Dr. Philip Singe is the Chief Medical Officer of Health in the fictional Region of King in Ontario, Canada. Upon learning that Ottawa Public Health is offering a walking school bus program, Dr. Singe asks Vincent Randall to investigate the evidence. In charge of the health promotion portfolio at King Region Public Health (KRPH), Vincent Randall has been asked to apply the principles of evidence-based public health to identify and appraise the evidence on walking school buses. KRPH may suggest a similar initiative to the King Region School Board during an upcoming meeting. Given the short timeframe of one week, Vincent is likely to begin his search by identifying systematic reviews of the literature that are pertinent to the walking school bus program.
The scenario depicted in the case is a common occurrence in public health organizations. In the process of developing new programs, the practices of other organizations and the opinions of leaders in the field can be influential. The case provides students with the opportunity to apply evidence-based practices to program and policy development in order to critically assess program options.
- Understand the importance of using evidence to inform health policy and program development.
- Distinguish systematic reviews from other types of research and recognize the benefits and challenges of using this type of evidence.
- Specify best practices in the conduct of systematic reviews and critically appraise the quality of a systematic review.
- Search for systematic reviews in repositories and journal citation databases.
- Using information from systematic reviews as a starting point, conduct searches for primary studies to inform public health practices.
Case Study Questions
- Using the epidemiological framework of population, intervention/exposure, comparison, outcome, and setting, develop a research question pertinent to the walking school bus program.
- Read the review by Smith and colleagues (Smith, 20151) and appraise the quality according to the criteria found in the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) checklist (http://amstar.ca/Amstar_Checklist.php).
- Use the following systematic review repositories to identify additional evidence pertinent to the walking school bus program:
a. McMaster University, Health Evidence (http://www.health-evidence.org/)
b. National Collaborating Centre for Methods and Tools (http://www.nccmt.ca/public_health_plus/all/1/list-eng.html)
c. Cochrane Database of Systematic Reviews (http://www.cochrane.org)
d. Cochrane Public Health Group (http://ph.cochrane.org/) – The Public Health Group is one of approximately 50 Cochrane Review Groups
e. Campbell Collaboration (http://www.campbellcollaboration.org)
f. Agency for Healthcare Research and Quality (http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/)
g. International prospective register of systematic reviews (PROSPERO) (http://www.crd.york.ac.uk/PROSPERO/)
- Develop a search strategy and apply the strategy to search for additional evidence from journal citation indices, including:
a. PubMED (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed)
b. Embase (http://www.embase.com)
c. PsycINFO (http://www.apa.org/psycinfo)
d. Cumulative Index of Nursing and Allied Health Literature (CINAHL) (http://www.ebscohost.com/cinahl)
- Specify an approach to systematically searching for evidence in the grey literature, including reports and guidelines from other public health units and national and international organizations.
- What are the appropriate next steps to applying evidence to decision-making? How should Vincent Randall prepare for a meeting with the King Region School Board?
evidence-based public health, systematic reviews, critical appraisal, health promotion, systematic review repositories, searching for evidence
John-Baptiste, A. (2018). Don’t Miss the Bus. in: McKinley, G. & Sibbald, S.L. [eds] Western Public Health Casebook 2018. London, ON: Public Health Casebook Publishing.