Health Promotion: Key issues on Health Promotion: Key issues on evaluation and evidence of its evaluation and evidence of its
effectivenesseffectivenessDavid V. McQueenDavid V. McQueen
Associate Director for Global Health Associate Director for Global Health PromotionPromotion
Santiago de Santiago de CaliCali, Colombia June 14, 2005, Colombia June 14, 2005
Health Promotion: Key issues on Health Promotion: Key issues on evaluation and evidence of its evaluation and evidence of its
effectivenesseffectiveness
Seminar on Evaluation and Public Seminar on Evaluation and Public Health Policies: Responding to Health Policies: Responding to
Health DeterminantsHealth DeterminantsSantiago de Santiago de CaliCali, Columbia June 14, , Columbia June 14,
2005; Intercontinental Hotel2005; Intercontinental Hotel
Today’s TalkToday’s Talk
The concept of evidenceThe concept of evidenceMethodological effortsMethodological effortsCritical elements of the debateCritical elements of the debateStrategic alliancesStrategic alliances
History and Theory of Public Health:History and Theory of Public Health:Slowly Changing ParadigmsSlowly Changing ParadigmsSanitary Era (when we knew it)Sanitary Era (when we knew it)
Germ TheoryGerm Theory
Infectious & Chronic Disease Infectious & Chronic Disease Epidemiology Epidemiology (individual risk factor epidemiology(individual risk factor epidemiology----“social” Epidemiology)“social” Epidemiology)
* * Health Promotion (finding it again)Health Promotion (finding it again)
The Historical Development of Health The Historical Development of Health Promotion in the 20Promotion in the 20thth Century: Two Traditions, Century: Two Traditions,
Two OriginsTwo Origins-- Both WesternBoth Western
The continentThe continent North AmericaNorth America
Framed by concernswith the social,economic and political roots of health
Focus on the sociopolitical
Framed by the enlargementof the traditional scope ofhealth education
Focus on the individual
The Historical Development of Epidemiology The Historical Development of Epidemiology in the 20in the 20thth Century: Two Traditions, One Old, Century: Two Traditions, One Old,
One RecentOne RecentEpidemiologyEpidemiology Social Social
EpidemiologyEpidemiology
Framed by concerns with etiology, traditional bio-medical model and a developed disciplinary base in scientific method
Framed by the enlargementof the traditional scope ofepidemiology
Focus on the individual plusfocus on the sociopolitical
Dominant Patterns of WorkDominant Patterns of Work
MethodsMethodsActionActionTheoryTheoryConcerned Concerned with CAUSEwith CAUSE
ActionActionConcepts and Concepts and PrinciplesPrinciplesMethodsMethodsConcerned Concerned with CHANGE with CHANGE in a in a CONTEXTCONTEXT
Epidemiology Health Promotion
Thus evidence takes on a different meaning ;In epidemiology it is often associated with etiologyIn health promotion it is associated with what works
Health Promotion Perspective: Health Promotion Perspective: The Components of The Components of ContextContext
LIFELIFESTYLESTYLE: Collective pattern of life conduct: Collective pattern of life conductLIFE LIFE CONDUCTCONDUCT: Pattern of behavior of an : Pattern of behavior of an individual in their dayindividual in their day--toto--day livesday livesLIFE LIFE CONDITIONSCONDITIONS: Patterns of resources of an : Patterns of resources of an individual or group (including health status)individual or group (including health status)LIFE LIFE SITUATIONSITUATION: Collective pattern of life : Collective pattern of life conditions conditions LIFE LIFE CHANCESCHANCES: Structural: Structural--based probability of based probability of correspondence of lifestyle and life situationcorrespondence of lifestyle and life situation
Adapted from Adapted from RuttenRutten, A. (1995). The implementation of health , A. (1995). The implementation of health promotion: a new structural perspective. promotion: a new structural perspective. Social Science & MedicineSocial Science & Medicine, , 41(2), 162741(2), 1627--1637.1637.
