nccmt webinar: infectious disease-focused methods and tools to support evidence-informed...

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Funded by the Public Health Agency of Canada | Affiliated with McMaster UniversityThe views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.

Infectious Disease-Focused Methods and Tools to Support Evidence-Informed Decision-Making

Susan Snelling, PhDSenior Knowledge Translation Specialist, NCCMT

Margaret Haworth-Brockman, MScSenior Program Manager, NCCID

June 9, 2016

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Poll Question #1

How many people are watching today’s webinar with you?

a) Just meb) 1 to 3c) 4 to 5d) 6 to 10 e) More than 10

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Housekeeping

• TC line will be muted during the webinar

Use Q&A to post comments / questions during the webinar

• ‘Send’ questions to All (not privately to ‘Host’)

Connection issues• Recommend using a wired Internet

connection (vs. wireless),

• WebEx 24/7 help line: 1-866-229-3239

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Housekeeping

Experiencing feedback?• Click Audio Broadcast at the bottom of the

Participants panel to join or leave the audio broadcast.

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Poll Question #2

Where are you connecting from today?

a) BCb) ABc) SKd) MBe) ON

f) QCg) NBh) NSi) PEIj) NL

k) YKl) NWTm) NUn) Outside

Canada

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Outline of Today’s Webinar• Introduction to

NCCMT and NCCID• A model for

evidence-informed decision making

• Steps in the process of evidence-informed public health

With reference to methods & tools

relevant for infectious diseases public

health practitioners, including approaches

that work for social determinants &

tuberculosis

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National Collaborating Centre for Methods and Tools (NCCMT)

Vision• The effectiveness and efficiency of Canada’s public

health system will be guided by the production, sharing and use of high quality evidence.

Mission• The NCCMT will enhance evidence-informed public

health practice and policy in Canada by providing leadership and expertise in supporting the uptake of what works in public health into practice.

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What is Evidence-Informed Public Health?

… the process of distilling and disseminating the best available evidence from research, context and experience, and using that evidence to inform and improve public health policy and practice.

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Poll Question #3

What sector are you from?a) Public Health Practitionerb) Health Practitioner (Other)c) Educationd) Researche) Federal/Provincial/Territorial Governmentf) Municipalityg) Non-Governmental Organizationh) Other

NCCMT Registry of Methods and Tools

Resources to support use of research evidence in public health

http://www.nccmt.ca/resources/registry

A free, searchable, online collection of knowledge translation methods and tools for public health

• Summary statements• Web links (when available) to Methods and Tools

NCCMT Registry of Methods of Tools for Knowledge Translation

What are methods and tools?

A process or series of steps to organize a Knowledge Translation activity

Dissemination framework

MethodAn instrument to carry out the steps of a Knowledge Translation activity

Dissemination checklist

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National Collaborating Centre for Infectious Diseases

We help public health practitioners find, understand and use infectious disease research and evidence.Integration of evidence and other information to improve public health policy & practiceConnections & collaborations for improved exchange

A Model for Evidence-Informed Decision-Making in Public Health

Stages in the process of

Evidence-Informed Public Health

Scenario: Setting the Stage for Evidence Use on an Infectious Disease

• Understanding the dynamics of TB in the inner-city & appropriate screening

• Outreach to at-risk populations

How can the steps of Evidence-Informed Public Health be applied

to this scenario?

Clearly define the question or problem

Define the question

PICOP populationI interventionC comparisonO outcome

Define the question: Apply our scenario

PICOP population: inner-city residentsI intervention: screeningC comparison: no intervention or usual

careO outcome: diagnosed patients in care

Recommended Tool: Define

Developing an Efficient Search Strategy Using PICO

http://www.nccmt.ca/resources/search/138

Use it to develop an evidence-search question using the PICO format.

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Efficiently search for research evidence

Recommended Tool: SearchNCCMT Search Pyramids

http://www.nccmt.ca/resources/search/181 http://www.nccmt.ca/learningcentre/EN/index.php

• Pre-populated with good sites for finding evidence in public health, and for certain specific topics.

• Start at the top for the most synthesized evidence.

• Saves time• Systematic approach to searching

Recommended Tool: Search

Recommended Tool: Searchwww.healthevidence.org

Tips for “Search”• Choose the highest possible level on the Pyramid• Pre-appraised sources make your search more

efficient• NCCMT online module on Searching through

Learning Centre

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Critically and efficiently appraise the research methods

Recommended Tools: AppraiseCritically Appraising Practice Guidelines: The AGREE II Instrument

http://www.nccmt.ca/registry/view/eng/100

Tools to Assess the Methodological Quality of Systematic Reviews: AMSTAR

http://www.nccmt.ca/registry/view/eng/97

Critical Appraisal Skills Programme: Checklists

Considering Sex and Gender in Research and Practice

http://sgba-resource.ca/en/ http://pwhce.ca/risingToTheChallenge.htm

Tips for “Appraise”

• Appraise is a filtering step, looking for sources of bias

• Answers the question: is this research/review of good enough quality that I should read further?

• All research has flaws! But some flaws are more serious than others.

