>> These factors contribute
to experiential evidence.
This type of evidence
will be discussed further
in the experiential
evidence module.
>> Going back to you know
knowing the community
that you work with and I think
that plays a really big part
on what we do but it, we
don't look at it in the sense
of okay this is your problem,
this is how I'm going
to help you.
It's how would you like for
me to help you and, you know,
just really involving everyone--
all the stakeholders
and everybody.
>> The framework for
thinking about evidence.
The framework includes
contributions from researchers
and practitioners to provide
a more comprehensive view
of evidence that is appropriate
and necessary for
decision making.
To inform public health decision
making the framework is composed
of three types of evidence
that complement one another.
Best available research
evidence.
Experiential evidence.
Contextual evidence.
[typing sounds] The local child
fatality review board annual
report revealed that suicide
was the second highest cause
of death among adolescents
in the county
over the previous year.
A work group was assembled to
address youth suicide prevention
and was tasked with choosing
an evidence based youth suicide
prevention model to
implement in the county.
The technical assistance, or
TA team, for suicide prevention
in the state was the first
stop for the work group.
The TA team directed the work
group to the Substance Abuse
and Mental Health
Administrations--
SAMHSAs, National Registry
of Evidence Based Programs
and Practices-- NREPP-- to find
the best available research
evidence on suicide
prevention strategies.
The TA team also guided
them in finding resources
for gathering contextual
evidence such as tools
for conducting a community needs
assessment and potential sources
of local data such as
census-tracked information
and school, hospital, and law
enforcement data on suicide risk
and protective factors
in the community.
The TA team also encouraged them
to document their own experience
and knowledge of the community
as well as the experience
and knowledge of
other stakeholders.
This experiential evidence could
provide an important perspective
for reviewing the research
and contextual evidence
and assessing the fit
between the various prevention
strategies and the
community context.
They shared some ways to make
that information explicit
and transparent as
they moved forward
with the decision
making process.
[music] Stages of the
decision making process.
Gathering evidence.
To gather evidence, first seek
out best available
research evidence,
find relevant evidence
registries,
and systematic reviews, or
other relevant research evidence
sources as available.
Collect information on your
setting that is related
to factors important
for the decision.
Consult the expertise
and knowledge
of stakeholders then confirm
that all information used
as evidence is replicable,
observable,
credible, and verifiable.
>> Practitioners have a lot
of resources available to them
if they are able to find them.
In the suicide prevention
world, we have resources
like the Suicide
Prevention Resource Center.
We have online resources
that provide information
about those programs
and practices
that have been effective
in other places.
And some of that information can
be incredibly valuable in order
to give us some direction
to head
in when we know a whole range
of options are available to us.
So looking at those programs
either on the Substance Abuse
and Mental Health Services
Administration website
that help document
the kinds of services
that we know have
been effective.
It's also crucial to talk
with the community members
that we're working with because
key leaders in the community,
whether they're formal
or informal leaders can
help provide that context
for what's going to be
accepted in this community
and how do we make sure that
those services are going to fit
in with the needs
of our community?
>> Interpreting evidence.
First, review the
research evidence
and determine how rigorously the
research studies are designed,
how well the strategies
were implemented,
and whether the strategies have
been replicated and evaluated
across multiple settings
and populations.
This information will help
you determine the strength
of the research evidence
indicating that a program,
practice, or policy is
effectively preventing violence.
However, depending on
the question or strategy,
the available research
evidence may be weak.
Explore areas where the
research, experiences,
preferences, and values of local
stakeholders vary then gauge the
feasibility and utility
of strategies in light
of the location and population
affected by the decision.
>> That can be pretty extensive
process in terms of helping them
to identify what it is that's
going to work best for them
and get to a point
where they're really,
where they're using what they
know about their own work
and their resources but also the
work and the resources available
in the field to make
programmatic
or other related decisions.
So we do quite a bit of that.
We work around capacity building
and improving the ability
of communities and states
to be able to do this work
and to do it self sufficiently
and to help sustain
their efforts
over a longer term period.
Again it's a way for us
to have a conversation
about what it means to be,
to have that evidence behind a
particular approach and a lot
of times we unpack some of the
research that's led a program
to be identified
as evidence based.
And so we look at the
population, you know,
where it was used and
the different demographic
information and how
that compares
to the communities they're
working in and whether or not
that will be a good
match or not.
>> Applying what you
learned from evidence.
Consider all three
types of evidence
to provide the best opportunity
to prevent violence
before it occurs.
In the application of evidence
stage, the collective sources
of evidence are considered,
prioritized and transformed
through group deliberation
into an actionable decision.
Use explicit inclusion
criteria for participants.
Focus on carefully defined
problems and document
where participant views differ.
Characteristics of the
decision making process.
The goal of evidence
based decision making is
to bring a high standard
of research evidence
into the decision making
process while taking
into account the contextual
and experiential factors
that influence decisions
for prevention.
Transparency.
The decision making process
should be an authentic effort
to gather and examine
all relevant evidence.
It should not be used to
justify or promote decisions
that have already been made.
Inclusiveness and participation.
Those who will implement
the strategy,
those who will be affected
by that implementation,
and those making
policy decisions
that will affect the strategies
implementation should be
included in the decision
making process.
Openness and explicitness.
At every level
of decision-making it should
be clear how evidence was
collected, what evidence
was collected,
and how that evidence
informed the final decision.
Skilled leadership
and facilitation.
Active guidance from those
in leadership positions during
the decision-making process
is important.
So is objective and
skilled facilitation.
Both of these support
identifying a shared
understanding while allowing
for dissenting opinions.
They also motivate the group
to commit to a conclusion
that supports the common good.
Defined process.
Terms that are clearly
defined, clear mechanisms
for collecting evidence,
timelines and other tools
to capture the process should
all contribute to transparency,
inclusiveness and explicitness.
It is important to keep
in mind that attaining all
of these characteristics
represents a goal
for optimal outcomes, but that
each decision-making scenario
will be unique, and the level
to which these characteristics
can be achieved will vary
from situation to situation.
[music] Overview.
Evidence based decision
making involves gathering,
interpreting, and
applying evidence.
Evidence includes the
best available research,
information on the circumstances
in which the program, practice,
or policy will be implemented,
and the insights from people
who bring subject matter
expertise, resources, training,
education, and practical
experience to the project.
All three types of evidence
are important for the success
of prevention programs,
practices, and policies.
Evidence-based decision-making
occurs
when the best available
research evidence is combined
with the contextual and
experiential evidence
from community data and
field-based expertise.
>> It's extremely important
to look at both what we know
from a research perspective
and what information we get
from the field, and
from people in practice.
And it's extremely important
that there be visible
and active dialogue from
practitioners in the process
of evaluating and
considering programs.
>> Knowledge check.
Evidence-based decision-making.