The use of Cochrane Reviews for decision making by a local public health department

Article type
Authors
Ward M1, Ciliska D2
1Peel Public Health, Canada
2McMaster University, Canada
Abstract
Background: Peel Public Health, one of Canada’s largest local public health departments, is midway through a ten year strategy focussed on evidence-informed decision making. Central to the strategy is a rapid review process, developed in-house, for finding, appraising and applying the best available research evidence to program and policy decisions.

Objectives: For the first 24 rapid reviews, the use of Cochrane Reviews in program decision making was examined.

Methods: Search results and relevance and quality assessments were reviewed to identify which rapid reviews used Cochrane Reviews. Topics were grouped according to domain of public health practice: communicable disease control, environmental health, chronic disease and injury prevention, family health, and other. Impact of the research evidence on the program decision was evaluated using a standardized tool for assessing applicability and transferability. Gaps were noted for domains where there were no Cochrane Reviews.

Results: A total of 22 Cochrane Reviews were used in one third (8 of 24) of the rapid reviews. Two reviews, both on workforce development, accounted for more than half (12 of the 22 Cochrane Reviews). Each public health domain used at least one Cochrane Review. However, chronic disease and injury prevention was underrepresented in the use of Cochrane Reviews. Research significantly influenced the final program decision in 12 of 24 reviews. Other decisions were more strongly influenced by politics, resources, reach or community needs. Program decisions included stopping a program, staying the course, developing a new approach to current programming, and starting a new program.

Conclusions: Public health decision making embraces a range of factors, of which research evidence is only one. Cochrane Reviews are being used regularly in our rapid review process, and are influencing our program and policy decisions.