You cannot look at the concept of You cannot look at the concept of evidence without taking into account evidence without taking into account the history of public health over the the history of public health over the past century that we just reviewedpast century that we just reviewedPart of the history during the latter Part of the history during the latter part of the 20part of the 20thth Century was the rise Century was the rise of evidence as a critical ideaof evidence as a critical idea
EvaluationEvaluation
EffectivenessEffectiveness
The three ‘Es’*The three ‘Es’*
*very different animals
Evidence
EffectivenessEffectiveness
Effectiveness is a broad, loosely defined Effectiveness is a broad, loosely defined term, generally linked to the notion of term, generally linked to the notion of “outcomes”“outcomes”Tied to the notion that effective health Tied to the notion that effective health promotion leads to changes in the promotion leads to changes in the determinants of healthdeterminants of healthRaises the “spectre” of costsRaises the “spectre” of costsUnderlying epistemology of “outcomes” Underlying epistemology of “outcomes” remains complicatedremains complicated
The concept of and search for The concept of and search for evidence depends onevidence depends on
Your point of viewYour point of viewYour trainingYour trainingYour view of “science’Your view of “science’Your view of “knowledge”Your view of “knowledge”Your contextYour contextYour way of workingYour way of working
Evidence does not exist as a “Thing in itself”
Where is the evidence found? This is both Where is the evidence found? This is both a conceptual problem and a a conceptual problem and a
methodological problemmethodological problem
Refereed science literature Refereed science literature
General published literatureGeneral published literature
Fugitive literatureFugitive literature
InternetInternet
The communityThe community
OtherOther
Finding Evidence Is Difficult Finding Evidence Is Difficult Databases and keywords are Databases and keywords are typically not well suited to find typically not well suited to find intervention studies efficientlyintervention studies efficientlyInterventions are not categorized Interventions are not categorized systematicallysystematically
Over the years the “evidence search” Over the years the “evidence search” in health promotion has expanded in health promotion has expanded
beyond looking for beyond looking for RCTsRCTs
Every design has strengths and Every design has strengths and limitations limitations
Randomization rarely appropriate or Randomization rarely appropriate or feasible feasible
Many other intervention and Many other intervention and research approaches prove to be research approaches prove to be more appropriatemore appropriate
General Comments on the efforts to General Comments on the efforts to evaluate health promotion interventionsevaluate health promotion interventions
What appears to be a relatively What appears to be a relatively straightforward task is not so straightforward task is not so simplesimpleDespite more than a decade of Despite more than a decade of efforts, we are still in early efforts, we are still in early stagesstagesMany considerations, methods a Many considerations, methods a key problemkey problem
Methodological approaches Methodological approaches to evaluate effectiveness in to evaluate effectiveness in
health promotionhealth promotion
Quantitative and Qualitative Factors in Deciding on Quantitative and Qualitative Factors in Deciding on Methods: Statistics and valuesMethods: Statistics and values
How big is the problem?How big is the problem?How much of the problem can be How much of the problem can be prevented?prevented?How much of the problem will an How much of the problem will an intervention prevent?intervention prevent?What are the benefits and harms?What are the benefits and harms?What does the intervention cost?What does the intervention cost?How do benefits compare to How do benefits compare to costs?costs?How much do I gain compared to How much do I gain compared to what is already happening?what is already happening?
Is it health Is it health promotingpromotingIs it feasible?Is it feasible?Is it acceptable?Is it acceptable?Is it appropriate?Is it appropriate?Is it equitable?Is it equitable?
