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Bridging the Gap between Individuals and Communities: Upgrading EBP through Collaboration
March 30th, 2011

When I started working as the Program Manager for the Resources for Training in Evidence-Based Behavioral Practice (EBBP) project, I brought with me a strong interest in shared decision-making and research-to-practice translation. I come from a public health background by degree but my work experience has been primarily clinical. I spent my years in graduate school studying for a Masters in Public Health in Behavioral and Community Health Sciences while supporting myself by working as a counselor and educator at a health clinic. Days were spent working one-on-one with patients; nights were spent learning about large-scale interventions across entire communities. I began to wonder: is it possible to address individuals and communities simultaneously? Can the two worlds be bridged to provide the personalization of clinical care with the resource savvy, widespread distribution of population-based programs?

Having created didactic modules in the past in order to fill gaps in behavioral science training, the EBBP project team decided to create modules for practitioners in the field who need to perform decision-making that integrates the Three Circles of EBBP. In collaboration with our Practitioner Advisory Council (PRAC), we created two new modules entitled “Shared Decision-Making with Individual Clients” and “Collaborative Decision-Making with Communities”. The PRAC was divided into two groups: one with practitioners who work clinically with individuals, the other with public health practitioners who work with communities. Although each sub-group created separate modules, the overlap between individual and community-based shared decision-making was apparent. The two groups met together this summer for a two-day meeting, and during that time were eager to contribute to the process of developing each other’s modules.

As the two group began to discuss the fundamental issues that arise in decision-making, it became apparent that many of the core concerns are the same for practitioners who work with individuals and those who work with communities. It is not often the case that there is an evidence-based practice about which the client or community is enthusiastic and there are available resources to cover the costs. In addition, there is a lack of literature to provide guidance for practitioners working to align evidence, client preferences, and resources. Despite different case examples, both PRAC groups expressed similar struggles in decision-making and a desire to provide resources to illustrate the process of collaborating to make use of what is available.

Ultimately, my experience coordinating the EBBP project has been very useful in helping me to conceptualize the overlap between individual and community-level work in healthcare. Coming from a background where my experience in this area was compartmentalized, it is refreshing to see these groups come together and express enthusiasm for each other’s work. It is inspiring to see practitioners from different disciplines working together to solve real-world problems, especially when we know that translatable solutions are needed to bridge the gap between research and practice. I am looking forward to seeing more collaboration between individual and community-level practitioners as a method of harmonizing and upgrading the evidence-based practice approach across health disciplines.

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