The State shall promote and protect the global environment to attain sustainable development while recognizing the primary responsibility of local government units to deal with environmental problems. The State recognizes that the responsibility of cleaning the habitat and environment is primarily area-based and that air quality management and control is most effective at the level of airsheds. The State recognizes the principle that "polluters must pay" and the important role of economic instruments in air quality management and control. The State recognizes that a clean and healthy environment is for the good of all and should therefore be a concern of all.
Key elements of EBPH have been summarized 3 as the following: Engaging the community in assessment and decision making; Using data and information systems systematically; Making decisions on the basis of the best available peer-reviewed evidence both quantitative and qualitative ; Applying program planning frameworks often based in health behavior theory ; Conducting sound evaluation; and Disseminating what is learned.
Data for community assessment As a first step in the EBPH process, a community assessment identifies the health and resource needs, concerns, values, and assets of a community.
This assessment allows the intervention a public health program or policy to be designed and implemented in a way that increases the likelihood of success and maximizes the benefit to the community. The assessment process engages the community and creates a clear, mutual understanding of where things stand at the outset of the partnership and what should be tracked along the way to determine how an intervention contributed to change.
Often conducted through national or statewide initiatives, surveillance involves ongoing systematic collection, analysis, and interpretation of quantitative health data.
Various health issues and indicators may be tracked, including deaths, acute illnesses and injuries, chronic illnesses and impairments, birth defects, pregnancy outcomes, risk factors for disease, use of health services, and vaccination coverage.
National surveillance sources typically provide state-level data, and county-level data have become more readily available in recent years Box 1. State health department websites can also be sources of data, particularly for vital statistics and hospital discharge data.
Additionally, policy tracking and surveillance systems Box 1 monitor policy interest and action for various health topics Other data collection methods can be tailored to describe the particular needs of a community, creating new sources of data rather than relying on existing data.
Telephone, mail, online, or face-to-face surveys collect self-reported data from community Implementing the e world.
Community audits involve detailed counting of factors such as the number of supermarkets, sidewalks, cigarette butts, or health care facilities.
For example, the Active Living Research website www. Qualitative data collection can take the form of simple observation, interviews, focus groups, photovoice still or video images that document community conditionscommunity forums, or listening sessions.
Qualitative data analysis involves the verbatim creation of transcripts, the development of data-sorting categories, and iterative sorting and synthesizing of data to develop sets of common concepts or themes No single source of data is best. Most often data from several sources are needed to fully understand a problem and its best potential solutions.
Several planning tools are available Box 1 to help choose and implement a data collection method. Selecting evidence Once health needs are identified through a community assessment, the scientific literature can identify programs and policies that have been effective in addressing those needs.
The amount of available evidence can be overwhelming; practitioners can identify the best available evidence by using tools that synthesize, interpret, and evaluate the literature. Systematic reviews Box 1 use explicit methods to locate and critically appraise published literature in a specific field or topic area.
The products are reports and recommendations that synthesize and summarize the effectiveness of particular interventions, treatments, or services and often include information about their applicability, costs, and implementation barriers.
Evidence-based practice guidelines are based on systematic reviews of research-tested interventions and can help practitioners select interventions for implementation.
The Guide to Community Preventive Services the Community Guideconducted by the Task Force on Community Preventive Services, is one of the most useful sets of reviews for public health interventions 27, The Community Guide evaluates evidence related to community or population-based interventions and is intended to complement the Guide to Clinical Preventive Services systematic reviews of clinical preventive services Not all populations, settings, and health issues are represented in evidence-based guidelines and systematic reviews.
Furthermore, there are many types of evidence eg, randomized controlled trials, cohort studies, qualitative researchand the best type of evidence depends on the question being asked.
Not all types of evidence eg, qualitative research are equally represented in reviews and guidelines. To find evidence tailored to their own context, practitioners may need to search resources that contain original data and analysis. Peer-reviewed research articles, conference proceedings, and technical reports can be found in PubMed www.
Maintained by the National Library of Medicine, PubMed is the largest and most widely available bibliographic database; it covers more than 21 million citations in the biomedical literature.
Practitioners can freely access abstracts and some full-text articles; practitioners who do not have journal subscriptions can request reprints from authors directly. Economic evaluations provide powerful evidence for weighing the costs and benefits of an intervention, and the Cost-Effectiveness Analysis Registry tool Box 1 offers a searchable database and links to PubMed abstracts.
These sources may provide useful information, although readers should interpret non—peer-reviewed literature carefully. Internet search engines such as Google Scholar http: Program-planning frameworks Program-planning frameworks provide structure and organization for the planning process.
Public health interventions grounded in health behavior theory often prove to be more effective than those lacking a theoretical base, because these theories conceptualize the mechanisms that underlie behavior change 32, Logic models are an important planning tool, particularly for incorporating the concepts of health-behavior theories.
They visually depict the relationship between program activities and their intended short-term objectives and long-term goals. The first 2 chapters of the Community Tool Box explain how to develop logic models, provide overviews of several program-planning models, and include real-world examples Box 1.
Evaluation and dissemination Evaluation answers questions about program needs, implementation, and outcomes Implementation of e-Government: Advantages and Challenges M. Alshehri, S. Drew Abstract — The objective of this paper is to review the updated and available literature about e-government implementation stages, its challenges and benefits.
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