Beyond Direct Impact
Systematic reviews are a cornerstone of evidence-based public health and there is much discussion about how this method could be improved upon for the benefit of decision-making from a systems approach. This paper, published in the International Journal of Hygiene and Environmental Health, sets forth five layers of influence to serve as a framework for the analysis of environmental health interventions and a better understanding of why interventions work or fail in different circumstances.
Rehfuess, Eva A, and Jamie Bartram. 2013. “Beyond Direct Impact: Evidence Synthesis Towards a Better Understanding of Effectiveness of Environmental Health Interventions.” International Journal of Hygiene and Environmental Health 217 (2-3) (July 29): 155–159. doi:10.1016/j.ijheh.2013.07.011.