Methods for evaluation of health promotion programmes

Abstract

In a seminar held by the Interdisciplinary Network for Epidemiological Research in Berlin (EpiBerlin) in November 2006 methodological aspects for evaluation of health promotion interventions for children and adolescents were discussed. Smoking and obesity are key factors in morbidity and mortality in Germany. Behaviour patterns influencing weight gain and starting smoking are often developed at a young age, yet health promotion interventions targeting young children and adolescents are difficult to evaluate. High quality studies on smoking interventions on the micro-level have been reviewed showing positive changes in knowledge; however no significant results in social competence. The reviewers concluded that interventions have failed to adequately address the needs of children and adolescents. Programmes should have a holistic approach and take into account contemporary youth culture and the preferences of boys and girls and of social groups. While there are sufficient data on the success of smoking interventions on the micro-level, tools for evaluation on the meso- and macro-levels still have to be developed. Evidence from the evalua tion of obesity prevention programmes for children and youth is scarce. At this stage results from evaluations only provide clues as to what works and what does not. There is a need for more rigorous evaluation of already existing prevention programmes worldwide. The lack of data from the evaluation of health promotion programmes is partly due to methodological difficulties. The high standards of evidence-based medicine by means of randomized controlled trials cannot be upheld in the evaluation of health promotion interventions. Programmes to promote health take place in a complex environment of social, political, cultural and economic factors that cannot be controlled for; therefore Randomited Controlled Trials (RCTs) may not be the desired design for evaluation, in particu lar for setting and community intervention approaches. By improving evaluation designs, non-randomized studies could be the appropriate choice for the evaluation of health promotion programmes.