Evaluating health promotion: the strategic evaluation framework

Abstract

The objective of this study was to produce a framework for evaluating health promotion that is both practical and theoretically defensible. There were six steps in developing this framework. First, the evaluation and health promotion literature was examined for lessons relevant to health promotion evaluation. Second, the author was involved as an evaluation researcher in a series of health promotion projects (five of which are reported here). Third, key practical, methodological, political and theoretical issues arising from these evaluation projects were identified and addressed. Fourth, taking these issues into account, an initial framework for health promotion evaluation was developed. Fifth, the framework was exposed to health promotion practitioners at a series of workshops run by the author and colleagues. Sixth, the strategic evaluation approach was further refined in the light of the Author’s continuing involvement in health promotion evaluation practice. Six elements make up the resulting Strategic Evaluation Framework for Health Promotion: a checklist for health promotion programme planning and evaluation; a matrix of health promotion strategies; a schema for health promotion programme objective setting; a set of criteria for selecting the type and level of evaluation for different projects within an overall programme; a model of where health promotion strategic evaluation fits within the social problem cycle; and lastly a strategic approach to determining priority health promotion evaluation research methods. Together, these address key issues which need to be dealt with in health promotion evaluation. Based on the belief that evaluation decisions should be strategically driven, this approach is particularly relevant in health promotion areas where issues are strongly contested by powerful stakeholders. This decision as to what and how to evaluate comes from examining the strategic priorities of the sector in which the programme is located. This is in contrast to more generalised calls for programme evaluation which demand similar evaluation types for all health promotion programmes regardless of the current strategic needs of the sector.