Evaluations of health promotion: combining realism with rigour

Large-scale, publicly-funded programs to reduce the risk of cardiovascular disease, cancer, AIDS and other health problems are now common in Australia. There is a need to objectively evaluate the effects of these programs, but there should be realistic expectations of such evaluations. Decisions about the appropriateness of conducting evaluation studies in the field settings need to be made with an awareness of whether new methods are being tested or whether already-tested procedures and principles are being used. The limitations on research and evaluation in field settings should also be acknowledged and the changes which are expected should be identified. Planners and administrators should have an explicit rationale for the goals, intervention methods and expected outcomes of health promotion programs. But they should be realistic about the limitations of program evaluations and avoid the traps of either attempting to adhere to inappropriately high standards of scientific rigour or of abandoning any attempts at evaluation. Some guidelines are suggested to assist planners and administrators make decisions about the extent and the appropriateness of conducting health-promotion evaluations.