Standards Required for the Development of CDC Evidence-Based Guidelines.

CDC is the nation's premier health promotion, prevention, and preparedness agency. As such, CDC is an important source of public health and clinical guidelines. If CDC guidelines are to be trusted by partners and the public, they must be clear, valid, and reliable.

A cost-benefit analysis of three older adult fall prevention interventions.

Introduction: One out of three persons aged 65 and older falls annually and 20% to 30% of falls result in injury. The purpose of this cost-benefit analysis was to identify community-based fall interventions that were feasible, effective, and provided a positive return on investment (ROI).

Methods: A third-party payer perspective was used to determine the costs and benefits of three effective fall interventions.

Measuring success: the case for calculating the return on investment of environmental public health tracking.

The Centers for Disease Control and Prevention's Environmental Public Health Tracking (EPHT) Program has funded multiple partners to develop a nationwide surveillance system that focuses on the environment and its impact on human health. To show that investing in a nationwide EPHT Network is a sound practice, the program must demonstrate that monetized improvements to the public's health due to tracking outweigh the costs. In the process of developing capacity for the EPHT Network, programs have had a positive impact on the public health.

Public goods and externalities: a research agenda for public health economics.

Among the many roles a government plays in our daily lives, protecting the public's health is one of the most conspicuous. The government provides goods and services such as registration of births and deaths, public health surveillance of disease and injury, outbreak investigations, research and education, health insurance for the poor and elderly, enforcement of laws and regulations, evaluation of health promotion programs, and assurance of a competent healthy workforce. In the past, economics in public health has almost exclusively focused on efficiency of programs through the use of cost-effectiveness or net present value measures clustered under the rubric of "economic evaluation.

Measuring the public's health.

Allocation of public health resources should be based, where feasible, on objective assessments of health status, burden of disease, injury, and disability, their preventability, and related costs. In this article, we first analyze traditional measures of the public's health that address the burden of disease and disability and associated costs. Second, we discuss activities that are essential to protecting the public's health but whose impact is difficult to measure.

Economics of prevention: the public health research agenda.

Public health policy makers often focus their attention on the economic evaluation methods (eg, cost-benefit and cost-effectiveness analyses) because of their interest in the economic returns from investment in prevention programs. This article presents a case for the broader applicability of economic theories and methods in development of public health prevention research issues. Public financing, delivery, and regulatory policies are often advocated and used to correct the imperfections in the market for preventive health services.

The effectiveness of early childhood development programs. A systematic review.

Early childhood development is influenced by characteristics of the child, the family, and the broader social environment. Physical health, cognition, language, and social and emotional development underpin school readiness. Publicly funded, center-based, comprehensive early childhood development programs are a community resource that promotes the well-being of young children.

Methods for conducting systematic reviews of the evidence of effectiveness and economic efficiency of interventions to promote healthy social environments.

The social and physical surroundings in which people live affect their health. Knowing what basic conditions and opportunities in communities advance or impede improvement of community health can inform public health practice and policy. This article describes the methods for conducting systematic literature reviews of three community interventions to promote healthy social environments: early childhood development programs, programs to promote affordable family housing in safe neighborhoods, and interventions to increase the cultural and linguistic competence of healthcare systems.

Reviews of evidence on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.

This report presents the results of systematic reviews of effectiveness, applicability, other positive and negative effects, economic evaluations, and barriers to use of selected population-based interventions intended to prevent or control dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis of recommendations by the Task Force on Community Preventive Services (the Task Force) about the use of these selected interventions.

Increasing diabetes self-management education in community settings. A systematic review.

This report presents the results of a systematic review of the effectiveness and economic efficiency of self-management education interventions for people with diabetes and forms the basis for recommendations by the Task Force on Community Preventive Services. Data on glycemic control provide sufficient evidence that self-management education is effective in community gathering places for adults with type 2 diabetes and in the home for adolescents with type 1 diabetes. Evidence is insufficient to assess the effectiveness of self-management education interventions at the worksite or in summer camps for either type 1 or type 2 diabetes or in the home for type 2 diabetes.

The effectiveness of disease and case management for people with diabetes. A systematic review.

This report presents the results of a systematic review of the effectiveness and economic efficiency of disease management and case management for people with diabetes and forms the basis for recommendations by the Task Force on Community Preventive Services on the use of these two interventions. Evidence supports the effectiveness of disease management on glycemic control; on screening for diabetic retinopathy, foot lesions and peripheral neuropathy, and proteinuria; and on the monitoring of lipid concentrations. This evidence is applicable to adults with diabetes in managed care organizations and community clinics in the United States and Europe.

