Implications of evidence-based practice for community health.

Evidence-based practice, developed in clinical medicine, is being applied to community health programs. Barriers to implementation of evidence-based practice noted in clinical medicine are likely to exist in community health settings and may be complicated by the nature of community health programs. These barriers include accessibility and availability of relevant data, social and political considerations of program decision-making, and conflicting expectations for evaluation research. This paper discusses barriers to both amassing evidence for practice and using evidence for decision-making in community health. The potentialfor conflict between practice goals set by evidence-based thinking and those set by community health organizations is also discussed. Implications for evaluations of community health programs are raised and recommendations for improving access to and use of evaluation information are made.