Tuesday, October 7, 2008

[EQ] Translational public health: rehearsing the evidence until the task is done - Causes in epidemiology: the jewels in the public health crown

Editorial

Translational public health: rehearsing the evidence until the task is done
                        

Gabriel M. Leung and Selena Gray

J Public Health 2008 30: 217-218; doi:10.1093/pubmed/fdn066 [Full Text] [PDF]

“…..Contributors to the first set of articles in the new ‘Perspectives’ section have focused on this same task through a different set of philosophical prisms.49 To their credit they decided to revisit, with fresh reasoning, the whole idea of causality in the public health sciences. The five authors, from as many countries, debate whether traditional approaches to defining and eliciting robust evidence of causality is still relevant in the current era of molecular epidemiology on the one hand and a neoclassical focus on multi-level environmental determinants of health on the other….”

Perspectives

Ian McDowell

From risk factors to explanation in public health
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 219-223; doi:10.1093/pubmed/fdn051 [Full Text] [PDF]


“….
How do we conclude that we actually understand, or can explain something? As with Popper's demonstration that the only proof of a hypothesis lies in failure to disprove it, we cannot prove understanding. An explanation is good only until we find a superior one. The minimal criteria are that explanations should span several layers of causal processes. They should incorporate a plausible theory, or theories, that trace the connections between the levels. There should be an analysis both of the dynamics of the process (‘why did this occur?’); and of its functioning (‘how do the processes operate?’). Desirable features include parsimony; presentation in the form of a mathematical model to permit empirical testing, and the ability to cover individual cases as well as patterns of cases. …”


Raj Bhopal

Causes in epidemiology: the jewels in the public health crown
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 224-225; doi:10.1093/pubmed/fdn052 [Full Text] [PDF]


“…..
Causal models are necessary but insufficient (to echo an epidemiological refrain) in the art and science of causality. Models are a simplification of reality—they help us conceptualize cause, but no causal answers pop out. The counterfactual (model) has no reality (by definition); the reliable trial design that mimics the counterfactual model so yielding causality has not yet been achieved—which is why systematic reviews, meta-analyses and numerous checklists on quality control and assessment of trials are available or in development; and we now know the causal interpretation problems of the other study designs that only conform with difficulty to the counterfactual model, but will always comprise the vast bulk of public health evidence…”


C. Mary Schooling

Explanations in practice
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 226-227; doi:10.1093/pubmed/fdn055 [Full Text] [PDF]

“….Ian McDowell's thought-provoking piece provides an all-encompassing up-to-date framework for public health explanations rooted in earlier paradigms and acknowledging the political agenda involved in the practice of public health. The challenge is how to use a diffuse and multi-layered framework to generate equitable strategies to improve global public health, firstly how to operationalize the framework in day-to-day practice and secondly how much emphasis to place on causality and explanation at each level….”


Alistair Woodward

Explanations adequate for public health
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 228-229; doi:10.1093/pubmed/fdn053 [Full Text] [PDF]

“…What do we mean by ‘risk factors’? The simplest reading would be any quantitative research that attempts to relate exposures, broadly defined, to particular health outcomes. ‘Exposures’ may be located at any level of complexity, from genome to geo-politics; the independent variables might be upstream, downstream or side-stream. Health outcomes may be measured in tissues, or individuals or populations, and amidst this variety, it is only measurement that the investigations have in common…”


Ana V. Diez Roux

Towards a realistic and relevant public health: the challenges of useful simplification
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 230-231; doi:10.1093/pubmed/fdn054 [Full Text] [PDF]

“….Ultimately, because the goal of public health is to improve health, the key challenge is figuring out how to identify the interventions or policies that are most likely to improve the health of populations in the absence of complete and full understanding of all the complex processes involved. But this ultimately is what makes our work as public health researchers both intellectually interesting and (hopefully) relevant to society. McDowell's thoughtful commentary stimulates us to continue our work towards this goal….”


