Bad evidence?

Listened to Ben Goldacre's documentary today on BBC Radio 4.

"Medic and author Ben Goldacre explores the idea of evidence-based policy and asks if it can ever become a reality in the UK... What is clear, is that bad policies cost us dear - both socially and economically. The challenges are many but the potential, argues Ben, could be truly transformational, both for society and for government."
Source: http://www.bbc.co.uk/programmes/b01phhb9

Over the Christmas break I have been marking coursework assignments from nearly 70 undergraduate students on the Applied Health Psychology module I teach. The students' task was to critically assess the UK's Change4Life public health programme, using the best evidence available.

This entailed identifying the different behaviour change techniques employed within the programme, then checking the published evidence (from controlled trials, systematic reviews, etc.) for how effective these techniques are at changing similar behaviours (diet, physical activity, alcohol consumption) in similar populations.

The evidence is somewhat mixed. Perhaps another example of ISLAGIATT in public policy?

Best practice in health psychology and related disciplines suggests a more systematic and evidence based approach to designing large scale public health programmes. This typically involves using intervention mapping, and includes a clear plan for rigorous testing of effectiveness that is built in before the programme is launched.

Meanwhile, I am adding the following recent paper to my 'must read' list:
Piggin (2012) Turning health research into health promotion: A study of causality and ‘critical insights’ in a United Kingdom health campaign.

Examples of Intervention Mapping used to develop programmes

Aarø, L. E., Flisher, A. J., Kaaya, S., Onya, H., Fuglesang, M., Klepp, K. -., & Schaalma, H. (2006). Promoting sexual and reproductive health in early adolescence in South Africa and Tanzania: Development of a theory- and evidence-based intervention programme. Scandinavian Journal of Public Health, 34(2), 150-158.

Byrd, T. L., Wilson, K. M., Smith, J. L., Heckert, A., Orians, C. E., Vernon, S. W., . . . Fernandez, M. E. (2012). Using intervention mapping as a participatory strategy: Development of a cervical cancer screening intervention for Hispanic women. Health Education and Behavior, 39(5), 603-611.

Corbie-Smith, G., Akers, A., Blumenthal, C., Council, B., Wynn, M., Muhammad, M., & Stith, D. (2010). Intervention mapping as a participatory approach to developing an HIV prevention intervention in rural African American communities. AIDS Education and Prevention, 22(3), 184-202.

Day, R. S., Nakamori, M., & Yamamoto, S. (2004). Recommendations to develop an intervention for Japanese youth on weight management. Journal of Medical Investigation, 51(3-4), 154-162.

Hou, S. I., Fernandez, M. E., & Parcel, G. S. (2004). Development of a cervical cancer educational program for Chinese women using intervention mapping. Health Promotion Practice, 5(1), 80-87.

Leerlooijer, J. N., Ruiter, R. A. C., Reinders, J., Darwisyah, W., Kok, G., & Bartholomew, L. K. (2011). The world starts with me: Using intervention mapping for the systematic adaptation and transfer of school-based sexuality education from Uganda to Indonesia. Translational Behavioral Medicine, 1(2), 331-340.

Leshabari, S. C., Koniz-Booher, P., Astrøm, A. N., De Paoli, M. M., & Moland, K. M. (2006). Translating global recommendations on HIV and infant feeding to the local context: The development of culturally sensitive counselling tools in the Kilimanjaro region, Tanzania. Implementations Science, 1(1)



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