County Health Rankings & Roadmaps, A Healthier Nation, County by County

The County Health Rankings models and measures

Our Approach

The County Health Rankings model of population health

What can I do?

Action Center

Explore guides and tools for improving health.

What Works for Health

Explore programs and policies that work!

What can I learn from others?

Reports

Key findings from the last four years of County Health Rankings and other national reports.

County-by-County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Choosing Your Strategy

Using Evidence Ratings

Evidence of effectiveness can help inform a ‘short list’ of strategies to consider more closely in your community. The stronger the evidence of effectiveness, the more certain you can feel that a strategy will work, and often, the farther you can stretch your resources.

A strategy rated Scientifically Supported has stronger evidence of effectiveness than a strategy rated Some Evidence which, in turn, has stronger evidence than a strategy rated Insufficient Evidence or Expert Opinion. Strategies with each of these ratings are generally more likely to work than those rated Mixed Evidence, and always more likely to work than those rated Evidence of Ineffectiveness.

Strategies rated Mixed Evidence have been shown not to work in some circumstances, and require careful consideration before implementing. Strategies rated Evidence of Ineffectiveness have consistently been shown to cause harm or not to work and are simply not good investments. You can learn more about how we assign ratings here.

The less robust the body of evidence supporting a strategy’s effectiveness, the more important it is to evaluate the effects of that strategy and share your results. 

Innovation

Understanding the body of evidence in your area of interest can help inform decisions about when to implement ‘tried and true’ strategies and when to be more innovative. When deciding whether to implement tried and true strategies, it is helpful to consider the following questions:

  • How similar is your target population (e.g., adolescents, seniors, or people with low incomes) to the population(s) the strategy has been shown to benefit?
  • How similar are your goals to the outcomes the strategy has been shown to change? (i.e., does the strategy's evidence of effectiveness rating apply to the outcome that matters to you?)
  • Can you implement the strategy just as it was studied and, if not, are there resources to confirm your approach is effective too?

Innovation is an important approach to problem solving—all strategies rated Scientifically Supported were, at one time, untested ideas. When you decide to be innovative, understanding what has been shown to work and what hasn’t can help ensure that your creative approaches will succeed. Evaluating these approaches, and sharing your results with others, can help build successful strategies for the future.

Community Context

Whether you are considering a ‘tried and true’ strategy or a more innovative approach, it is important to consider your community’s culture, priorities, and resources along with evidence of effectiveness. For example:

  • How feasible is it to implement your preferred strategy in your community?
  • Are there resources available to implement the strategy? Political will to support it?
  • Is your community ready for the strategy? Will they support it?

Involving a broad group of stakeholders, including local data and subject matter experts and members of the community you want to serve, can help you select the best strategy for your community.

Tools for Action

Throughout What Works for Health, you’ll find examples of communities putting strategies in action along with strategy-specific toolkits, model language, and implementation guides to help you get started.

The Roadmaps to Health Action Center also provides in-depth guidance to help: