Maintaining evaluation designs in long term community based health promotion programmes: Heartbeat Wales case study.

Abstract:

STUDY OBJECTIVE:To examine the difficulties of developing and maintaining outcome evaluation designs in long term, community based health promotion programmes. DESIGN:Semistructured interviews of health promotion managers. SETTING:Wales and two reference health regions in England. PARTICIPANTS:Nine health promotion managers in Wales and 18 in England. MEASUREMENTS AND MAIN RESULTS:Information on selected heart health promotion activity undertaken or coordinated by health authorities from 1985-90 was collected. The Heartbeat Wales coronary heart disease prevention programme was set up in 1985, and a research and evaluation strategy was established to complement the intervention. A substantial increase in the budget occurred over the period. In the reference health regions in England this initiative was noted and rapidly taken up, thus compromising their use as control areas. CONCLUSION:Information on large scale, community based health promotion programmes can disseminate quickly and interfere with classic intervention/evaluation control designs through contamination. Alternative experimental designs for assessing the effectiveness of long term intervention programmes need to be considered. These should not rely solely on the use of reference populations, but should balance the measurement of outcome with an assessment of the process of change in communities. The development and use of intervention exposure measures together with well structured and comprehensive process evaluation in both the intervention and reference areas is recommended.

authors

Nutbeam D,Smith C,Murphy S,Catford J

doi

10.1136/jech.47.2.127

subject

Has Abstract

pub_date

1993-04-01 00:00:00

pages

127-33

issue

2

eissn

0143-005X

issn

1470-2738

journal_volume

47

pub_type

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