www.ncceh.ca Cond nduc uctin ting g a Lit iterat rature ure Search h & Evide idence nce Revie iew: w: The he NC NCCEH EH App pproach Tina Chen, BSc., CPHI(C), MPH Leela Steiner, B.Sc., MA, PhD (cand.) October 2018
Out utline line 1. Intro to the NCCEH • Strategic priorities • KT product types • Current project highlights • Healthy Built Environment • Cannabis 2. What is evidence – informed decision making (EIDM)? 3. Knowledge Translation • Case examples 4. Step by step: Literature Reviews 5. NCCEH Ron de Burger Student Award
Established by the Public Health Agency of Canada in 2005 to promote the use of knowledge and evidence by public health practitioners and policy-makers in Canada.
NCCEH’s Mandate Synth thesi esize, ze, Identify ntify gaps in translat nslate, e, & & excha hange nge Bui uild ld capac acity ity kno nowledge ledge kno nowledge wledge • Provide tools, • Catalyze new • Incorporate evidence establish networks, research or from research and foster partnerships application of experience to improve research or develop policy & practice
Our ur tar arge get au audience ience Public health inspectors, Environmental health specialists Medical officers of health Policy-makers, government Land use planners Other health professionals: e.g., veterinarians, physicians, nurses, dietitians and nutritionists
ment (2005-13) Needs ds, gaps, and d opportun tunit itie ies assessme 3) 2012-2013 Environmental Health Needs and Gaps in Canada - Suggested Document Topics Percent of Total Number Interviewees of Rating Topic Interviewees as High Who Rated Area Topic Importance the Topic Health impact 81 26 Best practices for health impact assessment, for a range of environmental projects (from simple, assessment e.g., harbourside marine waste disposal, to mega-projects, e.g., mining, hydro power, wind turbines). When and to what level. Evaluation How to evaluate EH programs (including overall impact of program vs. different program, priority 73 26 setting of various programs), e.g., food safety, personal service establishments (e.g., based on burden of disease) Oil & gas 42 26 Health impacts of shale gas (hydraulic fracturing) at the local level Risk assessment & 42 26 Guide to risk communication with public and media, including where there is no standard or it is communication exceeded, e.g., old mine site and uranium in drinking water, mould, electromagnetic frequencies (not radon) (focus on gaps in guidance) 40 25 Understanding and communicating the health relevance of exceeding environmental standards, e.g., drinking water 36 25 Guide to human health risk assessment, including validation of predictions (e.g., US ATSDR, CDC, EPA) (consider complex chemical mixtures) Food safety Top sources of food-related risks and how to effectively reduce those (including irradiation, buy 32 25 local food, small operations) Enforcement 31 26 Comparison of how jurisdictions enforce regulations, including effectiveness (e.g., ticketing, disclosure), e.g., tobacco control (sales to minors, smoke-free environments) Risk assessment & 31 26 How to apply a consistent approach to risk categories for food premises, public pools, personal communication service establishments Drinking water Regulation of small semi-public water supplies – W hat are the most effective elements of a 27 26 regulatory program Health impact 27 26 How to assess health impacts of official community plans (e.g., water, septic, physical activity) and assessment provide meaningful input Housing 27 26 Provincial/territorial approaches to housing and health (best practices, including residential, rental) Miscellaneous 23 26 Effectiveness of use of social media in EH
St Strat rategic egic Prio iorities rities Built t Environment nment Clima mate Related Environmental nmental Health Emergenc ncy y Respo pons nse & Enhanci ncing ng Conta tamina nants nts & Ha Hazards ds Public Health h Capaci citi ties
Select lect exampl xamples es of of KT products roducts Evidence dence revie iews ws
Select lect exampl xamples es of of KT products roducts Gu Guidance ance documents uments
Select lect examples xamples of KT produ roducts cts Field ld Inquiries iries
Selec lect t examples amples of of KT produc roducts ts Topic ic pages es Whiteb eboar oard d animat mated ed videos os – Indigenous disaster response – Floods: Prevention, preparedness, response and recovery – Pesticide exposure in the urban environment – Neonicotinoid pesticides – Cannabis resources for environmental health practitioners – Health equity and Extreme heat can be a killer environmental public health https://www.youtube.com/watch?v=RBwgS_1D5FM practice
