Seeking best practices: a conceptual framework for planning and improving evidence-based practices.

How can we encourage ongoing development, refinement, and evaluation of practices to identify and build an evidence base for best practices? On the basis of a review of the literature and expert input, we worked iteratively to create a framework with 2 interrelated components. The first - public health impact - consists of 5 elements: effectiveness, reach, feasibility, sustainability, and transferability. The second - quality of evidence - consists of 4 levels, ranging from weak to rigorous. At the intersection of public health impact and quality of evidence, a continuum of evidence-based practice emerges, representing the ongoing development of knowledge across 4 stages: emerging, promising, leading, and best. This conceptual framework brings together important aspects of impact and quality to provide a common lexicon and criteria for assessing and strengthening public health practice. We hope this work will invite and advance dialogue among public health practitioners and decision makers to build and strengthen a diverse evidence base for public health programs and strategies.

Assessing the need for child-care health consultants.

This study surveyed health and safety needs of child-care programs; examined the perceptions of directors, the person identified as being responsible for a program, concerning health consultation; and determined how directors would secure funds to pay for consultative services. The survey was conducted in a state without mandates for child-care health consultation and minimal access to consultants. The researchers designed and pilot-tested a Child Care Health and Safety Survey. Working with a task group of statewide child health experts, the researchers revised the survey and mailed it to a random sample of child-care programs. Twenty-two Head Start Programs, 122 licensed child-care centers, and 116 family child-care homes participated, representing a return rate of 73, 36, and 30%, respectively. The majority of programs expressed interest in child-care health consultation offered for free or fee-based. Directors identified reasonable means of obtaining funds to support consultation. All programs had needs related to supporting health practices in their settings, provision of health services for staff, and health screening for children. Public health nurses, specially trained to advise child care, are well positioned to offer consultation. Systems of health consultation may be accepted as fee-for-service arrangements, supporting sustainability.

Teaching the public health core competency of policy development to baccalaureate student nurses.

Teaching the public health core competency of policy development to baccalaureate student nurses was the purpose of this project. This project was implemented through interdisciplinary collaboration of one innovative state health district and the faculty of a large, urban university. Through education in the core competency of policy development, attention to one county's assessed health needs was introduced to its county board of health with the goal of influencing health policy regarding those needs. Data obtained have continued to be used by this county in health planning and grant writing activities and have been built upon by other student groups.