Research

The Community Guide provides a research agenda for each topic it reviews to point out where more, or better, studies are needed to address questions about effectiveness, applicability and harms. These agendas can help scientists plan and conduct research, as well as secure funding.

Using Insufficient Evidence Findings

Nearly half of current Community Guide systematic reviews result in insufficient evidence findings. This finding does not mean that the intervention does not work; rather it means one of two things:

• Too few studies of fair to good quality exist to draw conclusions.
• A sufficient number of studies are found but their results are inconsistent.

If too few studies exist, this may be a reason for conducting additional research. Researchers should consider whether this is simply due to a lack of studies or due to a lack of studies with rigorous methods. If there is a lack of studies with rigorous methods, the research gaps section may offer insight into how to design future studies.

If studies exist, but the findings are inconsistent, researchers should consider these questions:

• Do trends exist in the favorable or unfavorable studies that can be explained by things such as:
  • Sample characteristic (e.g., race, ethnicity, age)?
  • Participation and exposure rates?
  • Historical events (e.g., national crisis or presence of a national media campaign)?
  • Methodological flaws (e.g., a larger number of before-after studies)?
• Was the intervention applied in a similar enough fashion across all studies to expect consistency?
• Was the intervention applied correctly in all studies?

Examining the studies included in a review will help researchers consider next steps.

Improving Research Quality

Chapter 12 of the book, The Guide to Community Preventive Services, addresses continuing research needs. It suggests specific ways to improve the quality of intervention research, such as:

• Setting priorities for topics to review
• Improving the quality of studies 
• Identifying theoretical bases via conceptual models
• Identifying outcome measures

Recently, there have been calls to encourage researchers to consult evidence reviews for information on research gaps (and settled research questions) before doing any primary studies.

The Community Guide relies on researchers to conduct studies that can move prevention research forward. It can help you determine which topics need more research and which have been sufficiently studied, so that you can successfully fund your projects and publish findings.

Community Guide in Action: The GUIA project — Assessment of physical activity interventions in Latin America

The GUIA project, funded by the Centers for Disease Control and Prevention/Prevention Research Centers (PRC) Program, was initiated by the Saint Louis University PRC in 2006. The goal of the project is to assess whether the evidence-based recommendations developed by the Community Preventive Services Task Force in the United States are applicable to Latin American countries.

Selected Resources

Agency for Healthcare Research and Quality, U.S. Department of Heath and Human Services

The Campbell Collaboration

National Institute for Health and Clinical Excellence (NICE)

The Cochrane Public Health Group, The Cochrane Collaboration