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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health

Authors: Laura Yarber, Carol A. Brownson, Rebekah R. Jacob, Elizabeth A. Baker, Ellen Jones, Carsten Baumann, Anjali D. Deshpande, Kathleen N. Gillespie, Darcell P. Scharff, Ross C. Brownson

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Evidence-based public health gives public health practitioners the tools they need to make choices based on the best and most current evidence. An evidence-based public health training course developed in 1997 by the Prevention Research Center in St. Louis has been taught by a transdisciplinary team multiple times with positive results. In order to scale up evidence-based practices, a train-the-trainer initiative was launched in 2010.

Methods

This study examines the outcomes achieved among participants of courses led by trained state-level faculty. Participants from trainee-led courses in four states (Indiana, Colorado, Nebraska, and Kansas) over three years were asked to complete an online survey. Attempts were made to contact 317 past participants. One-hundred forty-four (50.9 %) reachable participants were included in analysis. Outcomes measured include frequency of use of materials, resources, and other skills or tools from the course; reasons for not using the materials and resources; and benefits from attending the course. Survey responses were tabulated and compared using Chi-square tests.

Results

Among the most commonly reported benefits, 88 % of respondents agreed that they acquired knowledge about a new subject, 85 % saw applications for the knowledge to their work, and 78 % agreed the course also improved abilities to make scientifically informed decisions at work. The most commonly reported reasons for not using course content as much as intended included not having enough time to implement evidence-based approaches (42 %); other staff/peers lack training (34 %); and not enough funding for continued training (34 %). The study findings suggest that utilization of course materials and teachings remains relatively high across practitioner groups, whether they were taught by the original trainers or by state-based trainers.

