Developing Interventions

Interventions are control and prevention measures that public health officials select and implement at one or more points in time after initiating a field investigation in response to an acute public health problem. Regardless of the nature of the problem, an immediate need exists to understand what is happening and to recommend and implement control and prevention measures that are scientifically justified and acceptable to the community. Public health officials must recommend these actions often without incontrovertible epidemiologic proof of a causal association between the putative source or cause of the problem and occurrence of exposure and disease or injury. Under such circumstances, the key question for the field epidemiologist and decision-makers is: “How much epidemiologic certainty is required before initiating action?” This chapter discusses the decision-making process regarding interventions during the course of epidemiologic field investigations and concludes with a summary of actions relating to interventions that should be considered at each progressive stage of the field investigation.