When it comes to developing and implementing solutions to problems that affect our communities, evidence matters. Implementing or adapting strategies that are proven increases the likelihood of success in improving community health. Investments in strategies that are shown to work are smart investments that can stretch the impact of scarce dollars. Developed by the University of Wisconsin Population Health Institute in partnership with the Robert Wood Johnson Foundation, What Works for Health is an online tool that you can use to find policies and programs that have been shown to improve community health.
What Works for Health is an easy-to-use, searchable menu of policies and programs with a broad scope--it is based on the County Health Rankings model and looks at strategies that address the many factors that affect health, including health behaviors, access to care, social and economic factors, and the environment. Users can choose a health factor of interest (e.g., tobacco use, employment, or access to health care) and browse through the evidence ratings for particular programs, policies, or system changes that address the particular health factor of interest. For each strategy listed in What Works for Health¸ analysts search published and unpublished literature as well as the findings of other organizations that assess evidence of effectiveness and assign one of the following evidence ratings:
- Scientifically supported: The program, policy or systems change works – its effectiveness is supported by numerous studies or systematic review(s) with strong positive results; no existence of substantial contradictory evidence.
- Some evidence: The program, policy or systems change has been shown to work more than once -- research suggests positive impacts overall; further study may be warranted.
- Expert opinion: The program, policy or systems change has been recommended by credible groups, but research evidence on its effectiveness is limited. Credible groups are recognized for their impartial expertise in an area of interest.
- Insufficient evidence: It is too soon to tell how well the program, policy or systems change works -- evidence is limited or unavailable and further study is warranted.
- Mixed evidence: The program, policy or systems change may or may not work -- evidence is mixed and further study is warranted.
- Evidence of ineffectiveness: The program, policy or systems change doesn’t work -- research consistently shows harm or lack of effect.
Conducting literature reviews and assessing the strength of the evidence is a time-consuming process—What Works for Health saves you time by summarizing lots of information, while also providing you with full documentation and links to the original evidence. There are many organizations that assess the effectiveness of policies and programs. Each organization uses its own criteria to assess and rate evidence. Rather than reinventing the wheel, What Works for Health summarizes and links to research from other rating organizations. Examples of other organizations include:
- The Campbell Collaboration Library of Systematic Reviews
- The Cochrane Library
- The Guide to Community Preventive Services (The Community Guide)
However, it is important to note that evidence of effectiveness is just one of many factors to consider when choosing a strategy to solve a community health challenge. Community ‘fit,’ readiness, priorities, capacity, and resources are also important considerations. What Works for Health includes information on implementation examples and guides. Also, some strategies have not been tested enough to know how well they work – but some may have lots of potential and could represent some very innovative approaches. So, yes, evidence matters but so does innovation. If communities choose to implement innovative strategies with little to no evidence of effectiveness, they should do so knowingly. Evaluating these efforts is particularly important so that they and others can learn whether they really work.
Bridget Booske Catlin, PhD, MHSA directs the County Health Rankings & Roadmaps program at the University of Wisconsin Population Health Institute.