Background: An evidence-based approach is needed to effectively address the gap between population health goals in the United States and current morbidity and mortality rates. Recently, the authors developed an index to allow researchers to assess the frequency of evidence-based decision making (EBDM) practice in LHDs. The first descriptive analysis was conducted with data from the NACCHO 2010 Profile Study of Local Health Departments (LHDs). The current research was designed to assess changes in the percentage of LHDs using EBDM practices from 2010 to 2013.

Research Objective: To identify changes in the frequency with which LHDs carried out EBDM practices from 2010 to 2013.
 Data sets and sources: 
2010 NACCHO Profile of LHDs Survey, 2013 NACCHO Profile of LHDs Survey. The NACCHO Profile Surveys are conducted every 2-3 years. All LHDs in the country are invited to respond.

Study Design: Cross-sectional survey

Analysis: The research reported here used an index of EBDM practices previously developed by the authors. Descriptive analysis was used to identify the frequency with which LHDs used each EBDM practice comprising the index and the frequency of the total number of practices they used in both 2010 and 2013.

Principal Findings: Overall, the percentage of LHDs using EBDM practices increased from 2010 to 2013. Specifically, in 2010, forty-five percent of LHDs used three EBDM practices or fewer; 41.5% used four or five EBDM practices; and 13.5% used six or seven practices. In 2013, thirty-seven percent of LHDs used three EBDM practices or fewer; 39% used four or five practices; and 23.7% used six or seven practices. The overall increase in numbers of EBDM practices used by LHDs was largely driven by increases in percentages of LHDs that use the County Health Rankings (37.8% to 66.5%) and that use The Guide to Community Preventive Services (26% to 41.2%)(Table 1).

Implications for PH Policy and Practice: The results reveal that there is an increase in the use of EBDM practices in LHDs from 2010 to 2013. More research is needed to understand details of how LHDs implement EBDM strategies and use them to innovate the practice of public health.