1. Novick, Lloyd F. MD, MPH

Article Content

Since the founding of the Journal of Public Health Management and Practice more than 25 years ago, we have published systematic reviews and recommendations from the US Department of Health & Human Services' Guide to Community Preventive Services (Guide). The Guide has led the development of evidence-based public health. Disseminating evidence-based public health that leads to utilization by practitioners and public health agencies aligns with the core mission of JPHMP.


Another parallel interest is publishing evidence-based reviews that focus on the social determinants of health that impact health equity. JPHMP has published systematic reviews focusing on early childhood education to promote health equity, educational achievement as a social determinant of life expectancy, out-of-school-time academic programs, and others promoted by the Guide. This September/October issue continues this theme with a Systematic Guide Review by Peng and coauthors on housing and the homeless.


Other articles in the issue demonstrate the adoption of evidence-based public health throughout public health practice. Two articles link the accreditation of local and state health departments to evidence-based practice. Roba and coauthors find the Guide to be an indispensable tool assisting public health practitioners in selecting evidence-based interventions (EBIs). Local health departments involved in the accreditation process were 4 times more likely to consult the Guide. Similarly, Erwin and colleagues found that state health departments using EBIs are more likely to be accredited by the Public Health Accreditation Board.


An article by Zakaria, "Building Capacity of Evidence-Based Public Health Practice at King Saud University," shows the international reach of the Guide's influence. Informatic and cultural factors in Saudi Arabia present barriers to the implementation of evidence-based public health. The lack of national information or surveillance systems and inadequacies of public health research resulted in a lack of support for EBIs. An article by Poehler illustrates the use of EBIs in diabetes interventions. Mallory Kennedy describes EBIs in preparedness.


The Guide to Community Preventive Services, established in 1996, provides evidence-based findings of the Community Preventive Services Task Force. This task force is a panel of nonfederal public health and prevention experts. The Guide is staffed by the Centers for Disease Control and Prevention (CDC). Interventions on 22 health topics to improve health are now available after periodic systematic reviews of effectiveness that include economic analysis. Guide reviews lead to recommendations for preventive measures based on strong or sufficient evidence. The Guide has done systematic reviews that include vaccination, tobacco, adolescent health, asthma, diabetes, alcohol consumption, and health equity.1 These reviews lead to recommendations based on strong or sufficient evidence or a decision not to issue a recommendation because of a finding of insufficient evidence.


In June of 2019, a celebration was held at the CDC for 2 decades of achievement by the Guide. David Satcher, former CDC director, 1993-1998, who was instrumental in the Community Guide's formation, noted that it was developed to complement the clinical Guide to Preventive Services. "Together, the resources offer invaluable, evidence-based tools for community decision makers."2


In 1993, the Council on Linkages Between Academia and Public Health Practice discussed the creation of a companion to the Guide to Preventive Services that would guide public health.1,3-8 The council was made up of representatives from major organizations representing public health practice and academia. A major discussion point at meetings of the Council was the feasibility of gathering evidence for public health problems.


The W.K. Kellogg Foundation provided funding for a study that examined 4 health problems (cardiovascular disease, anemia, tuberculosis, and lead poisoning in children), in order to ascertain whether there was enough scientific evidence for generation of guidance on these issues. Expert panels were assembled to assess the evidence for each of the topics. Preventive medicine residents and public health graduate students were enlisted to assist with the literature review. Assembling and appraising the literature for each topic was a major effort. For example, for the cardiovascular disease topic, the MEDLINE search retrieved more than 33 000 citations of which 3181 were determined to be relevant. Eventually, of these, 220 articles were assigned to the database and used for guideline development.5-8


At the study's conclusion, in the summer of 1995, the Council on Linkages Between Academia and Public Health Practice concluded that public health practice guidelines based on evidence were feasible and the benefits immediate and far reaching. The results were presented to Philip Lee, assistant secretary for US Department of Health & Human Services, and David Satcher, director of the CDC, who expressed enthusiasm for the development of public health practice guidelines. Following this, Edward Baker, director of the Public Health Practice Office (PPHO) of the CDC, formed a national task force to explore the feasibility and benefit of these guidelines for public health.5-8


Challenges for the Guide continue. With finite staff and resources, examining all areas relevant to public health practice is not possible. The Guide and the Task Force are involved in a herculean task-prioritizing topics for review and then updating their findings as new evidence becomes available. The potential of the Guide is demonstrated by numerous contributions including those on vaccine-preventable disease, tobacco use prevention and cessation, prevention of injury from motor vehicle accidents, and physical activity. The influence of the Guide has been shown by the adoption in federal policy of a key finding of strong evidence for the effectiveness of state legislation setting 0.08% blood alcohol concentration limit. "Efforts like those of the Task Force will go a long way toward achieving our prevention goals by making it possible to be selective about the priorities we establish, the partnerships we build, and the methods we choose as we shepherd scarce resources to make prevention a priority."7 The value of the Guide in advancing the field of public health is apparent by viewing EBIs on their Web site:


For more information about this issue, listen to the September edition of The Editor's Podcast. (Supplement digital audio, available at




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6. Novick LF. Public health practice guidelines: a case study. J Public Health Manag Pract. 1997;3(1):59-64. [Context Link]


7. Novick LF, Kelter A. The Guide to Community Preventive Services: a public health imperative. Am J Prev Med. 2001;21(4 suppl):13-15. [Context Link]


8. Novick LF, Bialek R, Flake M. Guideline development project for public health practice. In: Novick LF, Morrow CB, Novick CG, eds. JPHMP's 21 Public Health Case Studies on Policy & Administration. Philadelphia, PA: Wolters Kluwer; 2018:333-355. [Context Link]