Chapter 2: Research and evaluation in health promotion: key stages, methods and types

Introduction

This chapter provides an overview of the different research methods that support the planning process described in Chapter 1. In particular, the chapter describes differences between research- and practice-based evaluation and explains the use of both quantitative and qualitative methods in evaluation. It summarises the six key stages of evaluation required to build an evidence base for health promotion and public health programs. These different approaches are described in greater detail in later chapters.

Evaluation is not a single action but a set of continuous tasks that start in the planning phase and continue throughout effectiveness testing and subsequent translation of an intervention, project or program. This chapter describes these stages of evaluation applied to health promotion and public health interventions.

2.1 Evaluation methods and types

Health promotion projects and programs vary in scope, scale, target population and setting. Four hypothetical examples are described below, and illustrate the differences in the evaluation tasks required.

1. A single project encouraging people attending a regional diabetes clinic to build skills that enable improved control over their disease and its effects and adopting healthier lifestyles

2. A project that aims to increase attendance by an underserved population at a regional cancer screening clinic (e.g. women from a culturally diverse background may have lower screening attendance rates)

3. A program promoting healthy eating in a community in a defined region, comprised of several intervention components, including mass media education, nutrition education in school classrooms and a project to introduce healthy menu choices in restaurants, schools and worksites across the community

4. A multiple-agency partnership between urban planning and transport departments aiming to use new urban designs for housing and recreational facilities to achieve improvements in the whole system—improving the physical and social environment to increase physical activity and wellbeing in the community

There is a distinction between the first two projects, which are discrete and have clear components, and examples three and four, which are more complex and comprehensive interventions. The evaluation methods and measures of outcome required are substantially different. In the first two, the target population is well-defined and the intervention is quite self-contained, suggesting well-controlled evaluation studies are possible (Chapter 5). The second two examples have multiple intervention components and considerable dependence on partnership with and between agencies and sectors. The evaluation methods required for these programs are discussed in Chapter 6, as comprehensive program evaluations (CPEs).

It is obvious from these four examples that there is no single, correct approach to evaluation. Interventions exist on a continuum, from single-component through to comprehensive multi-component programs. Evaluation of the four examples will differ in terms of the budgets required, length of time required for evaluation, evaluation designs and research methods used. Customised approaches should be used to plan, implement and evaluate each project or program.

The first example is set ...