A qualitative exploration of evidence-based decision-making in public health practice and policy: the perceived usefulness of a diabetes economic model for decision-makers

Purpose: The purpose of this paper is to explore the perceived usefulness of a diabetes economic model as a potential tool for aiding evidence-based decision-making in public health practice. Methods: Fifteen semi-structured interviews and two focus groups with four participants each were conducted with health and management professionals working in one public health department in a local council. Data were analysed using inductive thematic analysis to generate four themes. Findings: Findings reflect the attitudes and beliefs of a diverse staff group situated in public health services. They demonstrate that the economic model had perceived usefulness, and participants reported positive views regarding the principles of economic modelling for decision-making. The model was perceived as useful but potentially problematic in practice due to organisational constraints linked to limited organisational resources, restricted budgets and local priorities. Differences in the institutional logics of staff working in public health and stakeholders from local government were identified as a potential barrier to the use of the diabetes model in practice. Discussion: The findings highlight anticipated challenges that individuals tasking with making decisions for public health practice and policy could face if they selected to implement an economic modelling approach to fulfill the evidence needs of decision-makers. Previous studies have revealed that healthcare decision-makers would find evidence around the economic impacts of public health interventions useful, but this information was not always available in the context or format required. This paper provides insights into how staff working in public health perceive economic modelling and explores how they consider evidence from a diabetes model when making public health practice and policy decisions.