253673 Balancing Internal Validity of Controlled Trial Evidence with External Validity of Practice-Based Evidence

Monday, October 31, 2011: 1:30 PM

Lawrence W. Green, DrPH , Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA
Debates among members of the Community Prevention Services Task Force, liaison organization participants in their meetings, and CDC staff of the Community Guide (CG) have sought to find the right balance between research-tested interventions with their premium on evidence-based practice and real-time evaluation of new policies and innovative programs that produce practice-based evidence with its complementary emphasis on external validity. The result has been a significant movement toward the following:

Creating a broader understanding that - The Task Force and CG are equally concerned about external and internal validity. - Collecting information about both is integral to our processes. We regularly lament the scarcity of sufficient information on external validity or applicability. - Identifying the need for this information is a large part of our research evidence gaps. - We use a full range of study designs and do not treat RCTs as the best in our review process.

Identifying that both research-tested and practice-based interventions are excellent fodder for the CG. Increasing the frequency and quality of evaluation of practice-based innovations will increase the likelihood that they can contribute to the evidence-base as promising practices right up through TF recommendations.

Encouraging broad evaluation of programs and innovations to strengthen our understanding of effectiveness and applicability.

Seeking ways to have this information flow back into CG reviews and processes.

Learning Areas:
Public health or related education

Learning Objectives:
1. Differentiate between internal and external validity 2. Assess critically the value and limitations of different types of evidence 3. Describe efforts to build capacity for practice-based evidence through various forms of evaluation.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served on both the US Preventive Services Task Force and the Community Preventive Services Task Force; I headed the CDC Office on Science and Extramural Prevention Research; I have published extensively on the issues to be addressed by this panel, including a textbook on evaluation; I chaired the IOM Committee that reviewed the Prevention Research Centers; I have been the founding director of three prevention research centers in US and Canada; I headed the US Office on Health Promotion; I was Vice President of a foundation funding community health promotion programs and their evaluation; I served on an IOM committee on Bridging the Evidence Gap in Childhood Obesity Prevention and currently serve on another on Valuing Community and Prevention Research
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.