From Knowledge to Action: Challenges and Opportunities for Increasing the Use of Evaluation in Health Promotion Policies and Practices

Abstract

The gap between scientific knowledge and its concrete translation into improvement of people’s quality of life is well-known. (Berghmans & Potvin, 2005 p. 19) How to make evaluation useful and used are familiar topics that appear to be perennial concerns for evaluators in general. We often talk about the utilization of evaluation research results in policies almost like an inevitable output of evaluation, but we must recognize the challenges that can impede or limit this pursuit. In the health promotion field, for example, these challenges can help us explain the wellknown gap between available scientific knowledge, potential effectiveness of social interventions, and improvement in people’s quality of life, as quoted above. Our objective in this chapter is to present some theoretical assumptions and related factors associated with evaluation use as discussed in the literature, and to provide a framework that could increase opportunities to influence health promotion practices and policies with evaluative research. Our main working hypothesis is that although in the health promotion field we do not have an extensive experience with this specific subject, we can learn a lot about it, not only from the lessons of social and health programs evaluation in general, but also from the sociology of innovation, when evaluation is conceived as intervention on programs (Schwandt, 2005) and innovation implemented in the “social space of programs” (Potvin, Gendron, & Bilodeau, 2006). The first section thus begins with a theoretical overview guided by utilization models. It is followed by a brief discussion of levels and mechanisms of use or influence and complemented by specific comments on a set of health programs guidelines oriented by utilization-focused evaluation. Here we combine the expressions use and influence, following recent positions that we will present later in this chapter. The term influence is broader than use and it refers to the capacity or power