The Centers for Disease Control and Prevention (CDC) maintains the Guide to Community Preventative Services to be used as a primary source for evidence-based programs and policies to improve health and prevent disease in a community. The resource includes systematic reviews, evidence-based recommendations as well as indicating gaps in evidence and areas for further study. The guide serves as a catalyst for public health collaboration and as a credible resource for effective population-based approaches. The guide reviews risk behaviors and specific conditions such as those below:
- Tobacco Use
- Alcohol Abuse/Misuse
- Other Substance Abuse
- Poor Nutrition
- Inadequate Physical Activity
- Unhealthy Sexual Behaviors
- Vaccine Preventable Disease
- Pregnancy Outcomes
- Motor Vehicle Injuries
- Oral Health
- Social Environment
Interventions addressed in the Community Guide include increasing the availability of services, such as a worksite vaccination program; healthcare system changes, such as targeted messaging; laws and policies, such as child safety seat laws and environmental changes to improve health, such as the creation of walking and biking trails.
The Guide also provides models for evaluating community-based efforts toward increasing preventive services. The U.S. Task Force on Community Preventive Services applied these models to methods for increasing community demand for screening for breast, cervical and colorectal cancers, presenting evidence that screening for breast cancer and cervical cancer has been effectively increased with the use of client reminders, small media and one-on-one education. Screening for colorectal cancer by blood stool tess was increased with client reminders in primary care practics and small media (e.g., DVDs, brochures, posters, pamphlets). The figure below shows the evaluation of breast cancer screening.
Increase access by reducing out-of-pocket costs.
Increase demand with small media and one-on-one education.
Flowcharts from: Baron RC, Rimer BK, Coates RJ, et al. Am J Prev Medicine 2008
Community-based participatory research is one approach that is used to study complex health disparities. Health disparities may be related to differential access to care; disparities can also change with location and time.