Quantitative Factors Qualitative Factors
Why Systematic Reviews of Health Why Systematic Reviews of Health Promotion Interventions are seen Promotion Interventions are seen
as Usefulas UsefulMethods first developed by social Methods first developed by social scientists Distill and summarize scientists Distill and summarize large and diverse bodies of large and diverse bodies of evidenceevidenceReduce errors and biases in Reduce errors and biases in interpretationinterpretationMake assumptions explicitMake assumptions explicit
Systematic Reviews Are Not: Systematic Reviews Are Not: Limited to randomized controlled Limited to randomized controlled trials trials Limited to healthcare interventionsLimited to healthcare interventionsRestricted to a “biomedical model” of Restricted to a “biomedical model” of healthhealthWithout serious limitationsWithout serious limitations
Logic Models are often used Logic Models are often used to Organize Large Numbers to Organize Large Numbers
of Variable and Complex of Variable and Complex Intervention OptionsIntervention Options
Methods and models – the hope that models will clarify methods
Sociocultural Environment Logic Framework
Determinants
SOCIALRESOURCESstandard of livingculture and historysocial institutionsbuilt environmentspolitical structureseconomic systemstechnology
Neighborhood Living Conditions
Community, Development,& Employment Opportunities
Opportunities for Learning andDeveloping Capacity
Community Customs,Norms, & Processes
Civic Engagement & Participationin Decision-Making
Strategic Points for Interventions
Health Outcome
Health Promotion, Prevention,& Care Opportunities
PHYSICALENVIRONMENTnatural resourcessustainable
development
EQUITY ANDSOCIALJUSTICE
HEALTHIER COMMUNITIES
Consumer Demand•Household resources•Nutrition knowledge •Cultural practices •Psychosocial characteristics •Taste and preferences•Advertising and marketing
LOGIC FRAMEWORK NUTRITION & COMMUNITY HEALTH
Modifiable DeterminantsFood Supply Factors•Agriculture policy•Nutrition policy•Science and technology •Food production, processing, storage and distribution
•Food fortification•Food safety
Environmental Factors•Food Availability & Price•Neighborhoods•Schools•Worksites •Homes•Local, state & national food assistance programs
POPULATION FOOD INTAKEFood Consumption Patterns
(e.g. fruits, vegetables)Intake of Nutrients and
Food Components: VitaminsMinerals
FiberFats
Other food constituentsDietary supplements
AlcoholEnergy balance
Life StageRequirements
Pregnancy Lactation Childhood
AdolescenceAdulthood
Older Adulthood
IntermediateOutcomes
Community Health
Outcomes
Physiologic Indicators:
GrowthAdipose tissue
MusculoskeletalGastrointestinal
MetabolicCardiovascularReproductive
ImmunologicalNeurological
Genetics,Co-morbidities
• Morbidity• Mortality
• Measures of Health & Fitness• Quality of Life
PhysicalActivityPatterns
INTERVENTI
ONS
No Two Community No Two Community Interventions Are IdenticalInterventions Are Identical
Carefully combining information Carefully combining information about related but not identical about related but not identical interventions helps to interventions helps to •• Fully represent an intervention Fully represent an intervention
constructconstruct•• Enhance external validity and Enhance external validity and
usefulnessusefulness•• Identify common aspects of effective Identify common aspects of effective
interventionsinterventions
Defining Suitability of Study Defining Suitability of Study Design?Design?
GreatestGreatest•• Prospective with concurrent Prospective with concurrent
comparison comparison ModerateModerate•• Multiple beforeMultiple before--andand--after after
measurements but no concurrent measurements but no concurrent comparison ORcomparison OR
•• RetrospectiveRetrospectiveLeastLeast•• Single group beforeSingle group before--andand--afterafter•• CrossCross--sectionalsectional
What Factors Determine What Factors Determine Quality of Execution?Quality of Execution?
Description of intervention and Description of intervention and study populationstudy populationSampling proceduresSampling proceduresExposure and outcome Exposure and outcome measurementsmeasurementsApproach to data analysisApproach to data analysisInterpretation of resultsInterpretation of resultsOther issues Other issues
Drawing an Overall Conclusion About the Drawing an Overall Conclusion About the Strength of EvidenceStrength of Evidence-- a Complicated Taska Complicated Task
Number of studiesNumber of studiesDesign suitabilityDesign suitabilityQuality of executionQuality of executionConsistencyConsistencyEffect sizeEffect sizeOther Factors Other Factors ––zone of zone of complexitycomplexity
SmallSmallNoNoToo fewToo fewInsufficient design or Insufficient design or executionexecution
3. 3. InsufficientInsufficient
SufficientSufficientYesYes>> 55Greatest, Greatest, Moderate Moderate or Leastor Least
Good or Good or FairFair
SufficientSufficientYesYes>> 33Greatest or Greatest or ModerateModerate
Good or Good or FairFair
SufficientSufficient----11GreatestGreatestGoodGood
2. Sufficient2. Sufficient
LargeLargeMeet criteria for sufficient evidenceMeet criteria for sufficient evidence
SufficientSufficientYesYes>> 55GreatestGreatestGood or Good or FairFair
SufficientSufficientYesYes>> 55Greatest or Greatest or ModerateModerate
GoodGood
SufficientSufficientYesYes>> 22GreatestGreatestGoodGood
1. Strong1. Strong
Effect Effect SizeSize
ConsistentConsistentNumber Number of of StudiesStudies
Design Design SuitabilitySuitability
Quality of Quality of ExecutionExecution
Evidence of Evidence of EffectivenesEffectivenesss
Broad Participation in the Broad Participation in the Process Improves the ProductProcess Improves the Product
Multiple perspectives and Multiple perspectives and backgrounds backgrounds •• Improve completeness and Improve completeness and
accuracy of information accuracy of information •• Reduce impact of individual or Reduce impact of individual or
institutional perspectivesinstitutional perspectives•• Enhance usefulness of productsEnhance usefulness of products
Identifying appropriate change processes
HighCertainty about what works
Low
High
Low
Agreement about how to do it
Standards Guidance
Political compromise
Experiment
Innovation
Creativity
“Zone of Complexity”
Trial & Error
• Focus on areas with high certainty and high agreement
• Understand and utilze effective change processes
Evaluation of effectiveness Evaluation of effectiveness is part of the ongoing is part of the ongoing
debate around evidencedebate around evidence
The “evidence debate” The “evidence debate” Why is evidence so important?Why is evidence so important?
