Building the Evidence Base for Population-Level Interventions: Barriers and Opportunities

Background:  Emphasis on implementing evidence-based public health practice and programs is increasing, particularly at the federal level, and a focus on policy, systems, and environmental approaches to improve population health have been recognized as promising but sometimes have an underdeveloped evidence base. Additionally, barriers exist to conducting rigorous and appropriate evaluations. The U.S. Department of Health and Human Services (HHS) commissioned the development of an easy-to-understand resource to help decision-makers and practitioners identify promising and effective population-level interventions and to develop evaluations that further the field’s knowledge of intervention effectiveness.  

Methods: A review of grey, extant, and published literature on tools and methods related to assessing evidence for community-level interventions was conducted. This review informed an expert panel, which was convened to develop a resource to guide public health decision-makers and practitioners, particularly the HHS grantees.

Results: The resource developed by the expert panel focuses on the unique strengths and challenges associated with implementing and evaluating population-level approaches for improving health. The elements of community context--such as community resources and values, among others—are of particular importance to the success or failure of community-level interventions but these elements are not often captured in existing evidence resources. Developing measures of community context and methods to integrate these measures into evidence of effectiveness is a remaining challenge to the field. By piloting the resource, the HHS hopes to advance the field’s ability to measure and evaluate the effectiveness of community-level interventions.