title: Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.
abstract: BACKGROUND
  The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.
  
  
  METHODS
  The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.
  
  
  RESULTS
  In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.
  
  
  CONCLUSIONS
  This study makes an important contribution to understanding how evidence is used within the public health LG context.
  
  
  BACKGROUND
  ACTRN12609000953235.
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. armr@unimelb.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Armstrong
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. ewaters@unimelb.edu.au.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waters
authors.affiliation: MRC Unit for Social and Public Health Sciences, University of Glasgow, Glasgow, Scotland. MooreL1@cf.ac.uk.
authors.forename: Laurence
authors.initials: L
authors.lastname: Moore
authors.affiliation: School of Nursing, McMaster University, Hamilton, ON, Canada. dobbinsm@mcmaster.ca.
authors.forename: Maureen
authors.initials: M
authors.lastname: Dobbins
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. tpettman@unimelb.edu.au.
authors.forename: Tahna
authors.initials: T
authors.lastname: Pettman
authors.affiliation: School of Dentistry and Health Services, Charles Sturt University, Wagga Wagga, New South Wales, Australia. cate.m.burns@gmail.com.
authors.forename: Cate
authors.initials: C
authors.lastname: Burns
authors.affiliation: Population Nutrition and Global Health, University of Auckland, Auckland, Grafton, New Zealand. boyd.swinburn@deakin.edu.au.|New Zealand and WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, VIC, Australia. boyd.swinburn@deakin.edu.au.
authors.forename: Boyd
authors.initials: B
authors.lastname: Swinburn
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA. lmander@uw.edu.
authors.forename: Laurie
authors.initials: L
authors.lastname: Anderson
authors.affiliation: London School of Hygiene and Tropical Medicine, University of London, Bloomsbury, London, UK. Mark.Petticrew@lshtm.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Petticrew
mesh_terms: D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D055317:Evidence-Based Practice; D006291:Health Policy; D006801:Humans; D009111:Local Government; D015279:Organizational Culture; D011634:Public Health; D057170:Translational Research, Biomedical; D014739:Victoria