Additional Resources
Journal Articles
Books
Internet Sites

• Provides assurance that decision making is based on scientific evidence and effective practices
• Helps ensure the retrieval of up-to-date and reliable information about what works and doesn’t work for a particular public health question
• Provides assurance that one’s time is being used most efficiently and productively in reviewing the “best of the best” information available on the particular public health question.

Source: Public Health and Information Tutorial
 http://phpartners.org/tutorial/04-ebph/2-keyConcepts/4.2.4.html.  Accessed 9 Feb 2006.

Step 1: Determine the public health problem and define the question

Step 2 : Identify key concepts and terms

Step 3 : Select information sources

Step 4 : Conduct the search in subject-appropriate databases and other information sources

Step 5 : Select documents for review

Step 6 : Abstract relevant information from the documentation

Step 7 : Summarize and apply the literature review

Source: Adapted from Brownson, Ross C., Elizabeth A. Baker, Terry L. Leet, and Kathleen N. Gillespie, Editors. Evidence-Based Public Health. New York: Oxford University Press, 2003, p. 128. 
This adaptation is taken from: Public Health and Information Tutorial
http://phpartners.org/tutorial/04-ebph/2-keyConcepts/4.2.5.html.  Accessed 9 Feb 2006.

For example: 
Based on epidemiologic data, 21.3% of NZ school children aged between 5 and 15 years of age are overweight and 9.8% are obese. Your team has been asked to develop a school-based program to reduce the rate of obesity in children. Solutions being considered include health education, health promotion, nutrition, and exercise programs. You'd like to find out how some of these approaches and interventions have worked before you develop your plan.

The public health problem is: 
obesity in children.

Your question might be:
"What are some effective school-based programs for reducing obesity in children?"  

Once you have defined your question, identify and separate out the main concepts:

For the example above, key concepts might include:

school-based       programs      reducing        obesity          children

The next step is to think of all synonyms, abbreviations, alternative spellings, acronyms and broader and narrower phrases or words related to each concept. These can all eventually be used as search terms. The table below shows some of the similar terms and phrases which can be used for our five main concepts.

Databases
The following databases are relevant for public health, and are accessible to ADHB staff via ADHB Library Links.

• ACP Journal Club - Contains the two journals ACP Journal Club, and Evidence-Based Medicine.
• Cochrane Database of Systematic Reviews - Contains the full text of complete systematic reviews prepared by the Cochrane Collaboration and details of protocols (not-yet-completed systematic reviews).
• Cochrane Central Register of Controlled Trials - Bibliography of all controlled trials identified by Cochrane Review Groups and others.
• Cochrane Library (Wiley version) - Wiley version of the Cochrane databases. Contains all the Cochrane databases.
• Database of Abstracts of Reviews of Effects (DARE) - Contains critical assessments of systematic reviews done by groups outside the Cochrane Collaboration.
• Medline - Covers all the fields of medicine indexing articles from over 4600 medical journals from 1966 onwards.
• CINAHL - Covers the literature related to nursing and allied health.
• PsycINFO - Covers the literature in psychology, psychiatry and behavioural sciences.
• Ageline - Covers gerontology, with references to books, book chapters, journal articles, research reports, consumer guides and dissertations.
• Social Care Online - Updated daily, Social Care Online includes abstracts and some full text of social care literature.

In addition to the above databases, the University of Auckland subscribes to a range of databases relevant to Public Health, some of which are listed below. These are accessible to ADHB staff via University of Auckland computers. You can visit the Philson Library in person to access these, or contact library staff.

• Current Contents - Indexes contents pages of more than 7,000 journals including clinical medicine and life sciences.
• Embase - Major biomedical and pharmaceutical bibliographic database, indexing and abstracting over 3,500 international journals.
• ERIC - International database covering the field of education. Includes journal articles, conference proceedings, research reports, surveys, descriptions and evaluations of programmes.
• Index New Zealand - Key New Zealand database for social sciences, arts, humanities and general interest material. Also indexes some South Pacific journals.
• Sociological Abstracts - Indexes over 2,600 serials relating to sociology
• Australasian Medical Index - Indexes and abstracts articles from over 160 Australian health and medical serials not indexed for Medline, on all aspects of health and medicine.  