Conclusions

The findings of this study suggest that train-the-trainer is an effective method for broadly disseminating evidence-based public health principles. Train-the-trainer is less costly than the traditional method and allows for courses to be tailored to local issues, thus making it a viable approach to dissemination and scale up of new public health practices.
Appendix
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Literature
1.
Koo D, Miner K. Outcome-based workforce development and education in public health. Annu Rev Public Health. 2010;31:253–69. 1 p following 69.CrossRefPubMed
2.
Centers for Disease Control and Prevention. Fact sheet: public health infrastructure. Atlanta, GA: Centers for Disease Control and Prevention; 2001. Contract No.: Document Number|.
3.
Turnock BJ. Public health: What it is and how it works. 4th ed. Sudbury, MA: Jones and Bartlett Publishers; 2009.
4.
Institute of Medicine. Who will keep the public healthy? Educating public health professionals for the 21st century. Washington, D.C.: National Academies Press; 2003.
5.
Baker EA, Brownson RC, Dreisinger M, McIntosh LD, Karamehic-Muratovic A. Examining the role of training in evidence-based public health: a qualitative study. Health Promot Pract. 2009;10(3):342–8.CrossRefPubMed
6.
Brownson RC, Fielding JE, Maylahn CM. Evidence-based public health: a fundamental concept for public health practice. Annu Rev Public Health. 2009;30:175–201.CrossRefPubMed
7.
Dreisinger M, Leet TL, Baker EA, Gillespie KN, Haas B, Brownson RC. Improving the public health workforce: evaluation of a training course to enhance evidence-based decision making. J Public Health Manag Pract. 2008;14(2):138–43.CrossRefPubMed
8.
IOM. Committee for the study of the future of public health. The future of public health. Washington, DC: National Academy Press; 1988.
9.
Institute of Medicine. The future of the public’s health in the 21st century. Washington, D.C.: National Academies Press; 2003.
10.
Bender K, Halverson PK. Quality improvement and accreditation: what might it look like? J Public Health Manag Pract. 2010;16(1):79–82.CrossRefPubMed
11.
12.
Brownson RC, Gurney JG, Land GH. Evidence-based decision making in public health. J Public Health Manag Pract. 1999;5(5):86–97.CrossRefPubMed
13.
Glasziou P, Longbottom H. Evidence-based public health practice. Aust N Z J Public Health. 1999;23(4):436–40.CrossRefPubMed
14.
Jenicek M. Epidemiology, evidence-based medicine, and evidence-based public health. J Epidemiol Commun Health. 1997;7:187–97.
15.
Kohatsu ND, Robinson JG, Torner JC. Evidence-based public health: an evolving concept. Am J Prev Med. 2004;27(5):417–21.PubMed
16.
Brownson RC, Baker EA, Leet TL, Gillespie KN, True WR. Evidence-based public health. 2nd ed. New York: Oxford University Press; 2011.
17.
Brownson RC, Diem G, Grabauskas V, Legetic B, Potemkina R, Shatchkute A, et al. Training practitioners in evidence-based chronic disease prevention for global health. Promot Educ. 2007;14(3):159–63.PubMed
18.
O’Neall MA, Brownson RC. Teaching evidence-based public health to public health practitioners. Ann Epidemiol. 2005;15(7):540–4.CrossRefPubMed
19.
Gibbert WS, Keating SM, Jacobs JA, Dodson E, Baker E, Diem G, et al. Training the workforce in evidence-based public health: an evaluation of impact among US and international practitioners. Prev Chronic Dis. 2013;10:E148.CrossRefPubMedPubMedCentral
20.
Jacobs JA, Duggan K, Erwin P, Smith C, Borawski E, Compton J, et al. Capacity building for evidence-based decision making in local health departments: scaling up an effective training approach. Implement Sci. 2014;9(1):124.CrossRefPubMedPubMedCentral
21.
Milat AJ, King L, Bauman AE, Redman S. The concept of scalability: increasing the scale and potential adoption of health promotion interventions into policy and practice. Health Promot Int. 2012;28(3):285–98.CrossRefPubMed
22.
Milat AJ, King L, Newson R, Wolfenden L, Rissel C, Bauman A, et al. Increasing the scale and adoption of population health interventions: experiences and perspectives of policy makers, practitioners, and researchers. Health Res Policy Syst. 2014;12:18.CrossRefPubMedPubMedCentral
23.
Mangham LJ, Hanson K. Scaling up in international health: what are the key issues? Health Policy Plan. 2010;25(2):85–96.CrossRefPubMed
24.
Diem G, Brownson RC, Grabauskas V, Shatchkute A, Stachenko S. Prevention and control of noncommunicable diseases through evidence-based public health: implementing the NCD 2020 action plan. Glob Health Promot. 2015;10.
25.
Orfaly RA, Frances JC, Campbell P, Whittemore B, Joly B, Koh H. Train-the-trainer as an educational model in public health preparedness. J Public Health Manag Pract. 2005;Suppl:S123–7.CrossRefPubMed
26.
Trabeau M, Neitzel R, Meischke H, Daniell WE, Seixas NS. A comparison of “Train-the-Trainer” and expert training modalities for hearing protection use in construction. Am J Ind Med. 2008;51(2):130–7.CrossRefPubMed
27.
