International Journal of Epidemiology 2000;29:1099-1100
© International Epidemiological Association 2000
Book Review |
Evaluating Health Promotion. Practice and Methods.
M Thorogood, Y Coombes (eds). Oxford: Oxford University Press, 2000, pp.174. ISBN: 0–19–263169–1.
The small and light book from the Health Promotion Research Unit at the London School provides a substantial contribution on the well selected, most topical and important issues in both methods and practice of the evaluation of health promotion. It is not a comprehensive handbook of the evaluation methods, but more an eye opener and discussion starter in the present day issues in the field.
The selected methodological topics: the role and combining of quantitative and qualitative research; experimental designs; principles and importance of economic evaluation, focus groups in the evaluation; evaluation of the process (not only outcome); and risk factor simulation models. The practice of the evaluation is highlighted using real-life examples: in changing communities; in evaluation of mass media approaches; in clinical setting; but also in dissemination of research in the area of health promotion.
The editors and authors have succeeded in presenting health promotion in its historical context (growing from the public health), and at the same time in showing the relevance of the rigorous evaluation of health promotion. Now that cost-effective and evidence-based health services are emphasized, health promotion has to be amenable to scientific evaluation, but in a way respecting its long-term, multifaceted, social, cultural and multi-disciplinary dimensions. Yolande Coombes in the chapter on combining quantitative and qualitative approaches to evaluation shows how quantitative evaluation addresses whether there is a relationship with outcomes, whereas qualitative evaluation addresses why there is a relationship. Thus both approaches are needed. A social ecological approach not only combines the approaches, but it also takes into account the socio-cultural processes and context of health outcomes. Another chapter opening new doors is that of process evaluation during project implementation. The author, William Stewart, describes the relevance of flexibility, negotiations between different actors, shifting objectives, and the importance of reporting back in his example of a community HIV/AIDS prevention strategy project.
A pedagogically appropriate approach of questioning and showing different meanings of routinely used concepts, such a community (chapter by Rachel Jewkes), is used to good effect. The last chapter, written by Gillian Lewando-Hundt and Salah Al-Zaroo, handles the evaluation of the dissemination of health promotion research. The chapter points out an important problem of competing goals of academic research (publishing) and applied work (practical work) in the area of health promotion. Recent developments of including evaluation of dissemination already in the funding criteria are an encouraging start.
Themes like multidisciplinary evaluation and differentiating between process and outcome evaluation appear throughout the book, but this is not really repetition, but instead, a good way to emphasize the importance of these issues from different perspectives. The text of the book avoids difficult jargon. This makes the text easily accessible for both students and practitioners, but also for non-native English speakers. Use of boxes depicting key points of chapters is a good way of summarizing the content.
This little book can be warmly recommended for all public health and health promotion students and specialists. It is easy to read, but it provides a lot to think about as well as useful hints for research and practical health promotion.
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