title: An evidence-based public health approach to climate change adaptation.
abstract: BACKGROUND
  Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation.
  
  
  OBJECTIVE
  Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change.
  
  
  METHODS
  We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders.
  
  
  CONCLUSIONS
  A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers.
  
  
  CONCLUSIONS
  The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.
authors.affiliation: Climate and Health Program, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Hess
authors.forename: Millicent
authors.initials: M
authors.lastname: Eidson
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Tlumak
authors.forename: Kristin K
authors.initials: KK
authors.lastname: Raab
authors.forename: George
authors.initials: G
authors.lastname: Luber
mesh_terms: D000222:Adaptation, Physiological; D057231:Climate Change; D003657:Decision Making; D055317:Evidence-Based Practice / Q000379:methods; D006801:Humans; D015980:Public Health Practice