Select lect exampl xamples es of of KT products roducts Blogs gs
Knowledg wledge e mo mobil ilization ization an and excha change nge Monthly thly eNews ws • Training ining – Online courses – Seminar Series – EH practicum students – Medical students/residents Conference nce present ntatio ations ns • – CIPHI conferences – CPHA – Invited talks • Social al media
Succe uccessf ssful ul EH EHO Secondm econdments ents at at NC NCCE CEH 2016 Vancouver Coastal Health: Shelle lley Beaud audet • Float Tanks: Review of Current Guidance and Considerations for Public Health Inspectors • Float Tanks: Considerations for Environmental Public Health 2017 Interior Health: Chris is Russell sell • Identifying and Addressing the Public Health Risks of Splash Parks • Food crops irrigated with cyanobacteria- contaminated water: An emerging public health issue in Canada • Co-facilitated two NCCEH eJournal Club sessions • CIPIH National AEC presentation 2018 18 First Nations Health Authority: Case sey Neat athw hway • Radon in First Nations communities • Healthy housing for First Nations • Traditional/country foods and climate change/resource development
New KT products coming soon … Cannabis and EH issues: Fact Sheet • • Healthy Build Environment Forum • Plastics (food contact materials) and microplastics • Ethnic foods and food safety issues Lead in school drinking water • sampling protocols – Comparison of six agencies in Canada & US • Whiteboard animated video: ticks and environmental control
Ev Evidence idence-inf informed ormed decision cision-making making (E (EIDM) IDM) • EIDM is “the intentional and systemati ematic processes of bringing the bes est avail ilable le scie ienti tific ic evid iden ence e on specific questions together with other er rel elevant t in informa rmati tion on to help weigh options and in inform rm de decis isio ions s that will affect priorities, policies, programs and practices” (Pierson et al. 2012). • How to have EIDM in public health? – Effective knowled ledge ge translat anslation, ion, synthesi thesis, s, and exchan hange ge (KTSE) TSE)
Kno nowl wledge dge tra ranslatio nslation n ha has be been des n describ ribed d as …. • Activities that foster dissemination, adoption, and appropriation of the most up-to-date knowledge possible to allow for its use in professional practice (INSPQ, 2013) • Systematic review, assessment, identification, aggregation, and practical application of research by key stakeholders (NCDDR, 2005) A dynamic and iterative process that includes synthesis, dissemination, • exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system (CIHR, 2017)
What at kin ind d of of knowledge wledge doe oes s KTSE SE ca captur ure? e? • Public Health Knowledge (INSPQ, 2013) – Research-based • Fundamental/experimental, clinical, or applied • Products include: reports, peer-reviewed publications, lit reviews, systematic reviews, meta-analyses – Tacit knowledge • Know-how of practitioners, researchers, etc. who accumulated knowledge about theoretical knowledge and practical experience – Knowledge from data analysis • Collected, organized, analyzed and transmitted to stakeholders
KTSE SE ma may al also so be known wn as as: • Knowledge Transfer (commonly used outside of healthcare) – Systematic approach to capture, collect, and share tacit knowledge in order for it to become explicit knowledge – Process of getting knowledge used by stakeholders – All forms of ‘knowing’ including research, tacit/experiential knowledge • Knowledge Exchange • Research utilization Implementation • • Many more… often used interchangeably, but can mean different things
Man any y types pes of of lit lit revie view w for or dif ifferen erent pur urpo pose ses A systematic review in which data have been Meta extracted from the papers, pooled, and re-analyzed. Analyses A review in which papers Systematic have been collected and reviews/syntheses appraised in a systematic, protocol-driven manner. A review without an Descriptive or narrative explicit protocol; may be reviews only an opinion piece. There is no way to know. A list of paper summaries; Annotated bibliographies no synthesis here. Knowledge synthesis happens in the three upper levels
ST STEP BY ST STEP: : LI LITERA RATURE URE RE REVIE VIEWS
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