Factors Affecting Implementation of Evidence-Based Practices in Public Health Preparedness and Response.

CONTEXT: There is limited research on what factors are most salient to implementation of evidence-based practices (EBPs) among public health agencies in public health emergency preparedness and response (PHPR) and under what conditions EBP implementation will occur. OBJECTIVE: This study assessed the conditions, barriers, and enablers affecting EBP implementation among the PHPR practice community and identified opportunities to support EBP implementation. DESIGN: A Web-based survey gathered information from public health agencies. Data obtained from 228 participating agencies were analyzed. SETTING: State, local, and territorial public health agencies across the United States. PARTICIPANTS: Preparedness program officials from 228 public health agencies in the United States, including Public Health Emergency Preparedness (PHEP) cooperative agreement awardees (PHEP awardees) and a random sample of local health departments (LHDs). RESULTS: Respondents indicated that EBP is necessary and improves PHPR functions and tasks and that staff are interested in improving skills for EBP implementation. Top system-level barriers to EBP implementation were insufficient funding, lack of EBP, and lack of clarity regarding which practices are evidence based. PHEP awardees were significantly more likely to report a lack of EBP in the field, whereas LHDs were significantly more likely to report a lack of incentives. The top organizational-level barrier was insufficient staff. Most respondents indicated their agency culture supports EBP; however, LHDs were significantly more likely to report a lack of support from supervisors and leadership. Few respondents reported individual barriers to EBP implementation. CONCLUSIONS: Findings indicate an opportunity to improve dissemination strategies, communication efforts, and incentives to support EBP implementation in PHPR. Potential strategies include improving awareness of and accessibility to EBPs through targeted dissemination efforts; building organizational capacity to support EBP implementation, particularly staff capacity, knowledge, and skills; and identifying funding and incentives to promote EBP uptake and sustainment.

The Campus Sexual Assault Policy and Prevention Initiative: Findings From Key Informant Interviews.

Addressing the widespread problem of sexual assault in college environments requires both prevention programming and policies addressing sexual misconduct in institutions of higher education. Through the Campus Sexual Assault Policy and Prevention Initiative, nine programs funded by the Office on Women's Health approached this problem within a network of eight to 13 campuses apiece, supported by national organizations and local task forces. Near the close of the 3-year project period (June 2016-June 2019), key informant interviews were conducted with project directors and campus representatives. Contextual factors elucidating the project approaches, challenges, and successes were investigated through 31 interviews (nine grantee interviews and 22 campus representative interviews). Analyses across all interview content contributed to the development of several key themes related to staffing efforts to strengthen campus policies and prevention programs, working within institutions of varying structural characteristics, infusing efforts with trauma-informed perspectives, attending to cultural differences across campuses, and seeking to follow recommended guidelines in the context of campus-specific factors. Overall, the interviewees reported specific progress toward the program goals.