Evidence-Based/Knowledge Management Librarian, KnowledgesharePhil Jones BA (Hons) DipLib
Public Health Network/Knowledge Management Librarian
The Library, Sussex Postgraduate Medical Centre, Brighton General Hospital, UK
Received date: 9 November 2004 Accepted date: 24 November 2004
Public health has been edging its way towards the top of the NHS agenda for some time now. But what exactly do wemean when we talk about ‘PublicHealth’? Chief Medical Officer Sir Liam Donaldson suggests five key concepts which go together to make the public health agenda:1
•delivering population public health goals
•improving the outcome of care
•practising public health in a health service environment
•evaluating health services.
A good way to begin searching for useful websites would be to make a list of the different national organisations with a public health brief, for instance the Health Development Agency, the Commission for Health Improvement and theHealth ProtectionAgency. To these we can add some similar areas of relevance to public health, such as health inequalities and health promotion, or we can choose to focus on specific public health projects, such as smoking cessation or 5-a-day.
Our searcher now has a number of topic options in the area of public health. The final stage is to decide whether to choose the subject approach or to begin with a specific website. On the national scene, the obvious first choice would be the Department of Health (www.dh.gov.uk), which is an aggregation of many semi-autonomous sites. Another possible choice is the National electronic Library for Health (NeLH: www. nelh.nhs.uk) – though it should be noted that, at the time of writing, the NeLH was about to introduce a new single search environment. It remains to be seen how well it functions. There are many other local and national health-related organisations with useful websites. This article will consider and evaluate a selection of the most useful.
Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom: www.fphm.org.uk
There are a range of independent organisations aimed at promoting public health, and setting and developing standards for practitioners in the field. These professional bodies provide qualifications to members, run symposia and training courses, and publish journals, books and reports. The web presences of these organisations vary in terms of quantity and quality of resources, but a good place to start is the Faculty of Public Health.
The three key areas of activity for the multidisciplinary Faculty of Public Health are: professional affairs; advocacy and policy contribution; and education and standards; and the huge quantity of resources that can be found on this site support these areas. The website is easy to use, with a permanent navigation bar on the left-hand side, as well as ‘breadcrumbs’ along the top of the screen to let you see at a glance which section you are in.
Full membership of the faculty is by examination, and regulations, timetables, and fees can be found on the site.However, even if you are not able to become a member, there are plenty of useful resources available. For a start, there is some basic information about what public health means, what public health professionals do, and advice on how to move into this profession. For those who are already working in this area the faculty’s Standards Committee has produced a series of documents on good public health practice, which are available in PDF or Word format. These include guidance on appraisals for public health specialists and physicians, frequently asked questions on revalidation, and general standards for organisations with a public health function.
There is a range of publications available from briefing statements and press releases to a history of public health. There is a free online newsletter, in addition to the Journal of Public Health, which is available to members. Freely available reports cover a wide range of subjects fromhomelessness to obesity. There is an extremely comprehensive audit toolkit accessible from the ‘CPD’ (continuing professional development) section of the site, which takes you through planning an audit, measuring current performance, implementing changes and ensuring that improvements are maintained. This is a superb resource that includes pro forma for every aspect of service improvement, and is essential viewing for anyone considering a public health audit.
This section also includes a CPD portfolio and details of a faculty scheme for professional development, and other areas of the site cover events’ programmes, web-based discussion groups for specialist interests, and prizes for outstanding contributions to public health research or practice. The quantity and quality of resources on this site cannot be overstated.
Links to a variety of affiliated organisations are provided, and this makes a useful starting point for exploring other professional bodies. Worth mentioning is the Royal Society for the Promotion of Health (RSPH: www.rsph.org/), which is the UK’s longestestablished public health organisation and has a particularly comprehensive events diary available online. The RSPH provides certification and qualifications in public health, as does the Royal Institute of Public Health, whose site can be found at www.riph.org.uk/. The UK Public Health Association (www.ukpha.org. uk/) is another professional body for staff working in this area, and includes links to a number of interesting resources on health inequalities, communicable diseases and mental health. They also provide access to a World Health Organization publication on the state of health in the UK.
