Use of evidence-based interventions in state health departments: a qualitative assessment of barriers and solutions.
OBJECTIVE
Existing knowledge on chronic disease prevention is not systematically disseminated and applied. State-level public health practitioners are in positions to implement programs and services related to chronic disease control. To advance dissemination science, this study sought to evaluate how and why evidence-based decision making (EBDM) is occurring. Specifically, it identified barriers to using EBDM commonly faced by state-level chronic disease practitioners and solutions for increasing the use of EBDM.


METHODS
Descriptive research using online survey methods.


METHODS
State health departments.


METHODS
Members of the National Association of Chronic Disease Directors.


METHODS
Barriers to using EBDM and solutions to increase the use of EBDM.


RESULTS
In total, 469 people completed the survey (64% response rate). More than 60% of respondents described their position as project managers or coordinators. Nearly 80% of respondents were women, and 39% reported at least a master's degree as their highest degree. The survey elicited responses from every US state and the District of Columbia. Commonly-cited barriers to using EBDM included lack of time, resources, funding, and data. Participants noted that promising solutions to increase the use of EBDM include improved leadership, training, and collaboration.


CONCLUSIONS
These results identify several modifiable barriers to EBDM among state-level public health practitioners. This information may improve state health departments' abilities to facilitate and encourage EBDM. In turn, this may assist chronic disease practitioners in implementing chronic disease interventions that have been proven effective. The use of such interventions will improve public health through the prevention of chronic diseases.
Dodson
Elizabeth A
EA
George Warren Brown School of Social Work, Prevention Research Center in St Louis, Washington University, 660 S Euclid Avenue, Campus Box 8109, St Louis, MO 63110, USA. edodson@wustl.edu
Baker
Elizabeth A
EA
Brownson
Ross C
RC
D000328:Adult; D002908:Chronic Disease / Q000517:prevention & control*; D002983:Clinical Competence; D003299:Cooperative Behavior; D003657:Decision Making; D055317:Evidence-Based Practice / Q000379:methods*; D005260:Female; D005380:Financing, Government; D019538:Health Care Surveys; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015980:Public Health Practice; D036301:Qualitative Research; D013219:State Government; D014481:United States