Health Promotion International, Vol. 19, No. 1, 85-94, March 2004
© Oxford University Press 2004. All rights reserved
PERSPECTIVES |
Issues in measuring health promotion capacity in Canada: a multi-province perspective
1Saskatchewan Heart Health Program, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, 2Heart Health Nova Scotia, Dalhousie University, Halifax, Nova Scotia, Canada, 3British Columbia Heart Health Project, British Columbia Ministry of Health Planning, Victoria, British Columbia, Canada and 4Alberta Heart Health Project, University of Alberta, Edmonton, Alberta, Canada
Address for correspondence: Lori S. Ebbesen, Program and Evaluation Officer, Saskatchewan Health Research Foundation, 253-111 Research Drive, Atrium Building, Innovation Place, Saskatoon, Saskatchewan, Canada S7N 3R2, E-mail: lebbesen{at}shrf.ca
Significant international progress has been made researching and addressing the economic and social burden of cardiovascular disease, advanced particularly by international conferences and subsequent declarations, and the Canadian Heart Health Initiative (CHHI). The implementation focus of the CHHI on building capacity for heart health promotion is paralleled by efforts to measure capacity. Through the collective experience of Heart Health Programs in Nova Scotia, Saskatchewan, Alberta and British Columbia, critical issues in measuring health promotion capacity are identified and strategies for addressing them are presented. The provincial contexts for the programs vary, as do the conceptualizations of capacity and intervention strategies to build capacity. Yet, despite such differences across provinces, shared issues influencing measuring capacity number many. These include: multiple understandings of terms; evolving understanding of capacity; invisibility of capacity building; detecting change within a dynamic system; staff turnover; time course required for change; attribution for change in capacity; understanding a process through ‘snap-shot’ measurements; lack of existing ‘gold standard’ measurement tools; validity and credibility of instruments; evolving nature of measurement tools; gathering perspectives from multiple levels within organizations; dealing with conflicting perspectives; and managing and disseminating sensitive data. A number of strategies have been devised or adopted to address measurement issues, ranging from adopting participatory processes to the development of monitoring systems. Understanding and addressing issues in measuring capacity deserve attention as they may be potent influences in the dynamic interplay between research and intervention in the process of capacity building in the context of health promotion generally, and/or heart health specifically.
Key words: capacity building; health promotion; measuring capacity
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