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Challenges in Providing

Evidence for the Effectiveness

of Health Promotion

The 51

st

World Health Assembly

Urged all Member States to:“

adopt an evidence-based

approach to health promotion”

Health Promotion

“The process of enabling people

to increase control over, and to

improve, their health”

(Ottawa Charter for Health

Promotion)

What is “Evidence”?

• “Apparent, manifest, obvious,

palpable, clear, plain”

• “Something that has occurred

with certainty”

• “The product of observation”• “The product of experiment”

Is Evidence an Appropriate

Idea in Health Promotion?

(Cont.)

Conclusion-Recommendations

Evaluation Working Group

The use ofrandomizedcontrol trials toevaluate healthpromotioninitiatives is inmost casesinappropriate,misleading andunnecessarilyexpensive

Support the use ofmultiple methods

Support furtherresearch into thedevelopment ofappropriateapproaches toevaluating healthpromotioninitiatives

What Is “Acceptable”

Evidence in Health

Promotion?

• “We should assemble evidence of

success using a kind of ‘judicialprinciple’ -- by which I meanproviding evidence which wouldlead a jury to committingthemselves to take action evenwhen 100% proof is not available”(Tones, 1997)

Scientific Rigor in Health

Promotion Research

• “The process of systematically

studying a phenomenon, using anappropriate design and methods forthe problem, and often includingthe development and testing oftheory” (Allison and Rootman,1996)

Components of Scientific

Rigor in Health Promotion

Research

• Theoretically grounded• Sound research design• Ethically appropriate

Principles for Evaluation of

Health Promotion Initiatives

• Participation• Multiple methods• Capacity-building• Appropriateness

Collating Evidence on Health

Promotion Effectiveness

Centre for Health Promotion

U.S. Task Force on CommunityPreventive Services

Health Development Authority

Cochrane Collaboration

Ways of Sharing Evidence on

Health Promotion Effectiveness

• Learn to talk to our audiences

Ways of Sharing Evidence

(Cont.)

• Package what we know

properly

• Use appropriate media