Internet Resources
An extensive (but not exhaustive) list of Internet resources relevant to Public Health is listed below 

Grey Literature
Grey Literature comprises information that is not generally produced or marketed by commercial publishers e.g.  some reports, conference proceedings, technical reports, newsletters etc. Grey literature can add  value to your review of a topic, especially as health promotion and public health tend to create a lot of grey literature. You need to be aware that grey literature has not necessarily been peer reviewed before it is made accessible to you (unlike journal articles); you need to keep this in mind when you consider the quality of the evidence.

The New York Academy of Medicine Library publishes a quarterly  Grey Literature Report. 

Subject Searching Versus Textword Searching
There are two ways to search: Subject searching and Textword searching.  For Public Health topics we recommend that you use a combination of both.

Subject searching
Many catalogues and databases allow a type of "power searching" using controlled vocabulary called subject headings. These are a way of indexing content so that one subject heading retrieves most articles on the same topic, rather than having to type in all the alternative keywords and phrases.

For example, if you search using the subject heading (MeSH heading) Health Promotion on Medline, the database will find many article references containing the words or phrases health campaigns, promotion of health, wellness programs, promotional items, without these having to be entered as separate search terms.

To help you, some databases such as Medline also provide a mapping function, so if you type Health Campaign into the database it will automatically map you to the Health Promotion subject heading.

Tree structures (Trees)
Databases such as Medline, CINAHL, and PsycInfo* that have a list of subject headings arrange these in a hierarchy; related terms are grouped together going from general (broader) headings to more specific (narrower). These are called Tree Structures or Trees.

For example the Tree for Obesity in Medline looks as follows:

Obesity Hypoventilation Syndrome, Obesity, Morbid, and Prader-Willi Syndrome are all more specific (narrower) terms associated with Obesity.  Overnutrition is a more general (broader) term than Obesity.

*Note: PsycInfo does not have Trees - it has a Thesaurus.

The Thesaurus  for Obesity in PsycInfo looks as follows:

The Thesaurus lists terms alphabetically. Within this alphabetical display, terms have their own hierarchy. The Thesaurus indicates that Obesity is Used For the term Overweight. It also indicates Broader Terms for Obesity (Body Weight, Eating Disorders, and Symptoms) and Related Terms (e.g. Diets, Hyperphagia, etc). There are no Narrower Terms for Obesity in PsycInfo.

Exploding Trees
The Tree (or, in the case of PsycInfo, the Thesaurus) is often accompanied by an explode function which allows you to search for a broader term e.g. if you use the explode function in Medline you will include Obesity as well as all the narrower terms Obesity Hypoventilation Syndrome, Obesity, Morbid, and Prader-Willi Syndrome in your search.

Evidence Based Public Health Subject Headings
Some useful subject headings that can be used when conducting searches in Medline for evidence-based public health research articles include: Evaluation studies, Epidemiologic Studies, Program Evaluation, Evidence Based Medicine, Intervention Studies, Randomized Controlled Trials.  Some of these are also available as Publication Type Limits.

Note: Subject headings used for these concepts on other databases will differ - you need to investigate to find the most useful headings available on each database. Also, not all of these headings will be relevant for your topic.

Textword searching (Sometimes called keyword searching)
Not all databases provide the subject searching option and sometimes there may be no subject heading for your particular search term, or you may want to make your search as comprehensive as possible. In this case try textword searching either alone or in conjunction with Subject searching. Textword searching retrieves an exact match for the textwords you have entered. Textword searching generally looks in multiple fields of a database or catalogue. Thus in a database of article references textword searching might look for search terms in the title of the article, as well as in the abstract and subject heading fields.

Textword searching does not take into account the context of the word, and if a word can mean more than one thing you will retrieve some non relevant results.

Phrase searching
You can group words together to ensure they are searched as a phrase by putting quote marks around them. e.g. "health promotion". Some databases do not require this and will recognize a string of words as a phrase automatically. If you are unsure check the Help menu for the particular database you are using.

Truncation
For textword searching you can also use a feature called truncation when a word has variant endings.

