ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1620514
This article is part of the Research TopicInnovative Strategies for Urban Public Health Resilience in Crisis SituationsView all 24 articles
Canadian Public Health Experiences with Evidence during COVID-19 and a New Framework for Assessing Evidence in Emergencies
Provisionally accepted
- 1Queen's University, Kingston, Canada
- 2Carleton University, Ottawa, Canada
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Background: Public health emergencies like COVID-19 require public policy and practice decisions at a time of uncertainty and rapidly changing science. Methods: We conducted qualitative, phenomenological interviews with 25 senior Canadian public health leaders at local, provincial, and federal levels. Interviews explored how evidence was assessed, interpreted, and utilized during Canada's COVID-19 pandemic response. Data analysis followed rigorous inductive coding to identify key themes. Results: Participants highlighted limitations in traditional evidence hierarchies, emphasizing instead the critical role of timely, context-specific information such as predictive modeling, local surveillance data, and stakeholder insights. Officials described dynamically balancing methodological rigor with evidence credibility and applicability. We propose the Methodology-Credibility-Applicability (MCA) Evidence Framework, emphasizing simultaneous assessment across these three dimensions. Discussion: We document the experiences of public health leaders during the COVID-19 crisis, focusing on the assessment and use of evidence in decision-making. The results challenge established hierarchies for assessing evidence and highlight the need for flexible, multidimensional frameworks for evaluating evidence during crises.
Keywords: COVID-19, Evidence-based policy, Evidence hierarchy, public health decisionmaking, Crisis, uncertainty, Projection models, Canada
Received: 29 Apr 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Cotton, LaBarge and Nordstrom. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Christopher Cotton, Queen's University, Kingston, Canada
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