BACKGROUND Local public health service delivery and policy-setting in England was overhauled in 2013, with local government now responsible for the complex tasks involved in protecting and improving population health and addressing health inequalities. Since 2013, public health funding per person has declined, adding to the challenge of public health decision-making. In a climate of austerity, research evidence could help to guide the more effective use of resources, although there are concerns that the reorganisation of public health decision-making structures has disrupted traditional evidence use patterns. This study aimed to explore local public health evidence use and needs in this new decision-making climate. METHODS Semi-structured interviews with Public Health Practitioners across three Local Authorities were conducted, with sites purposefully selected to represent urban, suburban and county Local Authorities, and to reflect a range of public health issues that might be encountered. A topic guide was developed that allowed participants to reflect on their experience and involvement in providing evidence for, or making a decision around, commissioning a public health service. Data were transcribed and template analysis was employed to understand the findings, which involved developing a coding template based on an initial transcript and applying this to subsequent transcripts. RESULTS Increased political involvement in local public health decision-making, while welcomed by some participants as a form of democratising public health, has influenced evidence preferences in a number of ways. Political and individual ideologies of locally elected officials meant that certain forms of evidence could be overlooked in favour of evidence that corresponded to decision-makers' preferences. Political involvement at the local level has increased the appetite for local knowledge and evidence. Research evidence needs to demonstrate its local salience if it is to contribute to decision-making alongside competing sources, particularly anecdotal information. CONCLUSION To better meet decision-making needs of politicians and practitioners, a shift in the scope of public health evidence is required. At a systematic review level, this could involve moving away from producing evidence that reflects broad global generalisations about narrow and simple questions, and instead towards producing forms of evidence that have local applicability and can support complex policy-focussed decisions.

中文翻译：

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在英格兰地方公共卫生决策中使用研究证据的障碍和机会。

背景技术2013年，英国对地方公共卫生服务的提供和政策制定进行了全面改革，地方政府现在负责涉及保护和改善人口健康以及解决健康不平等问题的复杂任务。自2013年以来，人均公共卫生经费有所减少，这增加了公共卫生决策的挑战。在紧缩的气氛中，尽管有人担心公共卫生决策结构的重组已经破坏了传统的证据使用模式，但研究证据可能有助于指导更有效地利用资源。这项研究旨在探讨在这种新的决策环境下当地公共卫生证据的使用和需求。方法对三个地方当局的公共卫生从业人员进行了半结构化访谈，专门选择代表城市，郊区和县地方政府的站点，以反映可能遇到的一系列公共卫生问题。制定了主题指南，使参与者可以反思他们的经验和参与为公共卫生服务提供证据或作出决策的决策。转录数据并使用模板分析来了解发现，该发现涉及基于初始转录本开发编码模板并将其应用于后续转录本。结果越来越多的政治参与地方公共卫生决策，尽管一些参与者以民主化公共卫生的形式受到了一些参与者的欢迎，但它在许多方面影响了证据的偏好。当地民选官员的政治和意识形态个人意味着证据的某些形式可以有利于证据表明，符合决策者的偏好被忽视。地方一级的政治参与增加了对当地知识和证据的需求。如果研究证据与其他来源（尤其是轶事信息）一道为决策做出贡献，则需要证明其在当地的显着性。结论为了更好地满足政客和从业人员的决策需求，需要改变公共卫生证据的范围。在系统的审查级别上，这可能涉及放弃产生可反映有关狭义和简单问题的广泛全球概括的证据，