To use truncation, type in the stem of a word and use a symbol to replace all the possible endings of the word. Symbols vary depending on the resource you are using but OVID databases such as Medline and CINAHL use a $ sign. If you are unsure which symbol is used in a particular database, check the Help menu.

Thus random$ will look for randomise
                                                  randomised
                                                  randomize
                                                  randomized
                                                  ... etc

manag$ will look for manage, management, managing, ...etc

Be careful not to truncate too early. If you are looking for the textword children and type in chil$ you may retrieve results containing the words: children, chills, chilblain/s.

Boolean operators
To search effectively you will need to combine search terms and phrases with boolean operators.

Boolean operators are words which tell your database or catalogue to combine the phrases and keywords in a particular way. They can be used to ensure that phrases or keywords are included, or excluded in your results, and that your keywords relate to each other in meaningful ways.

There are three boolean operators: AND, OR, NOT.

AND
AND will give you the intersection between two (or more)  groups when you want your search result to contain elements from both (or all) groups.

health promotion AND obesity
will find results containing both terms health promotion and obesity.

OR
Use OR when you want any of the search terms to be included in your search result. You don't care which one. Use OR to ensure you include all the possible synonyms or alternative search terms for each of your concepts.

health promotion OR health education OR health program$
will give you results which contain any of the three search phrases. "Or means more." It will expand your search to include more results.

NOT
Use NOT to exclude phrases or words which you do not wish to include in your search results .

school NOT preschool
will retrieve results about school but will exclude any that mention preschool.

In the table below, OR is used between similar terms (down a column). AND is used between concepts when you are looking for the intersection between two or more concepts (across the columns).

In the examples above the boolean operators are in capitals. Some resources require that you do this. Others don't. If you are unsure, check the Help menu for the particular resource you are using. In addition some databases may use alternative symbols for boolean operators. e.g. "&" for and "/" for or " !" for not. Once again check the Help menu of the particular resource you are using for information about which symbol is used.  Also note the use of truncation symbols ($) and phrase searching (" ").

Nesting
If your search is more complex you can use brackets to group search terms together with appropriate boolean operators. This is called Nesting.
e.g. obes$  AND (child$ OR youth$ OR adolescen$)

Note the placement of brackets so that synonyms are grouped together.

This system allows you to do some very complicated searching
e.g. (child$ OR youth$  OR adolescen$ OR teen$) AND (obes$ OR overweight OR bmi) AND (nutrition$ OR exercise$ OR health promot$ OR health educat$)

Limits
Limits allow you to limit the result of your basic search - e.g. by language, (English only), by date (find only articles from 1990 onwards), by age group (e.g. paediatric only), by publication type (e.g. meta analysis, randomized controlled trial) etc.

Sample Search
Below is an example of how you might do an Ovid Medline search for our example: "What are some effective school-based programs for reducing obesity in children?"

A number of helpsheets and guides have been developed to assist you with database searching.  These can be accessed and downloaded from the Training and Help page - click here to access.  For further assistance, please contact Information Services.

1. For journal articles, check the Ejournals list on the ADHB Library Links page and if the article you require is in a journal included on this list, you can read and print it from an ADHB computer.
2. Check Voyager, the Library Catalogue (on the ADHB Library Links page) to see if the item is held in a University of Auckland library.
- If you find the item on Voyager you can request it by completing an electronic request form, or download a paper request form (to fax or post). This will usually take a few days to arrive.
- If the item is not found on Voyager you can complete an electronic request form, or download a paper request form (to fax or post) and we will try to obtain it for you from another library in New Zealand or overseas. This may take 2 or 3 weeks.

To find the electronic request form, and for more information about Document Delivery, click here.

1. Did the authors clearly outline their goals and aims? Did they make their research question clear? Could you as a reader understand what the authors were trying to achieve and how they were going to go about it?

2. Did the authors clearly describe the sample they used? Who were the participants, how old were they, and how were they recruited?

