May, 2008

May, 2008

D. Ciliska, RN, PhD&

Helen Thomas, RN, MScScientific Co-Directors

C. BuffettFunded by the Public Health Agency of Canada

Affiliated with McMaster University

Can I Use This Evidence in my Program Decision?

Assessment of Applicability and Transferability

May, 2008

Funded by the Public Health Agency of Canada

Affiliated with McMaster University

One of six centres funded by the Public Health Agency of Canada

3

Different topics

Different institutions

Collective

projects

National Collaborating Centres for Public Health

Mission: to translate existing and new evidence produced by academics and researchers in public health.

Build on existing strengths, foster linkages across various sectors of public health community to enhance efficiency and effectiveness of public health system.

Work as a network which supports knowledge demands around public health goals and priorities

Methods and tools for

what?

Methods and Tools for what?

K nowledge S ynthesis T ranslation and E xchange(KSTE)

Health-care

decisions

Evidence from

research

Evidence Transfer Gap

Evidence of Gap in Acute and Primary

Care Consistent evidence of failure to translate

research findings into clinical practice

30-40% patients do not get treatments of proven effectiveness

20-25% patients get care that is not needed or potentially harmful

Schuster, McGlynn, Brook (1998). Milbank Memorial Quarterly

Grol R (2001). Med Care

Is it any different in public health?

Steps of Evidence-Informed Decision-Making

1. Formulate an answerable question

2. Conduct an efficient literature search

3. Critically appraise the evidence

4. Apply the results in health care decisions

5. Evaluate the outcome

Applicability and Transferability Tool

-to assist managers and planners in decision-making about program priorities for your community

4. Apply Decision to Health-Care

Issue

Method

Extensive literature search Pilot tested with relevant group Sent out for review by managers

Criteria 

Applicabilityis it feasible in the local setting?

Political acceptability, barriers or leverage

Social acceptability Available resources Organizational expertise and capacity

Transferability

can the intervention achieve the same outcomes in the local setting?

Magnitude of the health issue locally Magnitude of potential reach Potential cost-effectiveness Target population characteristics Overall community capacity to accept and

implement

Criteria 

Involve relevant stakeholders

2. Give orientation to the process; establish time lines.

3. Choose which of the applicability and transferability criteria are most important for the particular intervention of interest and the local context, if these should be weighted, and what weights to assign.

Process 

4. Determine if/how final scoring will be done: addition of individual ratings; or discussion and consensus on each criteria.

eg: individually rate each criterion on a 1-5 point scale (1 is low impact/relevance or match and 5 indicates high level impact/relevance or match). Priority then goes to the highest scoring program.

5. Document whatever process was used in d).

Process 

Evaluation

In process Interviews with users Will also include unsolicited feedback

Questions?

National Collaborating Centre for Methods and Tools1685 Main Street West, Suite 302Hamilton ON  L8S 1G5Phone: 905-525-9140, ext. 20455Fax: 905-529-4184

Email: ciliska@mcmaster.ca

Web: www.ccnmo.ca/www.nccmt.ca