**13. An approach toward increasing evidence use in the practice of environmental/public health**

Education as well as training backgrounds are needed to improve and strengthen EBEPH proficiencies workforce. The prominence on EBEPH principles is not taught in the same way in all the subjects epitomized by public/environmental health professionals. For instance, a public/environmental health professional may not be sufficiently trained to pinpoint the most recent evidence as well as interpret other possibility than what an epidemiologist can do. A newly health educator graduate having a master's degree in public/environmental health is expected to have an expanded understanding of the significance of EBEPH better than a specialist in environmental health with a bachelor's degree. Perhaps less than half of environmental/public health practitioners have little prescribed training or education in the discipline of environmental/public health like health education, environmental health ethics and epidemiology [4, 5, 94]. Most of these specialists receive formal regular graduate education or training in a college of health sciences or other programs in public health. Presently, it seems that limited public/environmental health departments need more ongoing education and training around mandatory EBEPH. Although the recognized EBEPH concept is relatively novel, but not fundamental skills. For instance, evaluating a program intervention through reviewing scientific literature aimed at evidence are skills frequently taught in postgraduate programs in environmental/public health or other areas of academic disciplines, as well as they are the basis for the practice of public/environmental health. While, the most frequently EBEPH applied outline is perhaps that identified by Brownson and his colleagues (**Figure 5**), which tends to use a seven-steps procedure [52, 64, 95]. The framework procedure used for applying is not linear as well as involves several iterations [2, 52, 96]. Competencies are becoming increasingly evident in terms of more effective public/ environmental health practice [1–3, 97, 98]. For instance,

*'Silent Pandemic': Evidence-Based Environmental and Public Health Practices to Respond… DOI: http://dx.doi.org/10.5772/intechopen.100204*

#### **Figure 5.**

*Training approach for evidence-based environmental/public health. Adapted from Brownson et al., [64]; Hallfors et al., [93].*


#### **Table 3.**

*Characteristics of effective community coalitions.*



*'Silent Pandemic': Evidence-Based Environmental and Public Health Practices to Respond… DOI: http://dx.doi.org/10.5772/intechopen.100204*

> **Table 4.**

*Competencies in evidence-based environmental/public Health.a*

the EBEPH procedure, requires a certain set of competences to be capable of making evidence-based decisions [99] (see **Table 4**). EBEPH training programs in the developed countries aimed at public and environmental health professionals in their various state health agencies were created toward addressing these as well as other related competencies, [2, 3, 52, 100], community-based organizations as well as local health departments [2, 3, 101, 102], along with related programs have remained established in many countries [96, 99]. Some programs demonstrate evidence of efficacy [52, 102]. In the most frequent format, the faculty team with competence in EBEPH employs didactic lectures, computer workshops, as well as scenario-based exercises. The training programs scope could remain increased through stressing a train-the-trainer method [96, 99]. Other formats were employed, together with Internet-based self-study [101, 103], CD-ROMs, [99] distance as well as distributed networks learning, along with technical support that are targeted. Educational training programs can be very effective in delivering "change agents" who are seen as professionals, but also share general goals as well as characteristics through the trainees [104]. A leadership and staff commitment aimed at life-long learning are also key ingredient toward training successes [105]. Training implementation toward addressing EBEPH competencies must be in accordance with the principles of adult education and learning. These occurred problems remained recently articulated with Bryan along with his collaborators [106], who have stressed the need toward (1) recognize the reason why the audience is learning; (2) use a fundamental motivation toward learning the necessity of problems solving; (3) build as well as respect preceding experience; (4) developing learning methods that are aligned with the development background as well as recipient's diversity; and (5) actively participating with the participants in the education/learning process. Below are a sequential framework seven-stage steps, toward promoting better evidence use in everyday policy making (see **Figure 5**). It is remarkable to remember that this procedure is rarely a stringently linear or prescriptive one, nonetheless it must include several feedback "loops" as well as common processes that exist in multiple models' program-planning.
