Evidence-Based Decisionmaking for Community Health Programs

Over the years medical practice in the US has gravitated toward an evidence-based approach. This move has partly been driven by a growing desire for better patient care and greater efficiency. Although such aims are important for all aspects of health care less attention has been paid to the evidence-based approach outside hospitals clinics and doctors offices. This report determines the availability of evidence regarding the cost and effectiveness of community health programs and how health care organizations and foundations funding community programs used that evidence. Chapter 1 discusses the objectives and the focus of the report. Chapter 2 proposes a process for deciding which community level health programs to implement based primarily on the strength of scientific evidence that an intervention will work and is cost-effective. Chapter 3 assesses the feasibility of the proposed approach conducting a broad review of the literature. Chapters 4 and 5 present further information on the feasibility of the approach and on its utility by conducting focus groups and telephone interviews with funders and health care organizations. Finally chapter 6 formulates a series of recommendations for health care systems and public and private funders of health interventions. These recommendations suggest steps toward applying an evidence-based approach.