Public Health News: www.publichealthnews.com/
Public Health News is a weekly magazine that is produced in collaboration with the professional bodies listed above, and is therefore able to report the latest news from the heart of the public health community. The website is updated as every new issue is published, and a weekly visit will ensure that you are kept up to date with the most recent developments in public health. Conferences and events, parliamentary reports and bills, and newly published research are all reported on, and implications for practitioners are highlighted.
There is also a large jobs section, and in case you forget to check the site regularly it is possible to register online (free of charge) to receive news in your email, as well as job alerts tailored to your profession and region.
The site also includes feature articles, on topics as varied as the public perception of health professionals, the targeting of children by the junk-food industry, and workplace stress. Rounding out the site is a forum for discussion of how to tackle current public health issues. Electronic networking for the exchange of ideas is an extremely valuable and currently under-used form of professional development. Sharing and learning from experiences in this way will raise the quality of care throughout the country, as public health professionals share best practice. It is easy to register for the forum, and although usage is still relatively low, the frequency of postings is increasing.
TheGovernmentWhite Paper: Saving Lives: our healthier nation announced the establishment of a public health observatory in each of the NHS regions, whose task would be to monitor trends in disease, highlight areas for action and identify gaps in the knowledge of UK health. The observatories carry out projects in both research and health promotion, and draw together information from different sources.
While areas such as teenage pregnancy, coronary heart disease and primary care are priorities for all the observatories, other policy areas have been assigned to particular regional leads. Each public health observatory (PHO) must develop an inventory of data sources, methods, expertise and key contacts in their particular area. The Association of Public Health web address given above acts as a gateway to the websites of each of the local observatories, as well as providing a central repository of progress reports and an archive of work.
The coverage and usability of the individual PHO websites vary considerably.The South East PublicHealth Observatory (SEPHO: www.sepho.org.uk) site includes a particularly large and well constructed database of resources that can be searched or browsed by speciality, or geographical location. The results are divided into: collections, reports, data and tables, contacts, methods, news and events, and discussions. Item references include a brief description, publication date, and the coverage of the resource, so that users can see at a glance how useful each will be.
The public health observatories offer a great selection of research-based information, whatever region you are in, and are particularly useful when looking for statistics to inform a healthcare policy decision.
Although PHeL was originally launched in 2002, the current version of the site went live quite recently in July 2004. The new look is easy on the eye (unlike its big brother the NeLH), although navigation is still something of a struggle due to ambiguous headings, poor section labelling, and a lack of explanatory text. The PHeL has been developed by the Health Development Agency (HDA:www.hda-online.org.uk/)which is the national authority on what works to improve people’s health and reduce health inequalities. This is a very useful site in its own right.
In essence, PHeL acts as a gateway to a wide variety of public health information. The ‘Policies’ section provides easy access to public health policy information published since 1997, and is searchable (or browse-able) by government department. The information relates to England only, but there are links to sites covering Northern Ireland, Scotland and Wales. ‘Evidence and Data Sources’ provides access to the HDA’s evidence briefing documents, which review all the available evidence on a public health topic such as breastfeeding or drug-use prevention, as well as numerous other research-based documents and systematic reviews. Links to freely available electronic journals can also be found here.
‘Case studies’ in the ‘Knowledge into Action’ section of the site provides details of initiatives and projects from all across the country, along with contact details for the organisers. Initiatives include educational programmes, community projects, equipment loan schemes, and a host of others, organised by healthcare area. Finally, a range of links can be found under ‘Networking’, to public health events, organisations, and miscellaneous web resources. The PHeL is packed full of links to useful sites, every one of which has been quality appraised and summarised for quick assessment. Although browsing the site is not as easy as it could be, there is a search facility with an advanced search that lets you specify the health topic, target population and health setting you are interested in.