Conceptual framework of public health surveillance and action and its application in health sector reform.

Background: Because both public health surveillance and action are crucial, the authors initiated meetings at regional and national levels to assess and reform surveillance and action systems. These meetings emphasized improved epidemic preparedness, epidemic response, and highlighted standardized assessment and reform.

Methods: To standardize assessments, the authors designed a conceptual framework for surveillance and action that categorized the framework into eight core and four support activities, measured with indicators.

Reviews of evidence regarding interventions to reduce alcohol-impaired driving.

Background: Alcohol-related motor vehicle crashes are a major public health problem, resulting in 15,786 deaths and more than 300,000 injuries in 1999. This report presents the results of systematic reviews of the effectiveness and economic efficiency of selected population-based interventions to reduce alcohol-impaired driving.

Methods: The Guide to Community Preventive Services's methods for systematic reviews were used to evaluate the effectiveness of five interventions to decrease alcohol-impaired driving, using changes in alcohol-related crashes as the primary outcome measure.

Methods for conducting systematic reviews of the evidence of effectiveness and economic efficiency of interventions to reduce injuries to motor vehicle occupants.

Background: Motor vehicle occupant injury prevention is included in the Guide to Community Preventive Services because of the enormous health impact of these largely preventable injuries. This article describes the methods for conducting systematic literature reviews of interventions for three key injury prevention strategies: increasing child safety seat use, increasing safety belt use, and decreasing alcohol-impaired driving.

Methods: Systematic review methods follow those established for the Guide to Community Preventive Services and include: (1) recruiting a systematic review development team, (2) developing a conceptual approach for selecting interventions and for selecting outcomes that define the success of the interventions, (3) defining and conducting a search for evidence of effectiveness, (4) evaluating and summarizing the body of evidence of effectiveness, (5) evaluating other potential beneficial and harmful effects of the interventions, (6) evaluating economic efficiency, (7) identifying implementation barriers, (8) translating the strength of the evidence into recommendations, and (9) identifying and summarizing research gaps.

Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke.

This report presents the results of systematic reviews of effectiveness, applicability, other effects, economic evaluations, and barriers to use of selected population-based interventions intended to reduce tobacco use and exposure to environmental tobacco smoke. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis of recommendations by the Task Force on Community Preventive Services (TFCPS) regarding the use of these selected interventions.

Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The Task Force on Community Preventive Services.

This paper presents the results of systematic reviews of the effectiveness, applicability, other effects, economic impact, and barriers to use of selected population-based interventions intended to improve vaccination coverage. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis for recommendations by the Task Force on Community Preventive Services (the Task Force) regarding the use of these selected interventions.

Methods for systematic reviews of economic evaluations for the Guide to Community Preventive Services. Task Force on Community Preventive Services.

Objectives: This paper describes the methods used in the Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide) for conducting systematic reviews of economic evaluations across community health-promotion and disease-prevention interventions. The lack of standardized methods to improve the comparability of results from economic evaluations has hampered the use of data on costs and financial benefits in evidence-based reviews of effectiveness. The methods and instruments developed for the Guide provide an explicit and systematic approach for abstracting economic evaluation data and increase the usefulness of economic information for policy making in health care and public health.

Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services.

Introduction: A standardized abstraction form and procedure was developed to provide consistency, reduce bias, and improve validity and reliability in the Guide to Community Preventive Services: Systematic Reviews and Evidence-Based Recommendations (the Guide).

Data Collection Instrument: The content of the abstraction form was based on methodologies used in other systematic reviews; reporting standards established by major health and social science journals; the evaluation, statistical and meta-analytic literature; expert opinion and review; and pilot-testing. The form is used to classify and describe key characteristics of the intervention and evaluation (26 questions) and assess the quality of the study's execution (23 questions).

Developing an evidence-based Guide to Community Preventive Services--methods. The Task Force on Community Preventive Services.

Systematic reviews and evidence-based recommendations are increasingly important for decision making in health and medicine. Over the past 20 years, information on the science of synthesizing research results has exploded. However, some approaches to systematic reviews of the effectiveness of clinical preventive services and medical care may be less appropriate for evaluating population-based interventions.