Objective This study evaluates the impact of telelactation (video breastfeeding support visits) on breastfeeding satisfaction and the likelihood of breastfeeding another child. Breastfeeding satisfaction is a key person-centered outcome and indicator of breastfeeding success and is associated with a longer duration of breastfeeding. Methods This randomized controlled trial randomized pregnant individuals to receive a telelactation app (intervention group) or an infant care e-book (control group). The main outcome measured was self-reported breastfeeding satisfaction at 24 weeks postpartum, while a secondary outcome assessed the likelihood of breastfeeding another child. We estimated unadjusted and adjusted linear regression models for the effect of telelactation on breastfeeding satisfaction and logistic regression models for the effect of telelactation on the likelihood of breastfeeding another child. We also examined whether the effects of telelactation differed by breastfeeding problems experienced. Results Results indicated that telelactation significantly improved breastfeeding satisfaction scores by 0.53 points (confidence interval (CI): [0.04,1.04], P = 0.04) and increased the likelihood of participants being very likely to breastfeed another child by 7% (risk ratio = 1.07 [CI: {1.01, 1.14}, P = 0.02]; adjusted risk ratio = 1.07 [CI: {1.01, 1.14}, P = 0.03]). We found no significant differences in outcomes based on race or ethnicity. Further analysis highlighted that telelactation was particularly beneficial for participants experiencing common newborn/premature feeding issues. Conclusions Telelactation can enhance breastfeeding experiences and satisfaction, with implications for public health strategies targeting new parents.

Although libraries historically have focused on providing access to information, many libraries have expanded their scope to offer additional resources to their communities, such as computer and internet access, food bank programming, and language and literacy classes. Libraries tend to be trusted and welcoming spaces in which individuals from diverse backgrounds access valuable programs and resources at no cost. Therefore, embedding mental health support in library programming can feel like a natural fit, especially for communities with growing mental health needs and a lack of traditional mental health resources. In this toolkit, the authors draw from Libraries for Health (L4H), a mental health pilot program that aims to build community capacity for mental health and well-being by embedding mental health support in public libraries. L4H emerged from a partnership among St. David’s Foundation, RAND, Via Hope, and ten public libraries in central Texas in response to critical mental health needs and a shortage of mental health care providers. In collaboration with members of this partnership, RAND researchers developed this toolkit to share lessons learned in the L4H pilot. This toolkit is designed to help librarians identify and implement mental health supports within libraries to support their patrons’ mental well-being. It starts with a description of the rationale for incorporating mental health supports in libraries and a brief summary of how libraries approached this effort in the L4H pilot. The toolkit focuses on guiding librarians through the steps of successfully adding new mental health supports within their library environments.

Note: Several tables were revised on April 11, 2025, to correct some column headers. In this report, the authors present analyses of production cost differences among privately funded, market-rate apartments and publicly subsidized affordable apartments in California, Colorado, and Texas using a sample of cost data on more than 140 completed projects. The report highlights large cross-state differences in production costs—for example, the average market-rate apartment in California is roughly two and a half times the cost of a similar apartment constructed in Texas on a square-foot basis—and regional differences within California, where costs in the San Francisco Bay area are roughly 50 percent higher than costs in San Diego. The report also focuses on the specific contributions of different cost categories to these overall differences and seeks to identify related policy reforms—such as requiring faster approval times, removing complex design requirements that do not relate to safety or habitability, and reducing mandatory fees assessed on new multifamily housing—that can lower production costs and increase housing affordability in California.

In this report, the authors present analyses of a large sample of production cost data for both privately funded, market-rate apartments and publicly subsidized affordable apartments in three states: California, Colorado, and Texas.

