Health Promotion International, Vol. 19, No. 2, 141-156, June 2004
HEALTH PROMOTION INTERNATIONAL Vol. 19. No. 2 © Oxford University Press 2004. All rights reserved
Effect evaluation of a comprehensive community intervention aimed at reducing socioeconomic health inequalities in the Netherlands
1Department of Health Education and Promotion and 2Faculty of Psychology, Universiteit Maastricht, the Netherlands and 3Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
Address for correspondence: E. A. Abbema Department of Health Education and Promotion Universiteit Maastricht P.O. Box 616 6200 MD Maastricht The Netherlands, E-mail: e.abbema{at}nspol.nl OR ellisabbema{at}wanadoo.nl
SUMMARY
To date, comprehensive community health projects have not been evaluated in terms of their effect at the individual level, because outcomes are usually not defined at this level. In a community health project in the Netherlands, evaluation outcome mapping, a technique derived from intervention mapping, was used to identify distal as well as proximal programme objectives from which outcome measures could be derived. The intervention took place in a deprived area, where community members themselves defined stress, lack of area safety and parenting problems as the health-related problems they wanted to see addressed in the project. Local organizations wrote and implemented an action plan. The effects among residents were studied in a quasi-experimental design. Although no significant effects on improved perceived health or health-related problems were found at the level of the residents, the problems identified and their assumed causes showed significant coherence. This study is believed to be of relevance to evidence-based health promotion theory and practice as it demonstrates that it is possible to conduct an individual effect evaluation in a comprehensive community approach without jeopardizing the process of the intervention.
Key words: comprehensive community interventions; effect evaluation; evidence-based health promotion; socioeconomic health inequalities
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