Evidence-based public health: challenges and opportunities

This thesis contains eight studies, all of which are concerned with the generation and/or use of evidence to inform public health policy and practice in New South Wales (NSW).The first three studies use surveillance data to better understand the epidemiology of certain notifiable diseases in NSW and make recommendations for targeted public health action. The first study explores the association between selected enteric and vector-borne diseases and overseas travel, in particular return to one’s country of origin. The second study extends this analysis with respect to one disease (typhoid fever) to consider the importance of reason for travel in disease risk. The third study examines trends in invasive meningococcal disease in NSW, with a particular focus on people aged 65 years and over. The fourth, fifth and sixth studies are concerned with infectious disease control. The fourth study uses evidence from the scientific literature and relevant guidelines to develop a simple tool for use by general practitioners in diagnosing and managing patients with a zoonotic illness. The fifth study describes the investigation of an outbreak of gastrointestinal illness in South West Sydney, and demonstrates how decisive public health action can be taken even while understanding of the cause of the outbreak is evolving. The sixth reviews data collected at clinics held at Sydney International Airport to examine the effectiveness of airport screening in detecting cases of pandemic influenza A(H1N1)2009.The final two studies are evaluations of health promotion interventions with culturally and linguistically diverse communities. Mixed methods were used in the seventh study to assess the effectiveness of a hepatitis C campaign in generating information perceived as useful by the target audience in the Arabic, Chinese and Vietnamese press. The final study evaluates the impact of a multi-lingual oral health DVD in Arabic and Dari speaking refugees, by comparing relevant knowledge and be