Federal spending on evidence-based practices (EBPs) provides significant returns by offsetting billions of dollars in societal impacts each year. Practices are deemed evidence-based because they have demonstrated their effectiveness in addressing various social and health-related challenges. Federal agencies often invest in EBP delivery through discretionary grants, but there is limited guidance on how to optimize these grants to support large-scale EBP implementation. To address this gap, the authors held focus groups with federal and state agency officials (using the findings from ongoing RAND research to frame their discussions) to gather and synthesize their recommendations on how to optimize federal grantmaking for EBP implementation. With the focus group participants, the authors identified seven policy recommendations for federal officials to consider when designing, awarding, and executing grants for EBP implementation, including capacity-building in service delivery organizations to sustain EBPs after grant funding ends. The authors also present real-world case examples to illustrate how funding agencies have put each recommendation into practice.

In this report, the authors present seven policy recommendations to optimize federal investment into large-scale implementation of evidence-based practices in health and social services that they identified with federal and state agency officials.

Municipalities, law enforcement agencies, and the private sector can come together to detect, deter, and mitigate threats to the public from terrorism and other acts of targeted violence.

We estimate the cost effectiveness of corequisite English developmental education at community colleges compared to a traditional prerequisite pathway. Our context is the randomized controlled trial conducted by Miller et al. (2022) that estimated the effects of three different approaches to English corequisites implemented in five Texas community colleges. The main drivers of differential costs across pathways and colleges are the number of credit and contact hours in each pathway, class sizes, and the type of faculty used to teach courses (adjunct or full-time). Corequisites are less expensive than prerequisite pathways in two colleges, they are roughly similar in two other colleges, and they are much more expensive in one college. Miller et al. (2022) find that corequisites induced more students to pass the required college-level English course in all colleges but find no impact on persistence in college. From students' point of view, corequisites should be preferred because tuition payments are lower, and they entail a higher likelihood of success.

We estimate the cost effectiveness of corequisite English developmental education at community colleges compared to a traditional prerequisite pathway.

Telelactation – synchronous video visits with lactation consultants – can reduce disparities in access to professional breastfeeding support and improve breastfeeding experiences and rates. Prior literature on phone or app-based breastfeeding support has described use patterns for breastfeeding hotlines and apps that provide educational content. Telelactation video visits are now widely available. Although as many as a third of new parents used telelactation in 2020-2021, little is known about how individuals engage with these services. We described use patterns among new parents offered telelactation as part of a randomized controlled trial designed to assess effectiveness of telelactation across diverse populations of birthing people.

Telelactation – synchronous video visits with lactation consultants – can reduce disparities in access to professional breastfeeding support and improve breastfeeding experiences and rates. Prior literature on phone or app-based breastfeeding support has described use patterns for breastfeeding hotlines and apps that provide educational content. Telelactation video visits are now widely available. Although as many as a third of new parents used telelactation in 2020-2021, little is known about how individuals engage with these services. We described use patterns among new parents offered telelactation as part of a randomized controlled trial designed to assess effectiveness of telelactation across diverse populations of birthing people. Read More Subscribe to the Policy Currents newsletter Email Subscribe Topics Health EquityNeonatal CareRandomized Controlled TrialTelemedicine Document Details Document Details Copyright: Elsevier IncPublisher: American Journal of Obstetrics & GynecologyAvailability: Non-RAND Year: 2024 Pages: 5 Document Number: EP-70684 Research conducted by RAND Social and Economic Well-Being RAND Health Care This publication is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

