Learning and knowledge-production for public health: a review of approaches to evidence-based public health

Public health needs to be evidence-based if it is to be done correctly, whi ch means that learning and knowledge-production for public health must be c omprehensive and include knowledge from four different domains: distributio n of health, determinants or causal web, consequences, and intervention met hods. Specification of development trends in cardiovascular prevention poin ts at four generations of preventive programs; these include a clinical, a bioepidemiological, a socioepidemiological, and an environmental and policy -oriented generation. Generations differ in focus and strategy, in knowledg e base - the art of making an impact - and evaluation. Comprehensive public health programs often comprise components from different generations, lead ing to the need for an expanded model for research and evaluation. There is an urgent need for learning and knowledge-production using both quantitati ve and qualitative approaches for developing the evidence base for public h ealth action. In addition, epidemiological knowledge is necessary for makin g appropriate priorities.