Appropriate approaches to the evaluation of health promotion

Abstract

Appropriateness depends on an alignment of evaluation practice with the tenets of contemporary health promotion, including the notions of participation, community control and respect for people not as unthinking objects of research but as partners in knowledge development. In defining appropriateness three issues lie at the heart of the debate: what is being evaluated (the nature of health promotion programmes), appropriate for whom (who should gain from an evaluation) and appropriate for what (an issue relating to the evaluation question and the most appropriate design). The rules of evidence, paradigms and theories that inform health promotion as praxis go beyond narrow concerns of linear causality to wider issues of synergy, system variables and observation. This means characterizing health promotion programmes and policies as social reform or a process of change rather than a 'dose' or ' treatment'. Action research and particularly participatory action research approaches, which give primacy to learning over proving, lie at the heart of health-promotion evaluation.