3. Did the authors use the best possible design in the circumstances to find the answer to the question they were asking? (i.e. did the authors use the appropriate type of design to achieve their goals and aims?) 
Some types of research design are better and more robust than others. Certainly in some settings the randomised control trial (RCT) is commonly referred to as "the gold standard". In public health disciplines there is a wide variety of study designs used, as the circumstances either do not lend themselves to RCT, or it is inappropriate or unethical to attempt a RCT.

4. Did the study make a clear link to an appropriate and relevant theory?
Theories relevant to health promotion/public health may include the health belief model, stages of change model, theory of reasoned action, social learning theory, and organisational change theory. A useful website that has a summary of various  theories and models is http://www.healthpromotionagency.org.uk/healthpromotion/health/section5.htm
It is vital that any intervention that is carried out has a basis in theory; otherwise there is no theoretical reason given as to why a specific intervention may be effective, and potentially no explanation for success.

5. If the study is describing a public health intervention, did the intervention or project attempt to work at multiple levels, i.e. not just with individuals to effect change, but with the community concerned and the wider society? Research tells us that interventions that attempt to work on more than one level are more likely to be effective than a single level intervention.

6. What type of analysis did the authors use?
Was it appropriate for meeting their goals and aims? Did the authors provide some validation and reasoning for the data analyses they used? Did they do a good job of the analyses? Were the analyses described in a way that was easy to understand, that made sense in terms of the data they were looking at and was completed in manner that was robust and valid? If you are unsure about the analysis it is advisable that you ask someone who has some experience in the area.

7. Did the study report all the results that would be needed to decide if the project was effective or not?
If the study was looking at a change in eating behaviours, did the study include a measure of eating behaviours before the study was started and then again after, and did they report their measurement of these behaviours in the body of the text?

8. Did the study report results that justify the conclusions made?
For example if the authors said that there was a significant increase in the number of positive eating behaviours they observed after the intervention was implemented, did they report this statistic? And did they use the appropriate statistical procedure to determine this significance? For some basic information on statistical procedures in research and what you should look for in research articles see www.surveysystem.com/signif.htm

9. If the study is reporting an intervention, does the intervention used appear like it would be able to be maintained over a long period of time?
When looking for effective public health interventions it is important we consider how feasible they are in the real world. Although an intervention might seem very effective over a two month period would it be sustainable and effective for a longer period of time, a period of time that would improve the population's health?

10. Would the intervention be cost-effective?
Would a public health unit , a community organisation, an NGO, or a government organisation be able to carry out this intervention given the resources we have available to us?

11. Did the authors follow the appropriate ethical guidelines? Were there ethical issues they did not consider?
Working in public health it is important that we spend some time considering how ethical an intervention is before we implement it. A good way to keep up to date with ethical issues is to consider ethical issues in other research.

12. If the research was about issues specific to indigenous groups, or the participants were from indigenous groups, firstly, was the intervention/study design that was used appropriate for these groups, and was a methodology used to evaluate the intervention that was appropriate for these groups?
If methodologies are used that are not appropriate for indigenous groups then the results from the research may not give an accurate or true picture.

Source: Berentson-Shaw, J. (2005).  How To Do A Literature Review: A Guide For Health Promoters (pp. 10-11). Auckland. Auckland Regional Public Health Service. 

Journal Articles About Evidence Based Public Health

References are listed alphabetically by author surname.  Links are provided to the full text article where available or a Voyager record which shows Library holdings. 

Copies of articles not available in full text can  be ordered by completing a document delivery request form.

Brownson, R. C., Gurney, J. G., & Land, G. H. (1999). Evidence-based decision making in public health. Journal of Public Health Management & Practice, 5(5), 86-97.
View full text 

Doyle, J., Waters, E., Yach, D., McQueen, D., De Francisco, A., Stewart, T., et al. (2005). Global priority setting for Cochrane systematic reviews of health promotion and public health research. Journal of Epidemiology & Community Health, 59(3), 193-197. 
View full text 

Howes, F., Doyle, J., Jackson, N., & Waters, E. (2004). Evidence-based public health: The importance of finding 'difficult to locate' public health and health promotion intervention studies for systematic reviews. Journal of Public Health, 26(1), 101-104. 
View full text 

