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Methods: The Framework for Building High-Quality Evidence to Inform Decision-making

November 3, 2019
Methods
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Welcome to the Evidence for Action Blog!

“If our ideas are not evolving with verifiable evidence, they are not reliable ideas.”

― Carmine Savastano, Author and Editor-in-Chief of Neapolis Media Group

Since Evidence for Action (E4A) launched in 2015, with more than 2000 Letters of Intent and over 100 Full Proposals reviewed, we have seen time and again that methodological issues– the approaches used to evaluate an intervention –  are one of the most important barriers to providing compelling, actionable evidence to promote population health and reduce health inequalities. This motivated the creation of this blog, which is intended to provide an informal setting to discuss methods issues, share insights from the E4A Methods Lab (see below) and other leaders with expertise in designing and conducting research, highlight the innovative methodological approaches of E4A grantees, and much more.

Why did we create the E4A Methods Lab?

In an effort to address common methods questions and challenges in fielding rigorous quantitative research on population health, social conditions that impact health, and health systems E4A recently founded our Methods Lab. The goals of the Lab are to strengthen the research of E4A grantees and the larger community of population health researchers, to help prospective grantees recognize compelling research opportunities, and to stimulate cross-disciplinary conversation and appreciation across the community of population health researchers.

The Methods Lab is supported by the entire E4A team and the National Advisory Council, with Ellicott Matthay and Maria Glymour leading the Lab's projects.

What can you expect from the blog?

Members of the E4A team, National Advisory Committee, grantees, and other leaders in this space will contribute. Future posts will address methodological topics that we think are critical for population health research. Some will feature Methods Notes on concepts that frequently arise in E4A projects or related research—for example, choosing among study designs or presenting informative power or sample size calculations. We will also use this blog to feature discourse or conversations, such as interviews with leaders in the field about the methods topics they think are most important or challenging.

We invite you to make comments, initiate discussions, and suggest future topics and/or contributors for the blog.


Ellicott Matthay, PhD, is a social epidemiologist and postdoctoral scholar with E4A. Her research seeks to apply rigorous, multidisciplinary causal inference methods to inform and evaluate social programs and policies that improve population health and reduce health disparities, with an emphasis on the prevention of self-directed and interpersonal violence. She has substantial doctoral and postdoctoral training and experience in causal inference and epidemiologic methods. She conducts methodological investigations to improve the way the way that research in her substantive areas is done, because she believes that improving the methodological rigor of applied studies is one of the most important steps to identifying effective prevention strategies.

Maria Glymour, ScD, MS, is a social epidemiologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco. Her research focuses on how individual and contextual social factors experienced across the lifecourse, from infancy to adulthood, influence cognitive function, dementia, stroke, and other health outcomes in old age. She has dedicated much of her career to overcoming methodological problems encountered in observational epidemiology, in particular analyses of social determinants of health and dementia risk.

Why does high-quality evidence matter?
While there is ample evidence that the conditions in which people are born, grow, live, work and age impact health over the lifecourse, evidence gaps remain. We need evidence on which interventions may be the most effective in directly and indirectly improving population health, well-being, and health equity and give the biggest returns on our investments.

For example, findings from a study we funded evaluating the health impacts and savings resulting from a low-income home weatherization program led to expansion and allocation of additional resources to the program. Conversely, in the 80’s and 90’s significant resources were allocated to implement the D.A.R.E. program in schools across the country, only to later determine that D.A.R.E was ineffective in preventing kids from using drugs. High-quality, reliable evidence is needed to inform policy, implementation, and funding decision-making.

Why do methods matter?
Methods, or the study designs and analytical tools used in conducting research, establishing causality, and estimating impact, are a fundamental building block to the work of promoting the health of communities and populations. Without good methods, research results may not point in the right direction and can even be counter-productive. The methods issues that arise in research on social conditions and health can be particularly difficult: pure randomization is rarely feasible, measurement is challenging, and causal pathways underlying effects are complex and cyclical. Yet, social conditions are among the most important drivers of health and health inequities. It is essential that we tackle research questions on these topics with the best tools available.

Population health in the US is lagging behind that of international comparison countries. We believe this is because the US is underinvesting in population health resources relative to their potential benefit. High-quality methods are essential for providing a strong, convincing, and actionable evidence base on the strategies most likely to be successful in improving population health.