Evaluating Health Promotion--Progress, Problems and solutions

Abstract

This article addresses various aspects of health promotion evaluation that are under debate. The paper opens by noting the recent growth in research directed toward health promotion and its evaluation. Next the definition of success in health promotion is discussed in terms of 1) valued outcomes and valued processes 2) health outcomes 3) health outcomes and health promotion outcomes and 4) measurement of outcomes. The next section describes how best to evaluate success by presenting a hierarchy of evaluation stages (problem definition solution generation testing innovations intervention demonstration intervention dissemination and program management). Analysis of ways to assess cause and effect in evaluating outcome considers experimental designs to attribute cause and effect alternatives to experimental designs strategic issues in evaluating community/population interventions community interventions and social movements and building evidence using multiple methods and multiple sources of data. Examination of the evaluation of the process looks at program reach program acceptability and program integrity. The article concludes that the four key challenges to the evaluation of health promotion are 1) using research evidence more systematically while planning activities 2) improving the definition and measurement of outcome 3) adopting an appropriate evaluation intensity and 4) adopting an appropriate evaluation design.