Many believe that the success of health Many believe that the success of health promotion will depend upon its ability to promotion will depend upon its ability to demonstrate demonstrate scientificallscientificallyy that it is an that it is an effectiveeffective field of public health actionfield of public health action
In contrast, many believe that evidence, the In contrast, many believe that evidence, the very word, is very word, is inappropriateinappropriate for the field of for the field of health promotionhealth promotion
Between these two extremes are those who Between these two extremes are those who question the appropriateness of the various question the appropriateness of the various forms of evidenceforms of evidence and consider the basic and consider the basic issues of knowledge development in the field of issues of knowledge development in the field of health promotionhealth promotion
Finding Evidence Is Difficult Finding Evidence Is Difficult Databases and keywords are Databases and keywords are typically not well suited to find typically not well suited to find intervention studies efficientlyintervention studies efficientlyInterventions are not categorized Interventions are not categorized systematicallysystematicallyRequires Requires •• Database searchesDatabase searches•• Reviews of reference listsReviews of reference lists•• Consultation with experts Consultation with experts
Critical questionsCritical questions
How do you convince decision How do you convince decision makers to use evidence?makers to use evidence?How do you convince decision How do you convince decision makers that you have evidence?makers that you have evidence?How much evidence do you need?How much evidence do you need?What to do with insufficient What to do with insufficient
evidence?evidence?
Insufficient Evidence as Insufficient Evidence as Applied by the Task Applied by the Task
ForceForce
85 (56%) of 153 completed 85 (56%) of 153 completed reviewsreviewsOnly 2 (1.3%) “Only 2 (1.3%) “Recommend Recommend AgainstAgainst””
Insufficient Evidence Applied in the Tobacco ReviewsInsufficient Evidence Applied in the Tobacco Reviews
XXStudent AdvocacyStudent Advocacy
XXSchool policySchool policy
XXXXSchoolSchool--based educationbased education
XXRetailer EducationRetailer Education
XXRetailer Education+Retailer Education+
(X)(X)
XX
Serious Serious FlawsFlaws
XXActive EnforcementActive Enforcement
XXRetailer LawsRetailer Laws
XXYouth Access LawsYouth Access Laws
XXProvider FeedbackProvider Feedback
XXXXProvider EducationProvider Education
XXCessation ContestsCessation Contests
XXCessation SeriesCessation Series
XXCommunity EducationCommunity Education
Inconsist. Inconsist. EffectsEffects
Qualifying Qualifying StudiesStudies
Too Few Too Few StudiesStudies
Interventions with Interventions with Insufficient EvidenceInsufficient Evidence
Reasons for Insufficient Reasons for Insufficient EvidenceEvidence
(n=52 intervention reviews)(n=52 intervention reviews)Too few studies: 33 (63%) Too few studies: 33 (63%) Too few qualifying studies: 7 (13%)Too few qualifying studies: 7 (13%)Inconsistent effects: 8 (15%)Inconsistent effects: 8 (15%)Applicability: 2 (3.8%)Applicability: 2 (3.8%)Serious flaws: 8 (15%)Serious flaws: 8 (15%)
Strategic alliances as an Strategic alliances as an international response: international response: Focus on the IUHPEFocus on the IUHPE
There have been and are many There have been and are many efforts to efforts to produce evidenceproduce evidence for health promotion for health promotion
and the IUHPE GPHPE is part of this effortand the IUHPE GPHPE is part of this effort
E(EURO)WG Europe/Canada/USA E(EURO)WG Europe/Canada/USA CPSTF USA, CPSTF USA, Community Preventive Community Preventive Services Task Force, also called the Services Task Force, also called the “Community Guide“Community Guide””
IUHPE EUIUHPE EUCochraneCochraneGPHPEGPHPEMany othersMany others
A strategic questionA strategic questionWhat contribution can an What contribution can an
international organization make international organization make to the body of knowledge on the to the body of knowledge on the
effectiveness of community based effectiveness of community based healthhealth--related interventions, related interventions,
given the context of community given the context of community based funding programs?based funding programs?
