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Information-Seeking Behaviors and Other Factors Contributing to Successful Implementation of Evidence-Based Practices in Local Health Departments

Cilenti, Dorothy DrPH, MPH, MSW; Brownson, Ross C. PhD; Umble, Karl PhD, MPH; Erwin, Paul Campbell MD, DrPH; Summers, Rosemary DrPH, MPH

Journal of Public Health Management & Practice: November/December 2012 - Volume 18 - Issue 6 - p 571–576
doi: 10.1097/PHH.0b013e31825ce8e2
Original Articles

The objective of this article was to describe factors that contribute to successful translation of science into evidence-based practices and their implementation in public health practice agencies, based on a review of the literature and evidence from a series of case studies. The case studies involved structured interviews with key informants in 4 health departments and with 4 corresponding partners from academic institutions. Interviews were recorded and transcribed, coded by 2 independent, trained coders, using a standard codebook. A thematic analysis of codes was conducted. Coding was entered into Atlas TI software for further analysis. Results from the literature review indicated that only approximately half of programs implemented in state and local health departments were evidence based. Lack of time, inadequate funding, and absence of cultural and managerial support—including incentives—are among the most commonly cited barriers to implementing evidence-based practices. Findings from the case studies suggest that these health departments, successful in implementing evidence-based practices, have strong relationships and good communication channels established with their academic partner(s). There is strong leadership engagement from within the health department and in the academic institution. Implementation of evidence-based programs was most often related to high priority community needs and the availability of resources to address these needs. The practice agencies operate with a culture of quality improvement throughout the agency. Information technology, training, how the interventions are bundled, including their complexity and ability to be customized and resource requirements are all fruitful avenues for further research.

This article describes factors that contribute to successful implementation of public health science. Health departments that are successful in implementing evidence-based practices have strong relationships and good communication channels established with their academic partner(s). Implementation of evidence-based programs was most often related to high priority community needs and the availability of resources to address these needs.

NC Institute for Public Health and Department of Maternal and Child Health, UNC Gillings School of Global Public Health, Chapel Hill (Dr Cilenti); Prevention Research Center in St. Louis Brown School, Division of Public Health Sciences and Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis (Dr Brownson); NC Institute for Public Health and Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill (Dr Umble); Department of Public Health and Center for Health Policy and Services Research, University of Tennessee, Knoxville (Dr Erwin); and NC Institute for Public Health, UNC Gillings School of Global Public Health, Chapel Hill, and Orange County Health Department, Hillsborough, North Carolina (Dr Summers).

Correspondence: Dorothy Cilenti, DrPH, MPH, MSW, NC Institute for Public Health, Chapel Hill, NC cilenti@email.unc.edu.

Funding provided in part by a subaward through the University of Kentucky National Coordinating Center for Public Health Systems and Services Research, funded by the Robert Wood Johnson Foundation.

The authors thank the local health departments and academic researchers who were interviewed as part of this study, and Matthew Schnupp, MSPH, BSN, RN, for his assistance with the literature review and data collection activities.

The authors declare no conflicts of interest.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.