The gold standard for evidence-based public health, The Guide to Community Preventive Services is a primary resource to improve health and prevent disease in states, communities, independent, nonfederal Task Force on Community Preventive Services, The Guide uses comprehensive systemic review methods to evaluate population-oriented health interventions. The recommendations of the Task Force are explicitly linked to the scientific evidence developed during systematic reviews. This volume examines the effectiveness and efficiency of interventions to combat such risky behaviors as tobacco use, physical inactivity, and violence; to reduce the impact and suffering of specific conditions such as cancer, diabetes, vaccine-preventable diseases, and motor vehicle injuries; and to address social determinants oh health such as education, housing, and access to care. The chapters are grouped into three broad categories: changing risk behaviors; reducing specific diseases, injuries, and impairments; and methodological background for the book itself.

During the past century the major causes of morbidity and mortality in the United States have shifted from those related to communicable diseases to those due to chronic diseases. Just as the major causes of morbidity and mortality have changed, so too has the understanding of health and what makes people healthy or ill. Research has documented the importance of the social determinants of health (for example, socioeconomic status and education) that affect health directly as well as through their impact on other health determinants such as risk factors. Targeting interventions toward the conditions associated with today's challenges to living a healthy life requires an increased emphasis on the factors that affect the current cause of morbidity and mortality, factors such as the social determinants of health. Many community-based prevention interventions target such conditions. Community-based prevention interventions offer three distinct strengths. First, because the intervention is implemented population-wide it is inclusive and not dependent on access to a health care system. Second, by directing strategies at an entire population an intervention can reach individuals at all levels of risk. And finally, some lifestyle and behavioral risk factors are shaped by conditions not under an individual's control. For example, encouraging an individual to eat healthy food when none is accessible undermines the potential for successful behavioral change. Community-based prevention interventions can be designed to affect environmental and social conditions that are out of the reach of clinical services. Four foundations - the California Endowment, the de Beaumont Foundation, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation - asked the Institute of Medicine to convene an expert committee to develop a framework for assessing the value of community-based, non-clinical prevention policies and wellness strategies, especially those targeting the prevention of long-term, chronic diseases. The charge to the committee was to define community-based, non-clinical prevention policy and wellness strategies; define the value for community-based, non-clinical prevention policies and wellness strategies; and analyze current frameworks used to assess the value of community-based, non-clinical prevention policies and wellness strategies, including the methodologies and measures used and the short- and long-term impacts of such prevention policy and wellness strategies on health care spending and public health. An Integrated Framework for Assessing the Value of Community-Based Prevention summarizes the committee's findings.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

The Affordable Care Act, landmark health legislation passed in 2010, called for the development of the National Prevention Strategy to realize the benefits of prevention for all Americans¿ health. This Strategy builds on the law¿s efforts to lower health care costs, improve the quality of care, and provide coverage options for the uninsured. Contents: Nat. Leadership; Partners in Prevention; Healthy and Safe Community Environ.; Clinical and Community Preventive Services; Elimination of Health Disparities; Priorities: Tobacco Free Living; Preventing Drug Abuse and Excessive Alcohol Use; Healthy Eating; Active Living; Injury and Violence Free Living; Reproductive and Sexual Health; Mental and Emotional Well-being. Illus. A print on demand report.

There are at least three ways in which a public health program or policy may not reach stated goals for success: 1) Choosing an intervention approach whose effectiveness is not established in the scientific literature; 2) Selecting a potentially effective program or policy yet achieving only weak, incomplete implementation or "reach," thereby failing to attain objectives; 3) Conducting an inadequate or incorrect evaluation that results in a lack of generalizable knowledge on the effectiveness of a program or policy; and 4) Paying inadequate attention to adapting an intervention to the population and context of interest To enhance evidence-based practice, this book addresses all four possibilities and attempts to provide practical guidance on how to choose, carry out, and evaluate evidence-based programs and policies in public health settings. It also begins to address a fifth, overarching need for a highly trained public health workforce. This book deals not only with finding and using scientific evidence, but also with implementation and evaluation of interventions that generate new evidence on effectiveness. Because all these topics are broad and require multi-disciplinary skills and perspectives, each chapter covers the basic issues and provides multiple examples to illustrate important concepts. In addition, each chapter provides links to the diverse literature and selected websites for readers wanting more detailed information. An indispensable volume for professionals, students, and researchers in the public health sciences and preventative medicine, this new and updated edition of Evidence-Based Public Health aims to bridge research and evidence with policies and the practice of public health.

The aim of this systematic review has been to assess the evidence on the positive and negative effects of population wide drinking water fluoridation strategies to prevent caries. 214 studies met full inclusion criteria for one or more of the objectives. The best available evidence suggests that fluoridation of drinking water supplies does reduce caries prevalence. This review presents a summary of the best available and most reliable evidence on the safety and efficacy of water fluoridation. Given the level of interest surrounding the issue of public water fluoridation, it is surprising to find that little high quality research has been undertaken. As such, this review should provide both researchers and commissioners of research with an overview of the methodological limitations of previous search conducted in this area. The evidence of a benefit of a reduction in caries should be considered together with the increased prevalence of dental fluorosis. The research evidence is of insufficient quality to allow confident statements about other potential harms or whether there is an impact on social inequalities.

How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.

Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.