Making high-yield prevention choices: The intervention selection tool

The Community Preventive Services Task Force, the U.S. Preventive Services Task Force, and the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (among others) provide evidence-based interventions to prevent the leading causes of death and disease. Their excellent products, including the Guide to Community Preventive Services (The Community Guide), Guide to Clinical Preventive Guide, and Clinical Practice Guidelines are the right starting places when choosing interventions to address local health priorities. Yet, all interventions are not created equal. Decision factors such as the strength of the evidence, the number of deaths potentially averted, the likelihood of local uptake and penetration, and acceptability to the community all play a role in how interventions are chosen. Similarly, evidence may be a more or less compelling factor in some communities, compared to other decision factors. This session introduces a tool for health departments to weigh evidence and other decision factors in selecting best practices to improve health outcomes. The tool applies quality improvement methods to identify the best evidence-based interventions for responding to local needs from evidence-based public health resources (e.g., The Community Guide); assign importance to decision factors (e.g., potential number of deaths averted, strength of evidence, likely uptake, community acceptability); and compare potential interventions on each decision factor. This tool is based on a hypothetical exercise developed by Dr. Norma Kanarek entitled Strategic Practice Selection Exercise. Users of the tool can tailor the exercise to their community, weighing decision factors according to local priorities, or can substitute them with their own decision factors. The result is a weighted ranking of the interventions based on local applicability and likelihood of success. Health departments can use the tool to inform practical programmatic decisions on how to invest limited prevention resources to achieve the most high-yield results.