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Health Promotion International, Vol 12, 233-238, Copyright © 1997 by Oxford University Press
J Hepworth
Health outcomes research has developed as a means of evaluating the
effectiveness of health care interventions and as an approach to informing
resource allocation. The use of a health outcomes approach in health
promotions has made increasing demands on evaluation methodologies to
demonstrate program effectiveness. However, criticism of the contribution
of health promotion to outcomes research has made several assumptions about
the use of qualitative methodologies and the content of program objectives
largely derived for a biomedical approach. In contrast to the measurement
of biomedical interventions in clinical health care, health promotion
practice involves social phenomena, wide-reaching cultural, psychological,
political and ideological problems and issues. The integration of
methodologies of health promotion evaluation will inform further
conceptualisation of the health outcomes approach with the differentiation
of three types of outcomes: health development outcomes; social health
outcomes; and biomedical health outcomes. It is concluded that this
differentiation moves away from dualist concepts that advocate the
replacement of goals and targets with regional and locally based
approaches. Rather, the future direction for health promotion evaluation
needs to employ a framework that elaborates multiple methodologies and
approaches necessary for establishing what relationships exist between
morbidity, mortality, health advancement and equity.Key
words: health outcomes research; practice; qualitative
methodology; theory
ARTICLES
Debate. Evaluation in health outcomes research: linking theories, methodologies and practice in health promotion
Department of Public Health, University of Adelaide, Australia 5005
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