McClelland JW, Irving LM, Mitchell RE, Bearon LB, Webber KH. Extending the reach of nutrition education for older adults: feasibility of a Train-the-Trainer approach in congregate nutrition sites. J Nutr Educ Behav. 2002;34 Suppl 1:S48–52.CrossRefPubMed
28.
29.
Bess CA, LaHaye C, O’Brien CM. Train-the-Trainer Project meets organization’s strategic initiative for retention and continuous learning. J Nurses Staff Dev. 2003;19(3):121–7. quiz 8-9.CrossRefPubMed
30.
Green ML. A train-the-trainer model for integrating evidence-based medicine training into podiatric medical education. J Am Podiatr Med Assoc. 2005;95(5):497–504.CrossRefPubMed
31.
Levine SA, Brett B, Robinson BE, Stratos GA, Lascher SM, Granville L, et al. Practicing physician education in geriatrics: lessons learned from a train-the-trainer model. J Am Geriatr Soc. 2007;55(8):1281–6.CrossRefPubMed
32.
Stratos GA, Katz S, Bergen MR, Hallenbeck J. Faculty development in end-of-life care: evaluation of a national train-the-trainer program. Acad Med. 2006;81(11):1000–7.CrossRefPubMed
33.
Campbell NR, Petrella R, Kaczorowski J. Public education on hypertension: a new initiative to improve the prevention, treatment and control of hypertension in Canada. Can J Cardiol. 2006;22(7):599–603.CrossRefPubMedPubMedCentral
34.
Corelli RL, Fenlon CM, Kroon LA, Prokhorov AV, Hudmon KS. Evaluation of a train-the-trainer program for tobacco cessation. Am J Pharm Educ. 2007;71(6):109.CrossRefPubMedPubMedCentral
35.
Booth-Kewley S, Gilman PA, Shaffer RA, Brodine SK. Evaluation of a sexually transmitted disease/human immunodeficiency virus prevention train-the-trainer program. Mil Med. 2001;166(4):304–10.PubMed
36.
Burr CK, Storm DS, Gross E. A faculty trainer model: increasing knowledge and changing practice to improve perinatal HIV prevention and care. AIDS Patient Care STDS. 2006;20(3):183–92.CrossRefPubMed
37.
Gabel LL, Pearsol JA. The twin epidemics of substance use and HIV: a state-level response using a train-the-trainer model. Fam Pract. 1993;10(4):400–5.CrossRefPubMed
38.
Hiner CA, Mandel BG, Weaver MR, Bruce D, McLaughlin R, Anderson J. Effectiveness of a training-of-trainers model in a HIV counseling and testing program in the Caribbean Region. Hum Resour Health. 2009;7:11.CrossRefPubMedPubMedCentral
39.
Nyamathi A, Vatsa M, Khakha DC, McNeese-Smith D, Leake B, Fahey JL. HIV knowledge improvement among nurses in India: using a train-the-trainer program. J Assoc Nurses AIDS Care. 2008;19(6):443–9.CrossRefPubMedPubMedCentral
40.
Tobias CR, Downes A, Eddens S, Ruiz J. Building blocks for peer success: lessons learned from a train-the-trainer program. AIDS Patient Care STDS. 2011;26(1):53–9.CrossRefPubMed
41.
Hahn EJ, Noland MP, Rayens MK, Christie DM. Efficacy of training and fidelity of implementation of the life skills training program. J Sch Health. 2002;72(7):282–7.CrossRefPubMed
42.
Milat AJ, King L, Bauman A, Redman S. Scaling up health promotion interventions: an emerging concept in implementation science. Health Promot J Austr. 2012;22(3):238.
43.
Norton W, Mittman B. Scaling up health promotion/disease prevention programs in community settings: Barriers, facilitators, and initial recommendations. Hartford, CT: Patrick and Catherine Weldon Donaghue Medical Research Foundation; 2010. Contract No.: Document Number|.
44.
45.
Jacob RR, Baker EA, Allen P, Dodson EA, Duggan K, Fields R, et al. Training needs and supports for evidence-based decision making among the public health workforce in the United States. BMC Health Serv Res. 2014;14(1):564.CrossRefPubMedPubMedCentral
46.
Maylahn C, Bohn C, Hammer M, Waltz E. Strengthening epidemiologic competencies among local health professionals in New York: teaching evidence-based public health. Public Health Rep. 2008;123 Suppl 1:35–43.PubMedPubMedCentral
47.
Kaplan GE, Juhl AL, Gujral IB, Hoaglin-Wagner AL, Gabella BA, McDermott KM. Tools for identifying and prioritizing evidence-based obesity prevention strategies, Colorado. Prev Chronic Dis. 2013;10, E106.CrossRefPubMedPubMedCentral
48.
Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health. 2011;38(1):4–23.CrossRefPubMed
49.
Klein K, Sorra J. The challenge of innovation implementation. Acad Manag Rev. 1996;21(4):1055–80.
50.
Bennett S, Paina L, Ssengooba F, Waswa D, M’Imunya JM. The impact of Fogarty International Center research training programs on public health policy and program development in Kenya and Uganda. BMC Public Health. 2013;13:770.CrossRefPubMedPubMedCentral
51.
Paina L, Ssengooba F, Waswa D, M’Imunya JM, Bennett S. How does investment in research training affect the development of research networks and collaborations? Health Res Policy Syst. 2013;11:18.CrossRefPubMedPubMedCentral
Metadata
Title
Evaluating a train-the-trainer approach for improving capacity for evidence-based decision making in public health
Authors
Laura Yarber
Carol A. Brownson
Rebekah R. Jacob
Elizabeth A. Baker
Ellen Jones
Carsten Baumann
Anjali D. Deshpande
Kathleen N. Gillespie
Darcell P. Scharff
Ross C. Brownson
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1224-2

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