Evidence of Public Health Nursing Effectiveness: A Realist Review

Public Health Nurs. 2017 Jul;34(4):324-334. doi: 10.1111/phn.12320. Epub 2017 Mar 14.


Objectives: The purpose of this realist review was to examine PHN interventions and their outcomes during the period preceding the Affordable Care Act (1990-2010), to determine what types of interventions demonstrated effectiveness, and whether these were related to target population or setting.

Design and sample: The review focused on PHN interventions with data support documented over 20 years. A search of the published literature using CINHAL, PubMed, and ancestry methods resulted in 64 articles meeting the search criteria. The researchers reviewed each article for the relevant variables; achieved consensus for each variable; and summarized results using descriptive statistics.

Results: Documented PHN interventions targeted vulnerable populations. Interventions included health education, behavior change, and screening. There was evidence of effectiveness of PHN interventions in a number of studies; however, the study limitations and variety of intervention types make overall conclusions about PHN effectiveness challenging.

Conclusions: Despite the long history of PHN working in communities to promote and maintain the health of vulnerable populations, practice outcomes have not been well documented. Further work is needed to: strengthen the methods for documenting effectiveness of PHN practice; focus on promising PHN interventions via multisite studies; and translate evidence-based PHN interventions to practice settings.

Keywords: Public Health Nursing effectiveness; Public Health Nursing interventions; Public Health Nursing practice; community health nursing.

Publication types

  • Review

MeSH terms

  • Humans
  • Nursing Evaluation Research*
  • Outcome Assessment, Health Care*
  • Patient Protection and Affordable Care Act
  • Public Health Nursing*
  • Randomized Controlled Trials as Topic
  • United States