Framework For Evaluating Health Promotion
Health promotion is a relatively new discipline and a need was seen to develop a framework for the evaluation of health promotion programmes (Duignan et al 1992a), based on experiences gained from evaluating health promotion programmes in New Zealand and from the international evaluation literature.
A key lesson learned was that the selection of evaluation methods should be determined by the evaluation task at hand, rather than evaluators taking a fixed preference for either qualitative or quantitative methods. The norm for programme evaluation does not have to be the traditional model of external evaluaters, entirely separated from programme staff in a large scale and expensive arms-length outcome evaluation. Planning for evaluation needs to occur at all stages of the programme life cycle, and programme objectives should be expected to change and evolve in both new and established programmes. A formal policy on evaluation of programmes should be adopted by health promotion organisations to ensure consistency. Good management and good professional practice in health promotion programmes have an evaluation function which should be recognised.
Given the diverse range of health promotion strategies, evaluation approaches must be equally diverse. However, it needs to be recognised that health promotion is a long term process, and dramatic outcomes cannot be expected to occur within short periods of time. It is also not usually feasible to isolate the separate impact of one programme, since health promotion activity is often collaborative with other services and interests.
In considering the type of evaluation to choose and how to ensure that the results of evaluation are used, health promotion evaluation needed to be viewed in its wider political context. There may be sensitive issues around the power relations between those involved in the programme and in its evaluation which need to be considered from the outset of an evaluation strategy. In community and Maori programmes, in particularly, evaluation cannot be separated from questions such as who controls resources and to what extent the community is being empowered by the health promotion programme.
Based on this research, the Alcohol & Public Health Research Unit has developed manuals on planning and doing evaluation for an audience of health promoters, managers and planners (Duignan et al, 1992b; Turner et al., 1992).
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