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Health Promotion International, Vol 13, 27-44, Copyright © 1998 by Oxford University Press
D Nutbeam
Several issues of current debate in health promotion evaluation are
examined. These include the definition and measurement of relevant outcomes
to health promotion, and the use of evaluation methodologies which assess
both the outcome achieved and the process by which it is achieved.
Considerable progress is being made in understanding the complexity of
health promotion activity, and in the corresponding need for sophisticated
measures and evaluation research designs which reflect this complexity. The
more powerful forms of health promotion action are those which are long
term, and least easily predicted, controlled and measured by conventional
means. Against this, important and valued advances in knowledge and
credibility have come from more tightly defined and controlled
interventions, which have been evaluated through the application of more
traditional experimental designs. This tension between 'scientific rigour'
and the perceived advantages (in long-term effectiveness and maintenance)
coming from the less-well-defined content and methods of community
controlled programmes continues to pose technical problems in evaluation.
It is important to foster and develop evaluation designs which combine the
advantages of different research methodologies, quantitative with
qualitative, in ways which are relevant to the stage of development of a
programme. The use of a diverse range of data and information sources will
generally provide more illuminating, relevant and sensitive evidence of
effects than a single 'definitive' study. Evaluations have to be tailored
to suit the activity and circumstances of individual programmes-no single
methodology is right for all programmes.Key words:
evaluation; health promotion; measurement
ARTICLES
Evaluating health promotion - progress, problems and solutions
WHO Collaborating Centre for Health Promotion and Department of Public Health, University of Sydney, Sydney, NSW 2006, Australia
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