Continuum of Evidence of Eff ectiv

Well Supported Supported Promising Direction / Emerging / Undetermined Unsupp

Found to be eff ective

True experimental 

design

Quasi experimental 

design

Quasi experimental 

design

Randomized control 

trials and metaanalysis / systematic 

review

Program replication with evaluation replication

Comprehensive

Applied studies— 

diff erent settings 

(2+)

Applied studies—

similar settings

(2+)

Some evidence of 

eff ectiveness

Expected preventive 

eff ect

Eff ect is 

undetermined

Non-experimental 

design Sound theory only No research No sound theory

Single 

group design Exploratory study

Anecdotal / 

Needs 

assessment

Program replication 

without evaluation 

replication

Partial program replication without 

evaluation replication

Partial None

Real-world informed

Somewhat 

real-world 

informed

Not real-world informed

Ineff e

True or 

experiment

Randomize

trials or 

experiment

Program re

with eva

replic

Compre

Applied st

same/diff 

settin

Eff ect Internal 

validity

Type of 

evidence/ 

research design

Independent 

replication

Implementation 

guidance

External and 

ecological 

validity

More Research Needed

The various areas and dimensions of the Continuum of Evidence of Eff ectiveness are explained in the accompanying guidance document, Understanding Evidence. A Guide to the Continuum of Evidence of Eff ectiveness, which can be downloaded from www.VETOviolence.org or ordered in hardcopy from www

National Center for Injury Prevention and ControlDivision of Violence Prevention
Understanding Evidence

Best Available Research Evidence enables researchers, practitioners, and policy-makers to determine whether or not a prevention program, practice, or policy is actually achieving the outcomes it aims to and in the way it intends. The more rigorous a study’s research design, (e.g. randomized control trials, quasiexperimental designs), the more compelling the research evidence, indicating whether or not a strategy is effectively preventing violence.

While the Best Available Research Evidence is important, it is not the only standard of evidence that is essential in violence prevention work. Two other forms of evidence are also very important when making decisions based on evidence.Experiential Evidence is based on the professional insight, understanding, skill, and expertise that is accumulated over time and is often referred to as intuitive or tacit knowledge.1 

Contextual Evidence is based on factors that address whether a strategy is useful, feasible to implement, and accepted by a particular community.2,3,4,5 

These three facets of evidence, while distinct, also overlap and are important and necessary aspects of making evidence-based decisions about violence prevention strategies. 

A Framew

Thinking Abo

Best Available R

Experiential Evidence 

Evidenc

Decision 

The Continuum of Evide

tool that clar ifi es and de

Best Available Re

1. Orleans, Gruman, & Anderson, 1999 (March 4, 1999). Roadmaps for the next frontier: Getting evidence-based behavioral medicine into practice. Paper 

Medicine, San Diego, CA.

2. Canadian Health Services Research Foundation (March, 2004). What counts? Interpreting evidence based decision-making for management and policy3. Canadian Health Services Research Foundation (May, 2005). Conceptualizing and combining evidence for health system guidance.4. Substance Abuse and Mental Health Services Administration- National Registry of Evidence Based Programs and Practices. (2008). What is Evidence Bas

http://www.nrepp.samhsa.gov/about-evidence.asp

5. Victora, C., Habicht, J. P., & Bryce, J. (2004). Evidence-based public health: Moving beyond randomized trials. American Journal of Public Health, 94, 400-4