Presentation This Policy Brief aims to propose specific modalities that can strengthen the review processes of the Convention on Biological Diversity (CBD). It advocates for a purpose-oriented, multi-evidence, and multi-stakeholder approach that not only tracks progress but also fosters constructive dialogue, identifies solutions, and enables transformative actions to meet the 2050 goals to achieve a stepping up of efforts if needed (‘ratcheting effect’) towards and beyond 2030. These recommendations are critical for ensuring that the GBF’s ambitious goals are effectively implemented, particularly through inclusive and transparent global reviews. Supplementary material: Building blocks of the biodiversity global review's multidimensional approach and their challenges Key Messages The multidimensional approach proposed by COP15 represents a significant step forward in closing the “implementation gap” by enhancing the coherence between international ambitions and national efforts. Review mechanisms allow the international community to track progress and adjust strategies before the 2030 deadline, thereby reinforcing accountability and enhancing global biodiversity governance. A purpose-oriented global review aims not only at tracking progress but also identifying solutions, barriers, and transformative pathways for the effective implementation of the GBF. It should enhance learning and enable course corrections to achieve a ‘ratcheting effect’ while staying within the non-punitive approach adopted in the GBF. Integrating diverse knowledge systems (scientific, technical, and stakeholder inputs) into the review process will provide a more comprehensive understanding of the progress, challenges, and opportunities in implementing the GBF. A review process that includes the perspectives of civil society, indigenous groups, private sector actors, and local communities is crucial for building an inclusive, participatory approach to biodiversity governance. Dedicated dialogues between stakeholders and Parties should be institutionalized within the review process. To ensure a robust global review, it is essential to anticipate potential gaps and challenges in the implementation of the GBF’s review mechanisms. Proactive efforts must be made to identify and fill these gaps, whether in data collection, national reporting, or stakeholder engagement. By promoting a culture of continuous improvement and transparency, Parties and stakeholders can strengthen the overall effectiveness of the review process and enhance global biodiversity governance.

Longstanding inequities in cancer prevention and control require novel approaches to improve evidence-based intervention implementation. Exploring and elevating the perspectives of cancer prevention and control practitioners working to advance health equity and equitably implement evidence-based interventions is an important yet underutilized step among researchers working in this space. The purpose of this study was to explore practitioners' perspectives of how health equity is defined and integrated into their work, challenges of advancing health equity for implementation in local settings, and associated strategies. We conducted virtual key informant interviews and focus groups with 16 US practitioners (e.g. clinicians, health administrators, public health professionals) in 2021-2022. Interviews and focus groups were audio recorded and transcribed. Data were coded using inductive content analysis and summarized into themes. Four major themes emerged: (i) how health equity is conceptualized as a process and outcome; (ii) need to shift equity mindsets; (iii) importance of community partnerships; (iv) organizational policies and strategies for fostering equity in implementation. Respondents noted the need for research and medical communities to learn about the importance and benefits of allowing communities to shape implementation to advance equity in the delivery of evidence-based interventions and outcomes. Additionally, respondents emphasized that institutional leaders should initiate changes regarding equitable implementation at the organizational- and system-levels. Respondents endorsed the need to address equity issues related to the implementation of cancer prevention and control programs, practices, and policies. Many findings can be applied beyond cancer prevention and control to support equitable implementation and outcomes more generally. Read More Subscribe to the Policy Currents newsletter Email Subscribe Topics Cancer PreventionEvidence Based Health PracticeHealth EquitySurvey Research Methodology Document Details Document Details Copyright: Oxford University PressAvailability: Non-RAND Year: 2024 Pages: 10 Document Number: EP-70645 Research conducted by RAND Health Care This publication is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

MetaDTA是一款对诊断试验准确性研究进行Meta分析的在线、交互式应用程序，该应用程序调用R软件中lme4和shiny程序包实现统计分析并建立交互式用户界面。该应用程序无需用户了解任何有关统计和编程的知识，也无需安装任何专业软件，便于无专业统计知识的用户使用。本文将重点介绍MetaDTA平台诊断试验准确性的量化、结果可视化、交互式功能等，结合实例向用户介绍该应用程序的具体操作方法，旨在帮助相关研究人员完成诊断准确性研究Meta分析、绘制汇总受试者工作特征（SROC）曲线、绘制纳入研究质量评价结果以及进行敏感性分析。

Health care providers and systems use a vast array of implementation strategies, defined as "methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program or practice," to promote evidence-based health care practices. In this document, we summarize the findings of a review to identify which of these implementation strategies are supported by evidence. Read More Subscribe to the Policy Currents newsletter Email Subscribe Related Content ResearchImplementation Strategies for Evidence-Based Practice in Health and Health Care: A Review of the EvidenceJun 10, 2024 ResearchEvidence on the Effectiveness of Implementation Strategies: A Visual ToolJul 26, 2024 Topics Biomedical ResearchEvidence Based Health Practice Document Details Document Details Copyright: Patient-Centered Outcomes Research Institute (PCORI)Availability: Non-RAND Year: 2023 Pages: 9 Document Number: EP-70568 Research conducted by RAND Health Care This publication is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

