Chapter 2- Evidence-based Public Health

Describe what the P.E.R.I.E process is.

1. Problem – what is the health problem?

2. Etiology – what are the contributory causes?

3. Recommendations – what works to reduce the health impacts?

4. Implementation – how can we get the job done?

5. Evaluation – how well does/do the interventions work in practice?

What are the topics that are involved in how the evidence based process works?

Problem

Etiology

Recommendations

Implementation

Evaluation

When describing the problem (first step) -- what defines the occurrence of morbidity and mortality?

burden of disease (Impact)

What is the term for the risk of developing a disease over a period of time (new cases)?

incidence

What looking at the course of a disease to describe the problem-- what are some questions that can be asked?

◦How often it occurs

◦How does it spread

◦What happens when it occurs

◦Incidence and prevalence

This is the formula for what?

incidence

What is the term for the number of people who have a disease at a point and time (existing cases)?

prevalence

This is the formula for what?

prevalence

How do we establish contributory cause (etiology)?

research

If an infectious disease starts to kill a host quickly but the infectivity stays the same what happens to the incidence and prevalence?

incidence= stays the same

prevalence= decreases

term of a study where you are looking forward (follow into future)

prospective

term of a study where you are looking backwards (in the past)

retrospective

What type of study includes two groups of people (exposed and unexposed) are recruited into the study and "followed up" to see if they develop the outcome?

exposure --> outcome

cohort studies

What type of study occurs with ALTERED intervention group (manipulation)?

randomized controlled trials

What is the term for risk of developing the outcome relative to the exposure (strength of association), with exposure preceding the event?

relative risk

What can be calculated from Cohort Studies and Randomized Controlled Trials?

relative risk

when looking at contributory cause---What is the term for:

•How close are they related

•Relative risk

strength

when looking at contributory cause--- What is the term for:

•Higher levels of exposure, longer duration of exposure increased probability of the "effect."

dose- response

when looking at contributory cause---What is the term for:

•Similar results in multiple locations and populations

consistency

when looking at contributory cause---What is the term for:

•Known biological mechanisms explains cause-and-effect relationship

biological plausibility

These are taken into consideration when looking at what?

•Quality of evidence

• Magnitude of impact

•Benefits, harms, cost

-Effectiveness

recommendations

How do we carry out implementation?

stage of prevention / intervention

What are some questions used to evaluate results?

• Has the intervention been successful?

• How much of the problem was eliminated?

• What problem remains?

RE-AIM Framework for evidence-based interventions

•Reach

•Effectiveness

•Adoption

•Implementation

•Maintenance