Policy makers face increasing public health challenges caused by factors such as ageing populations, and changing environments and lifestyle behaviours. These challenges represent a health and economic burden, with those in worse health accruing higher health and labour costs, for example due to absenteeism from work. In response, policy makers are turning to evidence‑based decisions to improve population health in a sustainable way.
The guidebook is designed to promote high-quality evidence‑based decision making, by outlining a step-by-step process for selecting, implementing and evaluating best practice public health interventions. It can be used for all types of public health interventions, for this reason, information in the guidebook should be adapted to suit the specific needs of users.
Step 1, selecting an intervention, is broken into two key components: Step 1a) assesses whether an intervention is best practice while Step 1b) assesses whether the intervention can be transferred. Step 1a uses a MCDA framework consisting of five criteria to help policy makers identify best practice interventions: effectiveness, efficiency, equity, evidence‑base and extent of coverage. For each criteria, the guidebook specifies several indicators to measure performance using, to the extent possible, those in international, publically available datasets. An intervention evaluated as best practice in one setting may not necessarily perform well in another setting due to the influence of external factors. Therefore, Step 1b outlines four contextual factors policy makers should consider to determine whether an intervention is transferable: the population, sector specific, political and economic contexts.
Once an intervention has been identified as best practice and appropriate for transfer, it must be implemented in the target setting. Step 2 of the guidebook provides a rationale for a formal implementation process and a step-by-step guide to implementation, illustrated with practical examples. Preparing implementation involves identifying people who actively contribute to implementation efforts; assessing resource needs, capacity and readiness to implement; as well as drafting an implementation protocol covering information such as timelines and management oversight. Step 2 also discusses the process for monitoring implementation as it unfolds, and the importance of supportive feedback loops and providing implementers with continual support.
Finally, Step 3 of the guidebook outlines how to evaluate the intervention in the target setting. This requires designing an evaluation study using a programme logic model, which specifies the inputs, activities, outputs and outcomes associated with an intervention. For each element within the logic model, realistic indicators must be chosen, that is, indicators for which there are available data and sufficient resources to collect and analyse the information. Data to measure performance against indicators can be used to undertake one of several evaluations, the most common being process and outcome evaluations. Finally, results from evaluations should guide follow-up action on whether to adopt, adapt or abandon the intervention. Results should also be used to ensure lessons learned are applied to future implementations and to build stakeholder support.