How to support professionals with evidence?

1. How to support professionals with evidence? Djoeke van Dale Senior advisor Centre for Healthy Living

2. Content • Background • Best Practice portal • Implementation of BP • New strategies • Conclusions

3. Centre For Healthy Living Evidenceinformation To contribute to the health of all Dutch citizens by supporting health promotion professionals • Website and an intervention database • Assessment system for interventions (Recognition) • Specific information/ support in settings: • School • Day childcare / preschool • Municipality • Workplace Loketgezondleven.nl information about planning andprocesses 3

4. Database (Loketgezondleven.nl) • 350 good practices (governance function): Insight in quality and effectiveness • CGL putsinformation/data in the database (assessment information) • 994 interventions (collection and sharing): • Insight in HP intervention supply in the Netherlands • Professionals submit their intervention to the database. CGL verifies the content

5. toprovide policy makers and professionals with sound information on thequalityandeffectiveness of available health promotion interventions topromotethequality of theinterventions (research) The Recognition SystemObjectives Collaboration of 7 organisations One system for several sectors 5

6. Assesment system: The Recognition SystemImproving effectiveness in 2 directions Evidence-basedpractice Practice-basedevidence

7. Assessment levels • 994 interventions • in database • 350 best practices • 61 effective • 7 highest level 15

8. How? The submission form in a nutshell • Description of the intervention(Requiredforall levels) • target, targetgroup, planning of the intervention & methods • Theoretical foundation (Requiredfor ‘theoretically sound’ and ‘effective’) • scientificepidemiologicalanalyis, interventionmethods, strategiesandactivities are appropriateforandtailoredto the goals and target population, as indicatedbypublishedscientificevidence • Preconditionsforimplementationandqualityassurance(Requiredforall levels) • Requirementsfor training, implementation, qualityassurance ,costs • Process Evaluation • Evidenceforeffectiviness(Requiredfor‘effective) • First indications: pre-post design (monitoring) • Good indications: controlledstudy design (no follow up) • Strong indications: controlledstudydesign, including a 6 month follow up) 8

9. List of recommended interventions Interventies per gezondheidsthema Interventieoverzicht overgewicht Interventieoverzicht alcohol Interventieoverzicht drugs Interventieoverzicht roken Interventieoverzicht depressie Interventieoverzicht seksuele gezondheid Interventieoverzicht letsel

11. For both? Information OK! • What is used? • Are the professionals satisfied what about the professionals in the field??

12. Why choosing a best practice? Professionals use a best practice if: • Management supports the implementation of a best practice • Incentive programs of the government encourage the adoption/ implementation • Municipalities require the implementation of best practices • Intervention has to be easy to implement for the professional

13. Why not choosing for a best practice? Not using best practices: • Unfamiliarity with the database and different levels of evidence • Best practices can not be adjusted to local context (according to the practitioners) • Want to connect /align with the existing activities in the municipality or organisation • Professionas want to develop own interventions…want to have information about common effective elements/ What works X

15. 1. Adjusting a best practice to local context: keep the core elements • Message: best practices can be adjusted to local context • We provide information about the core elements of a best practice Core elements: Central to its theory and logic. Are thought to be responsible for the effectiveness of the intervention. Critical features of the intervention intent and design. Should be kept intact when program is implemented (centre.trt.org)

16. Example of core elements:A new Leaf Choices for healthy living • Structured assessment and counseling tool that emphasizes practical strategies for making changes in dietary and physical activity behaviors. • Risk perception(diet, physicalactivity, smoking) • Goal setting as collaborativeprocessand action planning • Self-efficacy(to built selfconfidence ) • Tip sheet (guidelines) to tackle barriers • Tailored feedback andfollow-up • Social support (participants learn why, where, and how to generate and sustain a successful social support network) (centre.trt.org)

17. 2. Provide information about What works? • An overview of ‘common elements’ of successful studies for one specific topic of a group of interventions • Best practices are shown as an example of these common elements /active ingredients.

19. 3.Model intervention? • Is it possible to develop a ‘ model’ intervention based on common effective elements which can be adapted to the local context? • Not 20 interventions differing slightly but one generic intervention • Professionals can adapt the model intervention to the needs of the local contexts.

20. Concluding remarks • From interventions only to also What works: improvement of quality of local work? • From mainly online information to also offline (workshops, regional gatherings) • Tailored advice to local communities (using practice based and evidence based information)

21. Thank you

22. Centrum Gezond Leven | 31-10-2016

23. What works • Review of literature • Focus on common effective elements of interventions • List of common effective elements • Focus groups with professionals • Practical document how to work on specific topic (alcohol prevention for elderly people) • Online and offline…workshop Centrum Gezond Leven | 31-10-2016