2023 Annual Report to Congress
Community Preventive Services Task Force Report for Fiscal Year 2023
CPSTF Makes Recommendations
The Community Preventive Services Task Force (CPSTF) is an independent, nonfederal panel of public health and prevention experts that provides recommendations and findings on programs, services, and other interventions to protect and improve population health. These recommendations and findings are based on systematic reviews of evidence of effectiveness and economics. CPSTF recommendations are not mandates but rather evidence-based options that public and private sector decision-makers can use to improve and strengthen health and safety in their communities. All CPSTF recommendations and findings are compiled in The Community Guide.1
Communities, businesses, the military, healthcare systems, schools, employers, state, and local governments, and others put CPSTF recommendations into practice. The broad portfolio of CPSTF recommendations and findings covers a range of public health issues relevant to all Americans (see Figure 1).
Figure 1: CPSTF recommendations cover public health issues relevant to all Americans.
CPSTF Annual Report to Congress
Each CPSTF finding and recommendation statement identifies critical evidence gaps2 and highlights remaining questions about the intervention. A CPSTF finding of “insufficient evidence” means that not enough evidence exists for the Task Force to determine if an intervention is effective.
This report to Congress summarizes recommendations and findings from effectiveness and economic reviews issued by CPSTF during fiscal year 2023. The report also includes identified gaps3 in research related to populations and age groups not adequately addressed by available evidence and priority areas for further examination.3 Researchers and funding organizations can use CPSTF-identified evidence gaps and insufficient evidence findings to prioritize areas for further research.
CPSTF Recommendations and Findings
During fiscal year 2023, CPSTF issued four recommendations or findings on the topics and interventions listed below. Selected evidence gaps identified from each systematic review are also presented.
1) Substance Use
CPSTF recommends family-based interventions4 that train parents and caregivers in preventive skills and practices based on strong evidence of effectiveness in preventing substance use among youth. Evidence indicates that interventions, primarily delivered to families of youth ages 10-14 years, were effective in reducing initiation and use of cannabis, alcohol, tobacco, illicit substances, and misuse of prescription drugs.
Evidence Gaps
CPSTF identified the following questions as priorities for research and evaluation:
- How effective are interventions for families of American Indian, Alaskan Native, Native Hawaiian, Pacific Islander, and Asian youth?
- How effective are interventions for families of youth who identify as a sexual or gender minority?
- How effective are interventions in reducing development of substance use disorders?
- How effective are interventions for families of adolescents ages 15 years and older?
During fiscal year 2023, CPSTF added findings from two economic systematic reviews5,6 to existing recommendations:
2) Nutrition, Physical Activity, and Obesity
CPSTF finds that the economic benefits exceed the cost for park, trail, and greenway infrastructure interventions.7
Evidence Gaps
- What is the cost-effectiveness of park, trail, and greenway interventions?
- What are the economic effects from intervention-associated displacement of residents from historically disadvantaged racial and ethnic populations and populations with lower incomes?
3) Cancer Screening
CPSTF finds patient navigation services to increase breast cancer8 screening are cost-effective.
Evidence Gaps
- What is the cost-effectiveness of patient navigation services to increase cervical cancer screening?
- What is the precise economic impact of patient navigation services within comprehensive health promotion interventions?
4) Mental Health
CPSTF finds insufficient evidence to determine whether multi-tiered trauma-informed school programs9 reduce symptoms of post-traumatic stress disorder (PTSD) or improve mental health and school-related outcomes including student behaviors, disciplinary actions, and absenteeism. Additional studies are needed to determine the effectiveness of multi-tiered trauma-informed school programs.
CPSTF Priorities for 2020-2025
CPSTF selects priority topics every five years for systematic evidence reviews of population health interventions. CPSTF used a data-driven process to select priority topics for 2020-2025, starting with Healthy People 2020 topics,10 soliciting topic nominations from public health partners and the public, and applying criteria (e.g., burden, disparities, preventability) to narrow the number of topics.11 The priority topics guide the overall work of CPSTF but do not preclude consideration of other topics. The nine topics listed below join the set of more than 20 topics considered by CPSTF since its inception in 1996.
