Program Evaluation and its Role in Evidence-Based Public Health

Program evaluation, and outcome evaluation in particular, adds to the evidence base of Army Public Health.

An evidence-based public health program, policy, or initiative is one for which the majority of available evidence (for example, program evaluation and research findings) suggests that it results in positive outcomes. The Army Public Health Center recommends implementing evidence-based public health programs, policies, and initiatives whenever possible because they are most likely to result in positive health outcomes.

Systematic Reviews are one means by which evidence-based programs, policies, or initiatives are identified.

Systematic Reviews examine the quality, quantity, and consistency of the scientific evidence regarding the effectiveness of programs, policies, or initiatives.

Many organizations focus on conducting systematic reviews to continually examine the best available evidence of public health activities. Some examples include:

The Cochrane Database of Systematic Reviews
The Cochrane Library publishes systematic reviews related to a wide variety of public health topics including injury prevention, nutrition labeling, tobacco reduction, obesity prevention, the use of social media in health promotion and more. Technical as well as plain language summaries are available for many systematic reviews and reviews are available by topic.

The Guide to Community Preventive Services(The Community Guide)
The Guide to Community Preventive Services (also known as "The Community Guide") is a collection of evidence-based findings of the Community Preventive Services Task Force. It is a resource to help communities select interventions to improve health and prevent disease. Community guide reviews answer three questions:

- What has worked for others and how well?
- What might the intervention cost and what is likely to be achieved through the investment?
- What are the evidence gaps?

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The Clearinghouse for Military Family Readiness (Pennsylvania State University)
The Clearinghouse for Military Family Readiness is an applied research center designed to help military communities identify, implement, evaluate and improve programs to strengthen military service members and families. The Clearinghouse has reviewed currently available evidence for more than 1,000 community-based and school-based programs and rates them as ineffective, unclear, promising, or evidence-based. These include programs specifically implemented within the military as well as non-military programs that could be implemented in a military setting. Fact sheets summarizing the available evidence for each program are publicly available.

United States Department of Agriculture Nutrition Evidence Library
The United States Department of Agriculture's (USDA) Nutrition Evidence Library (NEL) specializes in conducting systematic reviews (SRs) to inform Federal nutrition policy and programs.

National Association of City and County Health Officials Model Practices Program
NACCHO's Model Practices Program nationally honors and recognizes outstanding local public health practice and shares the outstanding practices through their Model Practices Database. These practices can potentially be implemented within Army communities to improve Soldier and Family health and wellness.

Substance Abuse and Mental Health Services National Registry of Evidence-Based Programs and Practices

SAMHSA's National Registry of Evidence-Based Programs and Practices(NREPP)is a searchable database of more than 330 interventions for the prevention and treatment of mental and substance use disorders.

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For information on how to conduct a systematic review, visit:

The Cochrane Collaboration Guidelines on Conducting Systematic Reviews of Health Promotion and Public Health Interventions

Where a systematic review has not been conducted or there is insufficient existing scientific evidence to conduct a systematic review, the evidence base can be developed through program evaluation studies that use well-accepted program evaluation methods (to include non-experimental, quasi-experimental, and experimental designs).

Programs improve and thrive as they grow in evidence along a continuum from Unsupported (that is, cannot produce evidence of a relationship between program services and program outcomes; sufficient data are not available) to evidenced-based (that is, endorsed by a systematic review). Click here to see the current Army continuum of evidence-based public health practice.

All Army PH programs, policies, and initiatives should demonstrate a commitment to establishing, measuring, and growing their evidence base over time. This requires a variety of evaluation studies and methods conducted in various settings and with various populations. If initial program evaluation studies reveal evidence of program, policy, or initiative effectiveness, further evaluation studies strive to enhance scientific rigor of and confidence in findings through improvements in methods that minimize threats to internal and external validity of evaluation findings.

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