Kirkwood, B. (2004). Making public health interventions more evidence based. BMJ, 328(7446), 966-967
View full text 

Kohatsu, N. D., Robinson, J. G., & Torner, J. C. (2004). Evidence-based public health: an evolving concept. American Journal of Preventive Medicine, 27(5), 417-421. 
View full text 

Rychetnik, L., Hawe, P., Waters, E., Barratt, A., & Frommer, M. (2004). A glossary for evidence based public health. Journal of Epidemiology & Community Health, 58(7), 538-545. 
View full text 

Tang, K. C., Ehsani, J. P., & McQueen, D. V. (2003). Evidence based health promotion: recollections, reflections, and reconsiderations. Journal of Epidemiology & Community Health, 57(11), 841-843. 
View full text 

Victora, C. G., Habicht, J. P., & Bryce, J. (2004). Evidence-based public health: moving beyond randomized trials. American Journal of Public Health, 94(3), 400-405.
View full text 

Brownson, R. C. (2003). Evidence-based public health. Oxford ; New York: Oxford University Press.  Location: Tamaki Library. Call number: 362.1 B88. 
The "bible" of evidence-based public health practice.
View Voyager Record

 Heller, R. F. (2005). Evidence for population health. Oxford ; New York: Oxford University Press. Location: Tamaki Library. Call number:  616 H47.
View Voyager Record

 Hodges, B. C., & Videto, D. M. (2005). Assessment and planning in health programs. Sudbury, MA: Jones and Bartlett Publishers. Location: Tamaki Library. Call number: 613 H68.
View Voyager Record

 Lin, V., & Gibson, B. (2003). Evidence-based health policy: problems and possibilities. Melbourne: Oxford University Press. Location: Tamaki Library. Call number:  362.10994 L73.
View Voyager Record

Cochrane Health Promotion and Public Health Field
http://www.vichealth.vic.gov.au/cochrane/activities/reviews.htm
The Cochrane Health Promotion and Public Health Field is part of the Cochrane Collaboration.  It aims to develop strategies to enable health promotion and public health practitioners and policy makers, and the general public, access to evidence on systematic reviews of health promotion and public health interventions. They assist with the dissemination of the findings of Cochrane reviews, but do not have a primary responsibility for producing them. However, they do have a role in ensuring that there are Cochrane Review Groups that can carry out reviews in all areas of health promotion and public health where the need for reviews has been identified. The Field also directs people to other sources of systematic reviews when topics have not been covered in the Cochrane Library. From this website you can see a list of Cochrane reviews (and protocols) of relevance to health promotion and public health. You can then access the full text (where available) via the Cochrane Library database available on ADHB Library Links database page. 
Note: This website also includes links to  useful websites for identifying systematic reviews in health promotion and public health that are not included in this bibliography. 

Public Health/ Health Administration  (a section of the Medical Library Association)
http://www.phha.mlanet.org/index.html  
Publishes a regular newsletter profiling new or improved public health resources.

Evidence-Based Resources for Public Health Practice 
http://library.umassmed.edu/ebpph/ebresources.cfm
Includes evidence-based guidelines, systematic reviews, filtered searches, and best practices.

Evaluation in health promotion.  Principles and perspectives, edited by Irving Rootman, Michael Goodstadt, Brian Hyndman, David V. McQueen, Louise Potvin, Jane Springett and Erio Ziglio.  WHO Regional Publications, 2001.
http://www.euro.who.int/InformationSources/Publications/Catalogue/20010911_43
This book comprises an extensive compilation and discussion of the theory, methodologies and practice of evaluating health promotion initiatives in Europe and the Americas.

Transparent Reporting of Evaluations with Nonrandomized Designs (TREND)
http://www.trend-statement.org/asp/trend.asp
22-item checklist specifically developed to guide standardized reporting of non-randomized controlled trials, complementing the widely adopted CONsolidated Standards Of Reporting Trials (CONSORT) statement developed for randomized controlled trials.

