In today's world, there's so much information about the ways to stay healthy or get healthy. Information is everywhere. But they're not all really created equal and they're not all ready for implementing in a whole community. In 1996, the Department of Health and Human Services created the Community Prevention Services Task Force to help to identify population health interventions that were scientifically proven to save lives, increase lifespans, and/or improve the quality of life. Those recommendations are housed on a website called the Community Guide. In this module, we're going to explore the Community Guide. We're going to describe how the recommendations are made, we're going to chart the stakeholders behind the Community Guide, describe some of the areas of population health that it covers and then summarize a few of the types of interventions that it explores. Then last but not least, we're going to describe how everyday people can use these recommendations. So what is the Community Guide? Well, it's a guide to the Community Preventative Services Task Force. It's a collection of evidence-based findings for population health interventions. It's recommended by a task force, the Community Preventive Services Task Force and it's meant to be a resource for communities, for businesses, for healthcare organizations, for schools, for community agencies, anybody that really is invested in improving the community health. So what's the Community Preventive Services Task Force? It's a special task force that was established in 1996 by the US Department of Health and Human Services. It's overseen by the CDC and its main goal is to identify evidence-based interventions for population health improvement, simple enough. Well, there's some complications with this. The findings and the conclusions that are in the Community Guide they belong to the Community Preventative Services Task Force, not the CDC, not the Department of Health and Human Services. There needs to be this separation because who is on this task force? They're not government employees, they really are people from the public health sector, from healthcare systems, from academia, that are invested in doing this work of identifying the evidence-based interventions that work, but people often misinterpret them. So I just want to make sure these are not mandates, these are not things that the CDC has put out. They are on the positive side, a systematic consideration of the available information and they really do give people insight into what works and what's not ready for prime time. Here's a picture of all the different official liaisons for the Community Guide. There are public health organizations, healthcare organizations and then federal agencies and large employers. The role of these official liaisons within the Community Guide platform is really to help prioritize topics, serve on review teams to help in the dissemination of those evidence-based interventions, and then really help to facilitate the translation. Because what might be in the evidence-based guideline really needs to get the next level of roll out into different communities or in different work sites. You'll notice here that the military is a part of the federal agencies and large employers and many of the community-based interventions work very well in those large populations. So who develops the evidence-based findings? It's actually quite a process. It starts with a systematic review team. So these are experts in the topic that they're focusing on. Some members from the Community Preventative Services Task Force, there's often a Community Guide liaison, often they will have a health economist or somebody who can think through the cost-effectiveness because really good evidence-based intervention you want to roll out also has to be something people can do in their local communities and then any consultants or Community Guide staff. That systematic review team is charged with really looking at and identifying all the relevant studies, assessing the quality of each one of those studies, and summarizing the evidence. The idea behind this whole review is to provide an accurate summary of the available evidence, analyze basically the generalizability of the findings. Could it be used everywhere or it doesn't have to be specified to only be used in certain communities and then to identify the gaps in knowledge. So this is really the caveat emptor that says, "Well, this intervention is good, but we don't know if it's going to work there." Those gaps in knowledge become some of the things that are turned to the research community to fill later on. So how's the Community Guide used? There are lots of different uses by a lot of different stakeholders. So some of the basic ones is to really help people to decide which programs or services or interventions to implement. Another is to take this evidence-based intervention and move it to the next level of developing evidence-based policies. As I indicated in the last slide, they can be used to prioritize areas for research, where do we have the gaps that need to be filled? Of course, people are going to use this wealth of information to inform funding decisions and support funding proposals. So it's really a very smart thing to be able to use all the work done by the Community Preventative Services Task Force to figure out where you want to invest your dollars if you're a foundation or an agency and if you're a grant writer, you want to put in the intervention because it's already been tested and approved. Then a lot of it is also used to educate people, educating those students within our public health schools and educating other stakeholders about what really matters and what could really make a difference. Right now, there are over 250 evidence-based recommendations on the Community Guide and they range for recommendations for everything from adolescent health and asthma, to emergency preparedness and excess alcohol consumptions or physical activity in pregnancy health, all the way to violence and worksite health. So I think that what you can see is that there's been a lot of work done on a lot of areas that really could make a big difference in communities if we actually put that energy towards moving these interventions into practice. The type of evidence-based interventions that you'll run into if you go to the Community Guide fall into a couple of key buckets. One, is informational interventions. So these basically are education programs or mass media campaigns. One of their best education programs is increasing the use of child safety seats. Many of us think of that now as a cultural norm because of how well this evidence-based intervention has been rolled out. We also all recognize the mass media campaigns for reducing alcohol impaired driving, we see them everywhere and it's one of the best uses of initial evidence that said, "If you remind people that they should not be drinking and driving and then make it a persistent message, it reduces that tragedy from people who're actually drinking and driving." There's also social and behavioral interventions. So behavioral interventions to reduce risky sexual behavior or pregnancy among teens or for instance, cognitive behavior therapy that really reduces the impact of trauma on children and teens. We also have a lot of good evidence on the impact of environmental policies. Two examples are street scale urban design, really getting lighting and improved safety so that increases physical activity for people in their neighborhoods or inner city streets or interventions to increase the price of tobacco and how that reduces tobacco use. Of course, they've got other interventions at the environmental that reduce air pollution or other kinds of pollutions. Then the last big type of evidence-based intervention has to do with the health system. Many of us don't think of that as community interventions, but it absolutely is. So disease management programs for diabetes control or client reminder recall systems to really help people remember to get their vaccinations at all different levels. So these are just a few of the different types of evidence-based interventions that you'll find in the Community Guide. One of the great things about the way that the Community Guide is set up is the layers of information that they provide. So any of these evidence-based findings have three levels. One is the snapshot. The summary of the findings, tells you about the intervention, why the task force recommended it and it often will have promotional material. So it's almost like one page spec sheets that you can share among your partners. The next level down is more detail about what the Community Preventive Services Task Force found. So it has information about the review, it has a summary of the results and the economic evidence for its effectiveness, the applicability in generalizability as well as some of the gaps in evidence. In particular, it's going to give information about the study characteristics, that's systematic review in some of the studies within it. Then last but not least, underneath of that are access to the supporting materials. Both the analytical framework and the summary of the evidence is often put in table forms, includes the studies that were actually reviewed and gives those references so that people can go in and see for themselves if they're really interested in that level of detail. So here's a picture of the actual Community Guide website. It's an easy to use website that you can search for particular domains and particular evidence-based interventions in the areas that you're interested in. I hope you get a chance to look at the Community Guide. It's a wonderful example of how to build a resource that everyone can use.