Topics within public health
Public health is a particularly large and nebulous subject with a large variety of subtopics, each of which is supported by numerous organisations (most of whom have a web presence). Useful sites can be found covering everything from the environment to dental health. The following four sites are key resources for smoking cessation, occupational health, nutrition, and midwifery respectively, and give a good indication of the resources that are available within public health specialities.
ASH is a public health charity whose aim is to sharply reduce and eventually eliminate the health problems caused by tobacco. Its website links to a comprehensive news service that pulls together all references to smoking and anti-smoking initiatives out of the international press (although the default state is ‘UK news’ only). This database of news stories is well constructed to allow browsing by a wide variety of subcategories, from ‘cancer’, ‘asthma’, and ‘COPD’, to ‘lawsuits’, ‘dining’, and ‘fashion’. There is also a separate section devoted to press releases.
Visitors to the site can also download fact sheets prepared by ASH aimed at raising awareness of the issues surrounding smoking cessation, and view statistics compiled by the Department of Health, the World Health Organization, and others. In addition to these resources the site contains Powerpoint presentations and other visual aids, reports and literature reviews conducted by independent bodies, and tobacco-related collections in journal databases. There are numerous links giving help and advice to those wishing to give up smoking.
The aim of the HSE is to ensure that risks in the workplace are properly controlled in order to protect people’s health. It has responsibility for regulating almost all the health and safety risks arising from work in Britain, and each risk has its own homepage within the site.
These pages cover: advice for workers; advice for employers; case studies; news items; and links to further resources. Many of these health and safety topic-specific pages are run by special units within the HSE, and contact details are provided for these groups. Alternatively, if you don’t want to browse by risk factor, you can go to the page of a specific industry for answers to frequently asked questions and references to guidance documents. The site even provides an opportunity for workers to become involved in discussions to influence health and safety policy.
The British Nutrition Foundation interprets and disseminates scientifically based nutritional knowledge and advice. It produces publications, runs conferences and seminars, and has developed a food and nutrition programme for use in schools. The website includes fact sheets on diet through life (broken down for pregnancy, babies, school children, adolescence, etc), and all sorts of information on the links between diet and health. Caffeine, salt, the role of iron, vegetarianism, and much more are covered. There is a wealth of information on different foods and ingredients, and an entertaining section on wartime rationing.
This is good place to come for digests of the latest news on the subject, and there is also a comprehensive collection of resources for promoting healthy eating to primary and secondary school children, which includes posters, presentations and quizzes. And of course there are numerous links to other organisations campaigning for food standards, good nutrition, and the fight against obesity.
This site covers the broadest possible range of midwifery practice and pregnancy topics, from evidencebased practice to relationship advice. Half the pages are focussed on supporting parents, and include FAQs and birth stories, a section for new fathers and a (payas- you-go) professional midwifery advisory service.
The other half of the site is for midwives and healthcare professionals. There are pages devoted to improving professional practice, with links to national guidelines, research databases, and a subset of the Cochrane library devoted to pregnancy and childbirth. The user is directed to a number of professional forums for the discussion of issues related to midwifery, and there are online training sessions to improve your search skills. Working life is not neglected either; not only can job listings be found on the site, but also products for midwives, and even a ‘pamper zone’ dedicated to perfecting the work–life balance. This is an interactive and light-hearted site that still contains much of value to help improve the patient experience.
Although the number of sites specific to public health is still relatively small (given its prominence on the national agenda), some very high-quality sites do exist. The range of resources available from these sites is large. They range from the strictly evidence-based guidelines and systematic reviews, to individual research reports and health promotion material, all the way down to job listings and career advice. The sites listed above provide a good starting point, and if you need information related to a particular health topic, the Public Health electronic Library will provide links to the most useful organisations.
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