Additional Resources

• Refer to NCCMT’s online learning modules for additional practice: http://www.nccmt.ca/professional-development/modules

• Week-long course at McMaster University: “What is Evidence-Informed Decision Making (EIDM)?” http://ccebn.mcmaster.ca/workshop

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Interpret information; understand how to prioritize

conflicting results

Recommended Tool: Synthesize

Briefing Note: Decisions, Rationale and Key Findings Summary

Use it to create briefing notes to inform decision-makers. Use ‘actionable messages’ to inform program and policy development.

Tips for “Synthesize”

• Bring good quality evidence together to determine results and implications

• If results ‘conflict’, prefer sources that are highest quality, most recent, most relevant to your question

• Identify actionable findings that can guide decisions

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Adapt the information to the local community

A Model for Evidence-Informed Decision-Making in Public Health

Recommended Tools: Adapt- Applicability and Transferability of Evidence

Online Learning ModuleAssessing the Applicability and Transferability of Evidence

Tips for “Adapt”

• In developing a local approach, consider:• Research evidence• Stakeholder perspectives• Media coverage – what’s going on in community• Political context• Local and regional data reports• Financial and human resources

• How can you adapt potential interventions to be appropriate for your community?

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Decide whether (and plan how) to implement

the change in practice or policy

Recommended Tool: ImplementOutreach Planning ChecklistGet the app: http://bit.ly/1UfwcrU

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Assess the effectiveness of the change in practice or policy

Recommended Tool: EvaluateImproving Future Decisions: Optimizing the Decision Process from Lessons Learned

Use it to evaluate your use of evidence in making decisions.

A reflective practice tool.

Tips for “Evaluate”Determine how effective you were at using an evidence-informed approach:• What process did you follow?• What can you learn from your process?• How could you improve your use of evidence? • How will you know if people are using the evidence? Have

they changed their practice?• Was the intervention adapted effectively at your local

level?

You may need to gather baseline data before you start if you want to assess change.

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Poll Question #4

How familiar are you with the methods and tools described today?

a) I am not familiar with any of the methods/tools

b) I have heard of one or more of the methods/tools

c) I have used one or more of the methods/tools

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Recommended tool: Evidence-Informed Decision Making Checklisthttp://www.nccmt.ca/resources/search/237

EIDM Phases & StepsFile Path / Link to

Saved Location on:(insert name of your

network here)

1. Define question Was a clear answerable search question developed?

What was the question? P I C O

2. Search for relevant evidence Was a comprehensive search strategy employed to find the best available

evidence to address this question? PICO search terms table (See: Developing an Efficient Search Strategy Using PICO)

Years searched: Pyramid results (See: Levels & Sources of Public Health Evidence) Search results (See: Keeping Track of Search Results: A Flowchart)

References saved in reference management software database (e.g. Reference Manager / RefWorks)

What relevance criteria were used to determine evidence for quality assessment: Primary Titles and abstracts as found in reference management database

Save as separate reference management database.

Secondary

Relevance assessment of full document versions Save as separate reference management database.

How many papers remained following relevance assessment(s)? (See: Flowchart, above)

3. Appraise Was quality assessment conducted on relevant evidence?

How many papers remained after quality assessment? (See: Flowchart, above)

4. Synthesize What were the results of the review of the evidence?

What were the actionable messages from the evidence?

5. Adapt.

NCCMT’s Applicability and Transferability tool; AHRQ’s Will It Work Here? A Decisionmaker's Guide to Adopting Innovations

6. Implement.

7. Evaluate.

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Poll Question #5

To what extent will the methods or tools described today be useful in your practice?

a) Very usefulb) Somewhat useful c) Not at all usefuld) Don’t know

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• Use Q&A to post comments and/or questions

• ‘Send’ questions to All (not privately to ‘Host’)

Your Comments/Questions

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Poll Question #6

What are your next steps? (Check all that apply)

a) Access a method/tool referenced in the presentation

b) Read an NCCMT summary about a method/tool described today

c) Consider using the methods/tools in practice

d) Tell a colleague about the methods/tools

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Availability of the Slides and Audio Recording• The PowerPoint presentation (in English and

French) and English audio recording will be available at:

• PowerPoint: http://www.slideshare.net/nccmt• Audio Recording: https

://www.youtube.com/user/nccmt

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Your Feedback is Important

Please take a few minutes to share your thoughts on today’s webinar.

https://nccmt.co1.qualtrics.com/SE/?SID=SV_8vlZFs7Dme2pwm9

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Join NCCMT for our next webinarTopic-Specific Methods and Tools to Support Evidence-

Informed Decision-Making: Resources for Practitioners Working in Injury Prevention PRESENTER: Susan Snelling, Senior Knowledge Translation

Specialist, NCCMT DATE: Wednesday, June 22 2016TIME: 1:00-2:30 pmhttps://health-evidence.webex.com/health-evidence/onstage/g.php?MTID=e5709e2b84fb3c8d00298494074d1b533 Do you work in the injury prevention field? Join us for a webinar to learn about a process for evidence-informed decision-making, and methods and tools that are specific to injury prevention. Remember to share information about this webinar with your colleagues who work in the injury prevention field!

For more information about the National Collaborating Centre for Methods and Tools:

NCCMT website www.nccmt.caContact: nccmt@mcmaster.ca

For more information about the National Collaborating Centre for Infectious Diseases:www.nccid.canccid@umanitoba.ca

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