204153 Evidence-based public health (nursing) and the science of eliminating health inequalities in the era of globalization

Tuesday, November 10, 2009: 2:30 PM

Veronique Lapaige, MD, PhD , Faculty of Nursing, Laval University, Quebec-city, QC, Canada
At the dawn of the 21st century, there is a move towards ²evidence-based everything² and many public health nurses feel the hot breath of the evidence-based practice and policy movement on their neck. The rise of this evidence-based movement is a sociohistorically interesting process, raising important questions about professional and decision-making practices and their epistemological basis, and about the types of evidence that contribute to that evidence base. Many of these issues are particularly important in contemporary debates around health disparities. Our purpose is to refute a Manichean view of evidence-based public health nursing (EBPHN), and to delineate the influences of our globalized world and its transformative dynamic on knowledge translation in decision-making environments. Our reasoning is based on the results of a mixed methods research study conducted in Canada within the period 2005-2008. Drawing on a transdisciplinary perspective, we theorized how the emergence of contemporary globalization is complexly and intimately interrelated with a restructuring public health field, with the rise of the evidence-based movement and with the development of the new interdisciplinary knowledge translation (research) field. Changing patterns of healthcare services and policies, disease, and medicine have been integrally linked to the historical evolution of human societies. In this presentation, we highlight the relationships between the evidence-based movement as nomothetic enterprise, and the various logics and imaginations driving or embodied within the sociohistorical process of globalization. We suggest that EBPHN can accommodate different forms of knowledge and evidence. We finally propose a fruitful way of thinking dialectically EBPHN and approaching the complexity of EBPHN to tackle health inequalities.

Learning Objectives:
1. Describe the impact of contemporary globalization on public health by identifying the key logics and imaginations driving or embodied within the sociohistorical process of globalization. 2. Differentiate evidence-based public health nursing from evidence-based clinical practice. 3. List two different forms of knowledge and types of evidence in healthcare and in public health nursing. 4. Discuss the relationship between globalization and the evidence-based decision-making movement.

Keywords: Evidence Based Practice, Public Health Nursing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a CHSRF/CIHR (Canadian Health Services Research Foundation/Canadian Institutes of Health Research) postdoctoral fellow. As knowledge translation CHSRF/CIHR fellow, my research and teaching interests are in: (1) the development of knowledge translation theory; (2) evidence-based public health tackling health inequities and the development of knowledge translation infrastructure for healthcare professionals; (3) the impact of globalization on the field of public health (practice base, public health research and educational change); (4) the epistemology and ontology of evidence including: (a) historical and conceptual analysis of what impact evidence had in the past, and what impact it has had in healthcare, (b) the role of qualitative research methods in public health and in evidence-based healthcare, (c) different upcoming angles for providing appropriate evidence to improve public health and public health nursing practice (and science). Lapaige, V. (in press). La santé publique globalisée [Globalizing public health]. Les Presses de l’Université Laval.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.