E-Roadmap to Evidence-Based Public Health Practice
http://www.publichealthsolutions.org/
Purpose: Provides one-stop shop for information about the definition and significance of evidence-based public health practice; finding data-demonstrated solutions to public health problems; learning how to be an efficient and effective consumer of public health research.  Published by NH Institute for Health Policy & Practice.  Also includes a step-by-step process for selecting, implementing, and evaluating demonstrated interventions to address an identified public health problem. 

Guide to Community Preventive Services
http://www.thecommunityguide.org/default.htm
Systematic reviews and evidence based recommendations regarding population-based interventions.

Public Health Electronic Library (PHeL)
http://www.phel.gov.uk/index.html
Aims to provide knowledge and know-how to promote health, prevent disease and reduce health inequalities.   

Evidence for Policy and Practice Information Centre (EPPI-Centre)
http://eppi.ioe.ac.uk/
The EPPI Centre is a collaborating partner of the Cochrane Health Promotion and Public Health Field and provides research support and methodology advise to the Field. The site contains methods for searching electronic databases, standardized coding strategies and guidelines for reviewing health promotion research. It also contains 3 searchable databases: Trophi, Bibliomap, and DoPher.

HP2010 Information Access Project (Partners in Information Access for the Public Health Workforce)  
http://phpartners.org/hp/
The purpose of this site is to make information and evidence-based strategies related to the Healthy People 2010 objectives easier to find. The National Library of Medicine and the Public Health Foundation staff have worked together to develop pre-formulated search strategies for selected Healthy People 2010 objectives.

Evidence-Based Practice for Public Health Project
http://library.umassmed.edu/ebpph/
The purpose of this project is to examine the clinical EBM models and assess their effectiveness to the public health literature. The project will also identify any existing evidence-based projects in public health and assess their effectiveness.

Evidence Based Health Promotion (Victorian Government Health Information)
http://www.health.vic.gov.au/healthpromotion/quality/evidence_index.htm
Includes evidence based reviews identifying  the effectiveness of different kinds of health promotion interventions.

New Zealand Health Technology Assessment
http://nzhta.chmeds.ac.nz/
A clearing house for health outcomes and health technology assessment. It is funded by the New Zealand Ministry of Health. The mission of NZHTA is to assist New Zealand health and disability services through the production and dissemination of evidence-based information for decisions on health policy and purchasing, service management, and clinical practice.

Evidence Network
http://www.evidencenetwork.org/
The evidence network began as a research-based policy and practice (EBPP) initiative in the UK to bring evidence into practice. It acts as the central base for a network of 8 nodes in the UK, all of which are responsible for bringing together various public health and social science evidence. The evidence network website also centralises a number of systematic reviews, completed by these units, on public health interventions. These can be accessed at http://evidencenetwork.org/Resources.html (click on EBPP Resources Listing).

Health Evidence
http://www.health-evidence.ca
A study funded by the Canadian Institutes of Health Research, involving individual interviews and focus groups with decision makers at various levels resulted in the development of a searchable online registry of synthesis research related to the effectiveness of public health and health promotion interventions. The intent of this registry is to provide relevant, synthesized, quality-rated research evidence to decision-makers to promote evidence-based public health decision-making. The site is now accessible free of charge.

NHS Centre for Reviews and Dissemination
http://www.york.ac.uk/inst/crd/
Offering rigorous and systematic reviews on selected topics, a database of good quality reviews, a dissemination service and an information service, helps to promote research based practice in health care (including health promotion and public health). At this site see Evidence from systematic reviews of research relevant to implementing the "wider public health" agenda. 

New York Academy of Medicine Library Grey Literature Report http://www.nyam.org/library/greyreport.shtml
Bimonthly publication of The New York Academy of Medicine Library alerting readers to new grey literature publications in public health.

GreyNet
http://www.greynet.org/pages/1/index.htm
The goal of GreyNet is to facilitate dialog, research, and communication between persons and organisations in the field of grey literature. GreyNet further seeks to identify and distribute information on and about grey literature in networked environments.

What Works for Children
http://www.whatworksforchildren.org.uk/
Part of the ESRC funded EvidenceNetwork, this site is a joint initiative between Barnardo's, the University of York and City University. Their resources section includes a guide to searching for evidence and 'EvidenceNuggets' -  summaries of research evidence.

Contact: L. Armstrong