Examples of efforts to Examples of efforts to produce evidence:produce evidence:
CPSTF USA, Community CPSTF USA, Community Preventive Services Task Force, Preventive Services Task Force, also called the “Community Guide”also called the “Community Guide”E(EURO)WG Europe/Canada/USA E(EURO)WG Europe/Canada/USA IUHPE EU, GPHPEIUHPE EU, GPHPEPAHOPAHOWHOWHOMany othersMany others
Evaluating HealthEvaluating Health Promotion: Promotion: Recommendations to Recommendations to
PolicyPolicy--makersmakers
WHOWHO--EURO Working Group* on EURO Working Group* on Health Promotion EvaluationHealth Promotion Evaluation
*The working group met many times over a *The working group met many times over a ten year period, with membership from Europe,ten year period, with membership from Europe,
Canada and the USACanada and the USA
ObjectivesObjectivesprovide guidance to policyprovide guidance to policy--makers makers and practitioners to foster the use of and practitioners to foster the use of appropriate methodsappropriate methods
examine current range of methodsexamine current range of methods
provide guidance to policyprovide guidance to policy--makers makers and practitioners to increase quality and practitioners to increase quality of health promotion evaluationsof health promotion evaluations
Major publication of the EWG was the Major publication of the EWG was the “Yellow Book”:“Yellow Book”:
Evaluation in health promotion: Principles Evaluation in health promotion: Principles and perspectives*and perspectives*
*This monograph, edited byRootman, Goodstadt, Hyndman, McQueen, Potvin, Springett and Ziglio
Was published by WHO in 2001 and contains critical articles in valuationfrom 55 authors, comprising 23 chapters.
The monograph was the product of an extensive series of discussions and reviews, setting a standard for addressing the issues involved in evidence and evaluation.
**This monograph, edited byThis monograph, edited byRootman, Rootman, GoodstadtGoodstadt, Hyndman, McQueen, Potvin, Springett and Ziglio, Hyndman, McQueen, Potvin, Springett and Ziglio
Was published by WHO in 2001 and contains critical articles in vWas published by WHO in 2001 and contains critical articles in valuationaluationfrom 55 authors, comprising 23 chapters. from 55 authors, comprising 23 chapters.
The monograph was the product of an extensive series of discussiThe monograph was the product of an extensive series of discussions and reviews, ons and reviews, setting a standard for addressing the issues involved in evidencsetting a standard for addressing the issues involved in evidence and evaluatione and evaluation.
