The CDC Healthy Aging Research Network: Advancing Science toward Action and Policy for the Evidence-Based Health Promotion Movement

Activities used by evidence networks to promote evidence-informed decision-making in the health sector- a rapid evidence review

BACKGROUND

Evidence networks facilitate the exchange of information and foster international relationships among researchers and stakeholders. These networks are instrumental in enabling the integration of scientific evidence into decision-making processes. While there is a global emphasis on evidence-based decision-making at policy and organisational levels, there exists a significant gap in our understanding of the most effective activities to exchange scientific knowledge and use it in practice. The objective of this rapid review was to explore the strategies employed by evidence networks to facilitate the translation of evidence into decision-making processes. This review makes a contribution to global health policymaking by mapping the landscape of knowledge translation in this context and identifying the evidence translation activities that evidence networks have found effective.

METHODS

The review was guided by standardised techniques for conducting rapid evidence reviews. Document searching was based on a phased approach, commencing with a comprehensive initial search strategy and progressively refining it with each subsequent search iterations. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed.

RESULTS

The review identified 143 articles, after screening 1135 articles. Out of these, 35 articles were included in the review. The studies encompassed a diverse range of countries, with the majority originating from the United States (n = 14), followed by Canada (n = 5), Sweden (n = 2), and various other single locations (n = 14). These studies presented a varied set of implementation strategies such as research-related activities, the creation of teams/task forces/partnerships, meetings/consultations, mobilising/working with communities, influencing policy, activity evaluation, training, trust-building, and regular meetings, as well as community-academic-policymaker engagement.

CONCLUSIONS

Evidence networks play a crucial role in developing, sharing, and implementing high-quality research for policy. These networks face challenges like coordinating diverse stakeholders, international collaboration, language barriers, research consistency, knowledge dissemination, capacity building, evaluation, and funding. To enhance their impact, sharing network efforts with wider audiences, including local, national, and international agencies, is essential for evidence-based decision-making to shape evidence-informed policies and programmes effectively.

Evaluation of Recruitment of Older Adults of Color into a Community-Based Chronic Disease Self-Management Wellness Pathway Program in Los Angeles County

Background

Established relationships between researchers, stakeholders and potential participants are integral for recruitment of potential older adult participants and Evidence-Based Programs (EBPs) for chronic disease management have empirically been shown to help improve health and maintain healthy and active lives. To accelerate recruitment in EBPs and potential future research, we propose a Wellness Pathway allowing for delivery within multipurpose senior centers (MPCs) linked with medical facilities among lower-income urban older adults. The study aims were to: 1) assess the effectiveness of three MPC-delivered EBPs on disease management skills, health outcomes, and self-efficacy; and 2) assess the feasibility of the proposed Wellness Pathway for lower-income urban-dwelling older adults of color.

Methods

We administered surveys and conducted a pre-post analysis among participants enrolled in any 1 of 3 MPC-based EBPs (n=53). To assess feasibility of the pathway, we analyzed survey data and interviews (EBP participants, MPC staff, physicians, n=10).

Results

EBP participation was associated with greater disease management skills (increased time spent stretching and aerobic activity) but not improvements in self-efficacy or other health outcomes. Interviews revealed: 1) older adults valued EBPs and felt the Wellness Pathway feasible; 2) staff felt it feasible given adequate growth management; 3) physicians felt it feasible provided adequate medical facility integration.

Conclusions

MPC-based EBPs were associated with improvements in disease management skills among older adults; a proposed Wellness Pathway shows early evidence of feasibility and warrants further investigation. Future efforts to implement this model of recruiting older adults of color into EBPs should address barriers for implementation and sustainability.

Recreational Activity and Facial Trauma Among Older Adults

Importance

As the US population ages, public health agencies have released guidelines encouraging aerobic activity and muscle-strengthening exercises among older individuals. Facial trauma from such activities among elderly individuals has long been underappreciated.

Objectives

To evaluate the incidence of recreational activity-associated facial fractures among older adults and to further delineate injury characteristics including demographics, fracture location, and specific activities.

Design, Setting, and Participants

The National Electronic Injury Surveillance System was used to collect data on emergency department visits from January 1, 2011, to December 31, 2015, for individuals 55 years of age or older who sustained facial fractures from recreational activities. Individual entries were evaluated for activity code, fracture site, and demographics. Weighting data were used to extrapolate national incidence.

Main Outcomes and Measures

Incidence and location of facial fractures and associated recreational activity.

