ShareCompartir Once the assessment and planning phases have been conducted, and interventions have been selected for implementationthe final stage of designing a workplace health program involves decisions concerning the monitoring and evaluation of program activities. Just as assessment data are critical for evidenced-based program planning and implementation, so too is evaluation to prove that workplace health interventions have been effective and build the business case for continuing them. Ideally, evaluation plans should be developed as part of the planning process and before beginning the intervention activities.
An equivalent control group is rarely available to assess the impact of large scale health promotion campaigns or new policies, which are often dependent on time trends comparisons. As a consequence, the interpretation of changes seen on timelines becomes a rather subjective appreciation.
Another main barrier to impact evaluation is the complexity of many health promotion interventions, especially those targeting human behaviour change. In addition, these programmes must address other changes in personal skills and environmental changes that facilitate and reinforce the healthy behaviour.
As a result, these interventions have many components, some of them closely tied to specific environments, and therefore they are difficult to standardise. Overall, we must admit that very often evidence is either not available or not possible to obtain, at least under the accepted paradigm of evidence.
Therefore, we need to find a new frame for the evaluation of complex health promotion interventions. In this regard, plausibility and adequacy statements have been invoked to assist judgement of health promotion activites when randomised clinical trials are not possible.
If we consider that previous evaluation cannot be taken as a valid reference, then we must assess what kind of evaluation is possible. When possible, we will use a strong design that can resist threats to internal validity, using an equivalent control group.
I believe we can and we should, especially when the alternative is to ignore the problems and limitations of the current situation. In any case, it might be better to make explicit the rules and the reasons for the decision taken.
For example, we can state that some kind of positive effect has been proved by at least one of the components of the programme, or that an explicit theoretical model of effect must be provided in advance, which must be checked by any combination of process and impact, quantitative and qualitative evaluation, to provide the best possible ground for utility.
Also, when previous evaluations are to be taken as reference, an explicit justification to expect that changes and adaptations from the original programme or any of its components as it was originally evaluated will not reduce effectiveness may be requested.
What this paper adds In this manuscript there is a brief discussion about the limits of current scientific paradigm for the evaluation of health promotion programmes and interventions.
No doubt the process of standardising and developing appropriate programme evaluation is going to be a long and complex endeavour, but it will eventually prove to be worthwhile.
If not the ideal, we should do our best to provide the best possible evaluation for every health promotion programme and intervention. There are too many efforts and resources at stake.
There is room for compromise, just as there is with everything in life. Oxford University Press, 2. An educational and ecological approach. Am J Public Health —[email protected]® is an employer-based training program. The ultimate aim of the program is to improve the organizational health of participating employers and certified trainers, with an emphasis on strategies to reduce chronic disease and injury risk to employees and an eye to improving overall worker productivity.
About program evaluation in health promotion Practitioners can use any number of structured programs to arrive at desired health outcomes. Take an effort to improve the nutritional status of low-income families. Possible activities include.
It includes a retrospective examination of the evolution of health promotion evaluation. This provides the context for assessing and understanding the current state of evaluations of initiatives addressing settings, policies and systems for promoting health. This page talks about evaluations of Child Profile Health Promotion mailings.
methods for health promotion evaluation; and • to provide guidance to policy-makers and practitioners to increase the quality of health promotion evaluations.
To achieve its objectives, the Working Group: • commissioned and reviewed more than 30 background papers dealing with key issues. Introduction to Program Evaluation for Public Health Programs Executive Summary - 1 Executive Summary This document is a “how to” guide for planning and implementing evaluation activities.
The manual, based on CDC’s Framework for Program Evaluation in Public Health, is intended to assist managers.