion Practice (pdf) from the National Cancer Institute.

Or, if you're feeling really motivated, there's a great book by Glanz, Rimer, and Lewis, Health Behavior and Health Education: Theory, Research, and Practice. It's available from Amazon.com: http://www.amazon.com/gp/product/0787957151

Cheers!

Blogging for Community Indicators

Here's blog I stumbled on one evening that you might enjoy.

http://communityindicators.blogspot.com/

He's done a mighty fine job of tracking online resources of community indicators. For those of you who take my EBPH workshop, maybe you'll become enamored with the whole community indicators thing. I am, although I don't get to study it the way I wish I could. Instead, I spend my time trying to find more sources of data and then organizing those sources so you can put the information all together, write those grants, prove your programs work, make City Hall happy-- whatever it is you need to do.

Take a spin through the Community Indicators blog. I found some great resources on it; I hope you do too.

Community Indicators

I don't know about you but one of the things I find the hardest to do is to start with a blank canvas. I need to see examples or templates--something that shows me how it might be done that I can not exactly copy but model from. It's not plagiarism. I just need ideas. Sometimes I start by borrowing structure, then revising to fit what I need to say. Sometimes I look at multiple examples, then pluck from each what works for me. Why reinvent the wheel?

Of course, I willgive credit where credit is due-- I'm not about the plagiarism! But what I'm talking about is different. Sometimes I just...don't...know...how...to...get...started.

If you're like me, then the thought of doing a community assessment from scratch could be a daunting task indeed. That's one reason I've been working on my community assessment workbook (coming soon). I figured I know where the data is hiding so I would create an Excel workbook that has select Healthy People 2010 objectives, US data, and Texas data. (Sorry for those of you in other states--I'm located in Texas and that's been the focus of my work.)

Here's the kicker-- I've also got links to sources of county data for every one of the objectives in my workbook. I've also weeded out the stuff that HP 2010 asks for that isn't easily available. I promise-- I'll have a link to it soon!

But-- you still have to put pen to paper, er, fingers to keyboard and write a descriptive text about your community. You can't hand people a bunch of printouts from a spreadsheet, right?

So, to make a short story long, here is one site that serves as a gateway to bunches of indicator initiators:

http://www.iisd.org/measure/compendium/

Here's a blurb from their web site:

"Welcome to version two of the Compendium of Sustainable Development Indicator Initiatives, a worldwide directory of who is doing what in the field of sustainability indicators. Work on an earlier version of the Compendium was carried out with several partners and donors, including the International Institute for Sustainable Development (IISD), Environment Canada, Redefining Progress, the World Bank and the United Nations Division for Sustainable Development."

Just for kicks, go to:

http://www.iisd.org/measure/compendium/searchinitiatives.aspxvv

to do a search for health. Limit the Scope to Local/Community and you'll still get bunches of hits. Try just public health for fewer results.

Happy searching! I hope you find this useful....

Access to Health Data

I'm a data nut. Okay, I don't necessarily want to either gather it or analyze it. I just want to know where it can be found! Here is my attempt to find all the data that is meaningful for Texas.
CHARTing Health Information for Texas
http://www.sph.uth.tmc.edu/charting/

The site is organized by:
Cause of Illness or Death: http://www.sph.uth.tmc.edu/charting/causes.htm
This section is further broken out into broad categories-- cancer, cardiovascular disease, other chronic diseases, infectious diseases, mathernal & child health, accidents & suicide, and other.


Sociodemography & Community Characteristics: http://www.sph.uth.tmc.edu/charting/social_community.htm
Health and health outcomes aren't just about how many times we see a doctor. There are many factors that influence our health (determinants of health). In this section, I've organized links to resources around some of those influences. So far I have 11 categories.

Environmental/Occupational Health: http://www.sph.uth.tmc.edu/charting/environment.htm

There are other resources on this site as well as the major areas listed above.

EBPH Web Sites

My goal is to make this as easy as I can for you. So, I created an Evidence-Based Public Health web site on my Library site that you can access.

http://www.sph.uth.tmc.edu/library/default.aspx?id=2909

From this page, you can search for systematic reviews which help you determine what we really know about interventions, health theories, treatments, etc.
http://www.sph.uth.tmc.edu/library/default.aspx?id=2909#systematic

There are guides to developing your own systematic review should you be so inclined.
http://www.sph.uth.tmc.edu/library/default.aspx?id=2909#develop

There are links to evidence-based guidelines:
http://www.sph.uth.tmc.edu/library/default.aspx?id=2909#guidelines

best practices:
http://www.sph.uth.tmc.edu/library/default.aspx?id=2909#best

other EBPH sites:
http://www.sph.uth.tmc.edu/library/default.aspx?id=2909#meta

and much more.

Welcome to Evidence-Based Public Health

This blog has been created to support a series of workshops. The project has been funded in whole or in part with Federal funds from the National Library of Medicine National lnstitutes of Health, Department of Health and Human Services, under Contract No NO1-LM-6-3505.

Resources used in the class will be listed here as well as other resources that public health practitioners (PHPs) might find useful.

I'm located in Texas so many of my links will be relevant only for Texas PHPs. Not all, but many!

I know you have many blog choices in addition to mine, so thank you for visiting!