- Heart Disease and Stroke Prevention
- Injury Prevention
- Mental Health
- Nutrition, Physical Activity, and Obesity
- Public Health Emergency Preparedness and Response
- Social Determinants of Health
- Substance Use
- Tobacco Use
- Violence Prevention
CPSTF Methods
For all evidence reviews, CPSTF uses a consistent, scientifically rigorous, published methodology. The Community Guide systematic review methods are described in an online, printable manual.12 Each review generally considers all types of comparative study designs and includes peer-reviewed studies that are published in English from the United States and other high-income countries.
CPSTF considers health equity13 in all systematic reviews. CPSTF has identified historically disadvantaged racial and ethnic populations and populations with lower incomes as populations of special importance in achieving health equity.
The fiscal year 2023 Report to Congress was prepared by the Community Preventive Services Task Force (CPSTF) in response to a statutory requirement.
“…providing yearly reports to Congress and related agencies identifying gaps in research and recommending priority areas that deserve further examination, including areas related to populations and age groups not adequately addressed by current recommendations.” (42 U.S.C. §280g-10)
The Centers for Disease Control and Prevention provides “ongoing administrative, research, and technical support for the operations of the Task Force.” (42 U.S.C. §280g-10)
References
1 Guide to Community Preventive Services. The Community Guide. https://www.thecommunityguide.org/. Page accessed: January 31, 2022.
2 Guide to Community Preventive Services. Evidence Gaps. https://www.thecommunityguide.org/pages/evidence-gaps.html. Page last updated: April 24, 2023. Page accessed: September 28, 2023.
3 Community Preventive Services Task Force. 42 USCA § 280g-10. Effective March 23, 2010.
4 Guide to Community Preventive Services. TFFRS – Substance Use: Family-based Interventions to Prevent Substance Use Among Youth. https://www.thecommunityguide.org/pages/tffrs-substance-use-family-based-interventions-to-prevent-substance-use-among-youth.html. Page last updated: September 20, 2023. Page accessed: September 28, 2023.
5 Guide to Community Preventive Services. Methods Manual – Part 2: Economic Review Process. https://www.thecommunityguide.org/pages/economic-review-methods.html. Page last updated: June 7, 2023. Page last accessed: September 28, 2023.
6 Carande-Kulis VG, Maciosek MV, Briss, PA, et al. Methods for systematic reviews of economic evaluations for the Guide to Community Preventive Services. American Journal of Preventive Medicine 2000;18(1S):75-91.
7 Guide to Community Preventive Services. TFFRS – Physical Activity: Park, Trail, and Greenway Infrastructure Interventions to Increase Physical Activity. https://www.thecommunityguide.org/pages/tffrs-physical-activity-park-trail-greenway-infrastructure-interventions-increase-physical-activity.html. Page last updated: April 11, 2023. Page last accessed: September 28, 2023.
8 Guide to Community Preventive Services. TFFRS – Cancer Screening: Patient Navigation Services to Increase Breast, Cervical and Colorectal Cancer Screenings and Advance Health Equity. https://www.thecommunityguide.org/pages/tffrs-cancer-screening-patient-navigation-services-to-increase-breast-cervical-colorectal-cancer-screenings.html. Page last updated: September 27, 2023. Page accessed: September 28, 2023.
9 Guide to Community Preventive Services. TFFRS – Mental Health: Multi-Tiered Trauma-Informed School Programs to Improve Mental Health Among Youth. https://thecommunityguide.org/pages/tffrs-mental-health-multi-tiered-trauma-informed-school-programs-improve-mental-health-among-youth.html. Page last updated: March 12, 2024. Page accessed: March 12, 2024.
10 Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. Healthy People 2020 Topics and Objectives. https://www.healthypeople.gov/2020/topics-objectives. Page accessed: January 31, 2022.
11 Lansky A, Wethington HR, Mattick K, et al. Priority Topics for the Community Preventive Services Task Force, 2020–2025: A Data-Driven, Partner-Informed Approach. American Journal of Preventive Medicine. 2022;62(6):e375-e378.
12 Guide to Community Preventive Services. Methods Manual for Community Guide Systematic Reviews. https://www.thecommunityguide.org/pages/methods-manual.html. Page last updated: June 7, 2023. Page accessed: September 28, 2023.
13 Guide to Community Preventive Services. Advancing Health Equity. https://www.thecommunityguide.org/pages/advancing-health-equity.html. Page last updated: September 27, 2022. Page accessed: November 1, 2023.