Public health policy interventions are associated with many important public health achievements. To provide public health practitioners and decision makers with practical approaches for examining and employing evidence-based public health (EBPH) policy interventions, we describe the characteristics and benefits that distinguish EBPH policy interventions from programmatic interventions. These characteristics include focusing on health at a population level, focusing on upstream drivers of health, and involving less individual action than programmatic interventions. The benefits of EBPH policy interventions include more sustained effects on health than many programs and an enhanced ability to address health inequities. Early childhood education and universal preschool provide a case example that illustrates the distinction between EBPH policy and programmatic interventions. This review serves as the foundation for 3 concepts that support the effective use of public health policy interventions: applying core component thinking to understand the population health effects of EBPH policy interventions; understanding the influence of existing policies, policy supports, and the context in which a particular policy is implemented on the effectiveness of that policy; and employing a systems thinking approach to identify leverage points where policy implementation can have a meaningful effect. Read More Subscribe to the Policy Currents newsletter Email Subscribe Topics Evidence Based Health PracticePublic HealthSocial Determinants of Health Document Details Document Details Copyright: Association of Schools and Programs of Public HealthPublisher: Sage JournalsAvailability: Non-RAND Year: 2024 Pages: 8 Document Number: EP-70551 Research conducted by RAND Social and Economic Well-Being This publication is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.

目的：了解乡村医生应对新冠疫情现状、困难及培训意愿，分析乡村医生是否具备了应对未来疫情的能力，并针对有关问题提出建议。方法：2023年3～6月，采取方便抽样对甘肃省武威市两个区县中59位乡村医生进行问卷调查，采用描述性分析和χ2检验进行统计描述和影响因素分析。结果：81%以上的乡村医生自我认知在新冠个人防护、对症治疗、基本药品使用、居家防护、中医药防治、新冠防治常识及健康教育等六方面较为熟悉，但近半数（49%）对如何判别感染患者不太熟悉；86%的乡村医生有参加新冠培训意愿，80%最倾向线上学习材料推送的培训方式，76%首选小组学习的组织方式。结论：乡村医生应对未来疫情的实际能力仍有局限性。未来还需从加强乡村医生的继续教育和改善外部环境的资源供给两方面，提高其应对未来疫情能力。

Health systems in the United States have an acute need to better understand how they can most effectively implement evidence-based practices (EBPs) to improve care for their patients. Although the definition can vary, EBPs are clinical interventions that have been tested through research andshown to improve patient outcomes. Research has shown that successfully getting EBP into routine care can require implementation strategies, defined as "methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program or practice." Many such strategies have been developed and tested, but much of the evidence for these strategies has focused on a given clinical setting or on a particular strategy. However,implementation strategies are intended to be applied across a wide range of EBPs. Thus, without a comprehensive synthesis across settings and strategies, it is difficult to understand the evidence in a broad context. This level of understanding is necessary for practitioners and others seeking to navigate the evidence across the full array of strategies to inform their choices. Therefore, this project sought to answer the following questions: 1. What is the quantitative evidence for the effectiveness of various implementation strategies to improve health, alone or in combination with other strategies? 2. What are the current gaps in the quantitative evidence for implementation strategy effectiveness? Read More Subscribe to the Policy Currents newsletter Email Subscribe Related Content ResearchEvidence on the Effectiveness of Implementation Strategies: A Visual ToolJul 26, 2024 ResearchEvidence on the Effectiveness of Implementation Strategies to Promote Evidence-Based Practices: Brief SummaryAug 1, 2024 Topics Biomedical ResearchEvidence Based Health Practice Document Details Document Details Copyright: Public DomainPublisher: Patient-Centered Outcomes Research Institute (PCORI)Availability: Non-RAND Year: 2023 Pages: 126 Document Number: EP-70493 Research conducted by RAND Health Care This publication is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations. RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.