EWG Principles for EWG Principles for Evaluation of Health Evaluation of Health Promotion InitiativesPromotion Initiatives
ParticipationParticipationMultiple methodsMultiple methodsCapacityCapacity--buildingbuildingAppropriatenessAppropriateness
IUHPE ReportIUHPE ReportA Report for the European Commission by the A Report for the European Commission by the
International Union for Health Promotion and International Union for Health Promotion and EducationEducation
Title: The Evidence of Health Title: The Evidence of Health Promotion Effectiveness: Shaping Promotion Effectiveness: Shaping Public Health in a New EuropePublic Health in a New Europe
A core document, 30 pagesA core document, 30 pages
An Evidence Book, 164 pagesAn Evidence Book, 164 pages
IUHPE ReportIUHPE ReportThree Components of Working GroupThree Components of Working GroupInternational Project Advisory GroupInternational Project Advisory GroupLead project AuthorsLead project AuthorsA Witness Group of Political ExpertsA Witness Group of Political Experts
IUHPE ReportIUHPE ReportKey General RecommendationsKey General Recommendations
11 Commission urged to develop Commission urged to develop appropriate infrastructure for the appropriate infrastructure for the development of successful health development of successful health promotion programs promotion programs
22 The impressive body of evidence The impressive body of evidence in health promotion best practice in health promotion best practice needs to be made available widely needs to be made available widely and systematically updatedand systematically updated
Characteristics of Working Characteristics of Working Groups on Evidence and Groups on Evidence and
EvaluationEvaluationMultiMulti--disciplinarydisciplinaryOften multiOften multi--cultural/multiple nationscultural/multiple nationsLarge endeavors Large endeavors Time consumingTime consumingRaising many questionsRaising many questionsReviewing published, Western Reviewing published, Western sourcessources
The Global Programme on The Global Programme on Health Promotion Health Promotion
Effectiveness (GPHPE)Effectiveness (GPHPE)A programme coordinated by the International Union for Health Promotion and Education in collaboration with the
World Health Organization, the US Centers for Disease Control and Prevention and many other partners:
African Medical and Research Foundation; Health Promotion Switzerland; National Institute for Health and Clinical Excellence, England; The Netherlands
Institute for Health Promotion and Disease Prevention; Pan-American Health Organization; Public Health Agency of Canada; Victorian Health Promotion
Foundation; Voluntary Health Association of India, among other international and regional partners.
The GPHPE aims to raise the standards of health promotion The GPHPE aims to raise the standards of health promotion policy and practice worldwide by:policy and practice worldwide by:
Reviewing evidence of effectiveness in Reviewing evidence of effectiveness in terms of health, economic, social and terms of health, economic, social and political impact;political impact;Translating evidence to policyTranslating evidence to policy--makers, makers, teachers, practitioners and researchers;teachers, practitioners and researchers;Stimulating the debate on the evidence of Stimulating the debate on the evidence of health promotion effectiveness.health promotion effectiveness.
GPHPE : Products (global level)GPHPE : Products (global level)
Special global issue of proceedings from the Francophone Special global issue of proceedings from the Francophone seminar on health promotion effectiveness (available)seminar on health promotion effectiveness (available)Special global issue on mental health promotion Special global issue on mental health promotion effectiveness (available)effectiveness (available)Special global issue on health promoting schools and Special global issue on health promoting schools and effectiveness (in development)effectiveness (in development)Special global issue on urbanisation (under Special global issue on urbanisation (under consideration)consideration)Articles published on the GPHPE, its aims and goalsArticles published on the GPHPE, its aims and goalsGlobal monograph to be released in Vancouver, 2007Global monograph to be released in Vancouver, 2007
GPHPE : Products (regional level)GPHPE : Products (regional level)
Europe : new publication on the challenges of Europe : new publication on the challenges of getting evidence into practicegetting evidence into practiceLatin America : report on state of the art of the Latin America : report on state of the art of the evidence of health promotion effectiveness, rapid evidence of health promotion effectiveness, rapid evaluation guide, and numerous articles and toolsevaluation guide, and numerous articles and toolsAfrica : conceptual framework and working paper, Africa : conceptual framework and working paper, publication commissionedpublication commissionedNorth America : evaluation tool kit, website, North America : evaluation tool kit, website, framework for community efforts to create framework for community efforts to create conditions that promote healthconditions that promote health
GPHPE : Operational structureGPHPE : Operational structure
Global and Regional Leaders/CoordinatorsGlobal and Regional Leaders/CoordinatorsGlobal Steering GroupGlobal Steering GroupPartners, interested parties, collaborators, and Partners, interested parties, collaborators, and independent scientific consultants across the independent scientific consultants across the globeglobePotential for creating interPotential for creating inter--regional forum regional forum around particular areas of interestaround particular areas of interest
GPHPE : Regional projectsGPHPE : Regional projects
Regions focus on developing their own Regions focus on developing their own priorities and definitions of evidence of priorities and definitions of evidence of effectiveness:effectiveness:•• Regions move at their own pace;Regions move at their own pace;•• Regions take into account their own context Regions take into account their own context
and develop plans accordingly;and develop plans accordingly;•• Regions feel ownership, while at the same Regions feel ownership, while at the same
time being full partners in the global time being full partners in the global programme.programme.
