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Evaluation is the formal process of judging the ‘value’ of something. In health promotion, an evaluation will determine the extent to which a program has achieved its desired health outcomes. Scientists, health practitioners, politicians and the wider community all have different views on what represents ‘value’ from a health promotion program, how success should be defined and what should be measured, as shown in the following examples.
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Policymakers and budget managers may judge the success of programs in terms of resource allocation and accountability for these decisions. Success is often defined by the relationship between financial investment and the achievement of health outcomes in the short term.
Health practitioners need to judge the likely and actual success of a program in achieving its defined health outcomes in real-life situations. Success may be defined in terms of the effectiveness of the program in achieving health outcomes, the practicality of implementation, program sustainability and the maintenance of health gains in the longer term.
The community that is to benefit from health promotion action may place value on the processes through which a program is conducted, particularly on whether the program is participatory and addresses priorities that the community itself has identified. Success may be defined in terms of relevance to perceived needs and opportunities for community participation.
Academic researchers judge a program’s success (or failure) in order to contribute to the science of and evidence base for health promotion programs and practice. Success may be defined in terms of the effects identified through rigorous scientific evaluation designs and measured through quantifiable and validated outcomes, and where the expected effects are theoretically based.
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These perspectives are distinct but not mutually exclusive. In each perspective, success is judged through improved health outcomes, yet each differs greatly in the emphasis given to the cost, practicality and processes involved in achieving these outcomes. Correspondingly, there is a spectrum of approaches used to evaluate health promotion programs. These range from highly structured, methodology-driven evaluations through to much less rigid, highly participatory forms of evaluation.
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As public health professionals and practitioners, we need to be accountable for what we do, and we need to make explicit what we expect to achieve through the investments that are made in health promotion and prevention interventions. All programs can benefit from some form of evaluation, but not all require the same intensity of evaluation effort.
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provide an overview of and a classification system for the evaluation of a health promotion project, program or intervention
distinguish between formative, process, impact and outcome evaluation
consider the relative contributions of qualitative and quantitative research methods
provide practical guidance on when and how to evaluate programs, and the range of evaluation designs and research methods that can be used to evaluate different project and program types
consider how best to ‘measure’ health promotion activity and outcomes
refer the reader to sources of further information.
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There is a companion website to accompany this volume, which will be updated regularly by the authors at https://evaluationinanutshell.com/. It is written and maintained by the authors to provide a repository of updated and annotated examples but is not part of this McGraw Hill publication.