Ian McDowell

Rejoinder
Journal of Public Health Advance Access published on July 11, 2008
J Public Health 2008 30: 232-233; doi:10.1093/pubmed/fdn056 [Full Text] [PDF]

‘…..the next challenge will be to develop analytic approaches capable of handling greater dynamic complexity. My goal was to propose some criteria by which new analytic approaches could ultimately be judged. In the meantime, I agree with all of the commentators that we absolutely need to get on with developing and testing interventions, even in the absence of full comprehension of the processes involved…”

 

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html



 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.  

[EQ] Systematic Reviews of Health Promotion and Public Health interventions

Systematic Reviews of Health Promotion and Public Health interventions

 

Rebecca Armstrong, Elizabeth Waters on behalf of the Guidelines for Systematic Reviews in Health Promotion and Public Health Taskforce.

Version 2, October 2007

 

Available online PDF [52p.] at: http://www.ph.cochrane.org/Files/Website%20Documents/Guidelines%20HP_PH%20reviews.pdf

 

“…These guidelines complement Sections 3 to 11 of the Cochrane Reviewers’ Handbook. The content has been prepared by health promotion and public health researchers, decision-makers and practitioners experienced with both the use and conduct of systematic reviews. While these guidelines were originally developed to support the conduct of systematic reviews, they are also important for the conduct of primary research and for more informal reviews of research

evidence. Many of the topics may not be unique to health promotion and public health reviews, but they are issues that are important in enabling research to be used in public health policy and practice decision making.


Conducting systematic reviews of complex health promotion and public health interventions can be methodologically challenging due to a number of reasons.[1] Systematic reviews should aim to address two questions;
1) does the intervention work (effectiveness), and
2) why does it work (including how does it work)? The guidelines present recommendations to enable authors to address the above questions.


The guidelines contain twelve topic areas. Each topic is designed with two sections: background and recommendations. The guidelines suggest that review authors consider and address each of the recommendations in their review. Whilst it may not be possible to elicit some of the recommended information from the studies, for example, intervention context, theoretical frameworks, and process data, it is important to report when this data is not available. The gaps in reporting should stimulate further improvements in public health and health promotion research, and its publication….”

 

Content:

 

1. Planning the review

2. Study designs to include

3. Searching for health promotion and public health literature

4. Quality Assessment

5. Theoretical framework

6. Integrity of intervention

7. Heterogeneity in public health and health promotion reviews

8. Integrating qualitative and quantitative studies

9. Ethics, equity and inequalities

10. Sustainability

11. Context

12. Applicability

References

 

 

Guidelines for Systematic Reviews in Health Promotion and Public Health

 

Nicki Jackson

Cochrane Health Promotion and Public Health Field

Victorian Health Promotion Foundation

The production of this handbook was funded by a grant from the Australian Government Public Health Education and Research Program (PHERP).

 

Available online as PDF file [98p.] at: http://www.ph.cochrane.org/Files/Website%20Documents/HPPH_systematic_review_handbook.pdf

 

This handbook provides a working framework to conduct a systematic review of a health promotion or public health intervention. The purpose of this handbook is to describe the steps of the systematic review process and provide some working examples to practice prior to commencing a review. The handbook, however, is not intended to be used as a single resource for conducting reviews.

 

Contents

Introduction

Unit One: Background to Systematic Reviews

Unit Two: International Systematic Review Initiatives

Unit Three: Resources Required

Unit Four: Developing a Protocol

Unit Five: Asking an Answerable Question

Unit Six: Finding The Evidence

Unit Seven: Data Abstraction

Unit Eight: Principles of Critical Appraisal

Unit Nine: Synthesising the Evidence

Unit Ten: Interpretation of Results

Unit Eleven: Writing the Systematic Review

 

Professor Elizabeth Waters Director, Cochrane Health Promotion and Public Health Field, Chair in Public Health, Deakin University

Dr Celia McMichael School of Public Health, La Trobe University

Dr Lucie Rychetnik Sydney Health Projects Group, The University of Sydney

John Bennett Project coordinator, School of Public Health, The University of Sydney

 

Train the Trainer manual:
PDF 146p. at: http://www.ph.cochrane.org/Files/Website%20Documents/Train_the_trainer_manual.pdf

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

------------------------------------------------------------------------------------
PAHO/WHO Website

Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.