Evaluations in Public Health

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Winston Churchill said, “True genius resides in the capacity for evaluation of uncertain, hazardous and conflicting information”. Nowhere is this truer than in public health. The potential to benefit society through evidence-based evaluation is substantial. At the Regional Academic Public Health Forum at University of East Anglia in October 2016, academics and non-academics discussed some of the challenges and solutions. Using the Cambridge busway project, David Ogilvie (MRC Epidemiology Unit, University of Cambridge) set the backdrop. He described problems around grasping the right population, an appropriate comparison, a dynamic intervention and suitable outcomes.

Barriers to public health evaluation discussed by delegates fell into two main themes. Firstly a mismatch between academics and local evaluators. Academics want funded evaluations, ideally from a UK Research Council, over a long time frame, which will produce high impact papers. Local evaluators want low cost evaluations, over a short period which will provide decisions. The net effect is disengagement from both sides. The second barrier was a lack of resources; funding, time, expertise, measurement tools and data. Academics don’t have enough time or funding. Local evaluators don’t have the expertise, especially statistical. And neither have access to good quality routinely collected quantitative and qualitative data.

There were two main solutions. First better communication and partnerships. Each organisation requires a broader appreciation of the motivations and levers of each other. Furthermore evaluators need to be aware of past and present evaluations. Better collaboration and informal networks are vital. Evaluations should be published, either in peer review journals or some other electronic platform. But partnerships aren’t just needed between academics and local evaluators but also with patient groups to promote co-production. One idea to pull all this together was to have a regional evaluation co-ordinator or hub. The second solution was more effective embedding of evaluation within organisations. Academic expertise is crucial to do this effectively. Aims should include developing systems which routinely collect high quality data, planning adequately funded evaluations from the start and building local expertise.

The demand for evaluations in public health will always out-stretch supply and capacity. David Ogilvie argued for strategic opportunism and robust pragmatism. Our collaborative and cumulative effort can ensure that we capitalise on the best opportunities and generate the high quality evidence needed to make a real difference to patients and the public.

John Ford

N.B. This meeting marks the re-launch of the Regional Academic Public Health Forum in the East of England. If you would like to be added to the mailing list for future events please contact John Ford (john.ford@uea.ac.uk)

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