Health promotion through healthy public policy: the contribution of complementary research methods

The focus of the "new public health" is moving from the level of individuals to the level of organizations, communities, and broader social policies. Traditional quantitative methods which are appropriate at the level of individual behaviour change, require adaptation and refinement when sociopolitical change becomes the mechanism for health promotion. Because of their training and experience, health services researchers and health educators, especially psychologists, are understandably resistant to making necessary methodologic changes. Well-designed and carefully conducted qualitative studies, using techniques such as ethnographic interviews, participant observation, case studies, or focus group activities, are required to complement quantitative approaches. These studies can fill gaps where quantitative techniques are suboptimal or even inappropriate. Hard qualitative techniques can also support soft quantitative methods. Their utility in process evaluation is now beyond dispute. Recent work at the New England Research Institute is used to illustrate the role of qualitative research in the evaluation of health promotion through planned sociopolitical change.