Results

During the study period, there were 20 519 emergency department visits for recreational activity-associated facial fractures among adults 55 years of age or older (8107 women and 12 412 men; mean [SD] age, 66.5 [9.1] years). The annual incidence of facial fractures increased by 45.3% from 2011 (n = 3174) through 2015 (n = 4612). Bicycling (26.6%), team sports (15.4%), outdoor activities (10.1%), and gardening (9.5%) were the most common causes of facial fractures. Walking and jogging caused 5.5% of fractures. In cases specifying site of fracture, nasal (65.4%) and orbital (14.1%) fractures were the most common. A greater proportion of men than women sustained bicycle-associated fractures (35.7% vs 14.9%; P = 3.1056 × 10-170), while more women than men sustained fractures associated with gardening (15.5% vs 6.1%; P = 2.1029 × 10-97), outdoor activities (14.6% vs 7.7%; P = 4.3156 × 10-50), and gym exercise (7.7% vs 1.3%; P = 3.0281 × 10-114). Men harbored a greater likelihood than women of orbital (14.9% vs 12.8%; P = 6.1468 × 10-5) and mandible fractures (9.3% vs 2.0%; P = 9.3760 × 10-64). Walking and jogging and gardening comprised a greater proportion of injuries in older cohorts.

Conclusions and Relevance

Facial fractures sustained from recreational activity increased by 45.3% during a 5-year period among older adults. Although bicycling was the most common activity facilitating these injuries, many other pursuits represent areas of concern. Nasal fractures predominated, although orbital fractures increased with age. These findings offer areas for targeted prevention and provide valuable information for patient counseling. Furthermore, initiatives encouraging greater activity among this population may need to be accompanied by guidelines for injury prevention.

Level of Evidence

NA.

The Healthy Aging Research Network: Modeling Collaboration for Community Impact

As the first Centers for Disease Control and Prevention (CDC) Prevention Research Centers Program thematic network, the Healthy Aging Research Network was established to better understand the determinants of healthy aging within older adult populations, identify interventions that promote healthy aging, and assist in translating research into sustainable community-based programs throughout the nation. To achieve these goals requires concerted efforts of a collaborative network of academic, community, and public health organizational partnerships. For the 2001-2014 Prevention Research Center funding cycles, the Healthy Aging Research Network conducted prevention research and promoted the wide use of practices known to foster optimal health. Organized around components necessary for successful collaborations (i.e., governance and infrastructure, shaping focus, community involvement, and evaluation and improvement), this commentary highlights exemplars that demonstrate the Healthy Aging Research Network's unique contributions to the field. The Healthy Aging Research Network's collaboration provided a means to collectively build capacity for practice and policy, reduce fragmentation and duplication in health promotion and aging research efforts, maximize the efficient use of existing resources and generate additional resources, and ultimately, create synergies for advancing the healthy aging agenda. This collaborative model was built upon a backbone organization (coordinating center); setting of common agendas and mutually reinforcing activities; and continuous communications. Given its successes, the Healthy Aging Research Network model could be used to create new and evaluate existing thematic networks to guide the translation of research into policy and practice.

Using Social Network Analysis to Assess Mentorship and Collaboration in a Public Health Network

Introduction

Addressing chronic disease burden requires the creation of collaborative networks to promote systemic changes and engage stakeholders. Although many such networks exist, they are rarely assessed with tools that account for their complexity. This study examined the structure of mentorship and collaboration relationships among members of the Healthy Aging Research Network (HAN) using social network analysis (SNA).

Methods

We invited 97 HAN members and partners to complete an online social network survey that included closed-ended questions about HAN-specific mentorship and collaboration during the previous 12 months. Collaboration was measured by examining the activity of the network on 6 types of products: published articles, in-progress manuscripts, grant applications, tools, research projects, and presentations. We computed network-level measures such as density, number of components, and centralization to assess the cohesiveness of the network.

Results

Sixty-three respondents completed the survey (response rate, 65%). Responses, which included information about collaboration with nonrespondents, suggested that 74% of HAN members were connected through mentorship ties and that all 97 members were connected through at least one form of collaboration. Mentorship and collaboration ties were present both within and across boundaries of HAN member organizations.

Conclusion

SNA of public health collaborative networks provides understanding about the structure of relationships that are formed as a result of participation in network activities. This approach may offer members and funders a way to assess the impact of such networks that goes beyond simply measuring products and participation at the individual level.