GPHPE: Distinguishing aspectsGPHPE: Distinguishing aspects
The GPHPE:The GPHPE:Is a worldwide programme.Is a worldwide programme.Advocates the importance of effectiveness to Advocates the importance of effectiveness to researchers, practicitioners and decisionresearchers, practicitioners and decision--makers.makers.Will support regional approaches, given the different Will support regional approaches, given the different stages of the development of the field.stages of the development of the field.Is about drawing into the programme what can be Is about drawing into the programme what can be learned and valued from each region while giving learned and valued from each region while giving the opportunity for regions to learn from each other.the opportunity for regions to learn from each other.
GPHPE : VisionGPHPE : VisionThe GPHPE is a programme intended to uncover The GPHPE is a programme intended to uncover and find evidence for effectiveness. This may and find evidence for effectiveness. This may translate into various approaches in regions given translate into various approaches in regions given their current capacity to carry out this kind of their current capacity to carry out this kind of research or related activities. The intention and research or related activities. The intention and goal is to find answers and solutions based on goal is to find answers and solutions based on best practice in order to be able to advise on how best practice in order to be able to advise on how interventions could be better carried out based interventions could be better carried out based upon the evidence.upon the evidence.
GPHPE : Next stepsGPHPE : Next steps
Enlargement and strengthening of regional Enlargement and strengthening of regional initiativesinitiativesDevelopment of content for the Global Development of content for the Global Monograph series Monograph series Increased networking and exchange across Increased networking and exchange across regions, increasing synergy to develop regions, increasing synergy to develop capacitycapacity
Some indicators of achievement by Some indicators of achievement by the GPHPE will be :the GPHPE will be :
1.1. RepresentativenessRepresentativeness
the extent to which health promotion initiatives the extent to which health promotion initiatives from a diversity of countries, cultures and from a diversity of countries, cultures and peoples is represented in the project;peoples is represented in the project;how complete it is in identifying all the potential how complete it is in identifying all the potential health promotion projects that should be health promotion projects that should be included;included;the extent to which health promotion the extent to which health promotion interventions are distinctively recognised.interventions are distinctively recognised.
Some indicators of achievement by Some indicators of achievement by the GPHPE will be :the GPHPE will be :
2. Quality of reflection2. Quality of reflection
the ability of the analytical review framework(s) the ability of the analytical review framework(s) developed to distinguish the features of effective developed to distinguish the features of effective projects;projects;the ability of an adequate number of reviews to the ability of an adequate number of reviews to take place.take place.
Some indicators of achievement by Some indicators of achievement by the GPHPE will be :the GPHPE will be :
3. Relevance of knowledge for use3. Relevance of knowledge for use
the extent to which the knowledge obtained from the extent to which the knowledge obtained from the project is translated into use by practitioners;the project is translated into use by practitioners;the extent to which the knowledge obtained the extent to which the knowledge obtained influences research priorities as well as policy influences research priorities as well as policy and decision makers;and decision makers;the general improvement in the knowledge, the general improvement in the knowledge, education and training of health promotion education and training of health promotion professionals. professionals.
Summing upSumming up
Evaluation is a critical hallmark of Evaluation is a critical hallmark of good public health and health good public health and health promotionpromotion
Need to understand the Need to understand the complications and dimensions of the complications and dimensions of the task we are undertakingtask we are undertaking
Summary with regard to concepts, Summary with regard to concepts, methods, and alliancesmethods, and alliances
Conceptualization of evidence must relate Conceptualization of evidence must relate to the concepts of health promotionto the concepts of health promotionMethods are many and varied; context is Methods are many and varied; context is related to methodrelated to methodAlliances promote a synergy among Alliances promote a synergy among efforts that add valueefforts that add valueInvestment in evaluation for Investment in evaluation for evidence has been seen as critical by evidence has been seen as critical by governments, international governments, international organizations and the general field of organizations and the general field of public health researcherspublic health researchers