What is an Evidence-Based Practice and Why should you care?

I first heard the phrase “evidence-based” about fifteen years ago, when I was working as a doula and parent educator in Austin, TX. One of the OBGyns wore a button with the phrase, “I practice evidence-based medicine.” When I asked him about it and he said he practices medicine based on the most current scientific information available, I naively asked: “Don’t all doctors?” He said, “no, they do not”! He was on a mission to change this! He lectured, wrote, and talked to anyone that would listen to him about the necessity for this change. Over the next few years, I provided prenatal and/or postpartum support to over 1000 women (as a doula, childbirth or parent educator). Hearing the birth stories and witnessing the poor birth outcomes many experienced, it became crystal clear that indeed we have a problem in the US and evidence-based medicine is not being implemented. The US currently has one of the highest rates of maternal deaths in the world and our rates are rising! We aren’t doing great in the area of infant mortality either. In the CDC’s own report (quick get it while it is still available); the US ranked 26th out of 29 of the Organisation for Economic Co-operation and Development (OECD) countries in infant mortality. With the awareness that many other countries are doing significantly better than we are, it is also clear that it is not because we don’t have the knowledge or resources to assist women and babies so they thrive (or even live!). Choices are being made! This is just one example of the importance of demanding evidence-based medicine.

Table1 EBP

Infant Mortality Rates of OECD countries (Source: www.cdc.gov)

Now, imagine the unthinkable. One of your loved ones needs medical attention requiring immediate and life-saving surgery. Would you want a surgeon that uses the techniques that have the most research behind their success and ability to save your loved one’s life? Or would you go with the surgeon that you’ve known for a long-time, that prefers to operate the way they “have always done it”– even if that means the chance of your loved one dying is higher? Is that a chance you would take? These may seem like obvious examples, because they are high stakes and the risk/outcomes are immediate. However, evidence-based practices (or EBPs) are important in many fields besides medicine. As an educator and research scientist, along with my colleagues, I have worked tirelessly to change the culture around EBPs in schools, community service agencies, and at the legislative level to help bring awareness about why they should be standard practice!

Evidence-based-practices help people reach their highest potential and save lives!!

Simply put, evidence-based practices are those services, interventions, strategies, and/or programs that have strong scientific evidence that they produce the desired outcome. One study alone is not enough for a practice to become “evidence-based,” studies are replicated, programs/practices are implemented skillfully, and they are evaluated. Practices do not become “evidence-based” because one person or one team thinks they are “great” or they have a “feeling” about the potential. If you would like to learn more about how to incorporate EBPs into your work, it is likely your professional organization offers training or can help you find resources. There are also learning communities online that focus on implementing EBPs.

So now that you know a little about EBPs and why they matter. Are you concerned, that the Trump administration has forbidden the terms “evidence-based” (and “science-based”) from use in official documents? The CDC is being encouraged to use the language that the “CDC bases its recommendations on science in consideration with community standards and wishes,” what happens when the “community standards and wishes” are based in fallacy, racism, sexism, and/or ignorance? Think back to the scenario of your loved one needing surgery would you want the surgeon operating out of vague “standards and wishes” that your loved one comes through the surgery? Or do you want them to rely on methods that are scientifically proven?

We have seen mounting and blatant disregard for science within this administration. Refusal to believe in climate change – willfully ignoring 15,000 scientists from 184 countries! This is a glaring example of how information does not lead to a change in belief. (See also:Why facts don’t change our minds). This level of disconnect between scientific fact is unnerving when it occurs within the average person, but when it is the MO of arguably the most powerful person on the planet we should be extremely alarmed! Turning away from science in this part of human history is reckless and extremely dangerous! At no point in time has it been more critical for humans to make scientifically sound decisions! The future truly is at stake.

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And on that heavy note, I’ll share my mantra that gets me through this incredibly dark time ­– I cannot single-handedly make everything in the world better but I can do my very best to not cause harm. I will continue to use evidence-based practices when working with youth and families and if funding for research continues, I will continue to conduct studies to generate new EBPs. A small step I’ve taken today was to create a handout about EBPs to share with other educators (You can download it here). For those not familiar with EBPs, I hope I have given you enough information for you to understand why removing the language of “evidence-based” is dangerous. If not, feel free to begin a respectful discussion in the comments.

  7 comments for “What is an Evidence-Based Practice and Why should you care?

  1. December 18, 2017 at 6:37 am

    That is very frightening. I am an evidenced based practitioner. frightening times

    • December 18, 2017 at 8:07 am

      Agreed! Thank you for being an evidence based practitioner! It is so important!

  2. December 18, 2017 at 6:54 am

    Thank you for keeping this in the conversation!

    • December 18, 2017 at 8:06 am

      Thank you! I do hope it sparks conversation and people get very vocal about this topic!

  3. January 19, 2018 at 1:16 pm

    It really does amaze me that as much research as we have, that we don’t use it to practice evidence based medicine. I realize things change as we learn more but to continue practicing based on faith or ideas with no backing, makes absolutely no sense. But then again we do live in times where science is not considered real but the rantings of people with no clue are. Thanks for bringing this up 🙂

  4. February 8, 2018 at 11:17 am

    I’m a former registered health professional (Kinesiologist) and a woman who chose to have all three of my children at home, using midwives and a doula, after careful consideration of the evidence. As such, I’m absolutely horrified at the ignorance that several OBGYNs display with regards to the safety of home births.

    OBGYNs who refused to follow evidence-based practice because of their own belief systems fuel the media’s misrepresentation of real, safe, physiological birth, whether in hospital or at home, and it drives me nuts.

    I don’t live in the U.S., but banning the words “evidence-based” seems to me to be a completely ridiculous, if not dangerous decision. Also, I thought this was the “land of the free?” How does banning words fit into that narrative?

    Thank you for this post; I think more health practitioners should read it!

    • R.Harwick,PhD
      February 8, 2018 at 7:12 pm

      Thank you for your thoughtful words. The current attack on science in the US is appalling. I ask myself everyday if the US will ever be the land of the free. I’m still waiting for that liberty and justice for all promise too…

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