Evaluating Australian Indigenous community health promotion initiatives: a selective review

Effective health promotion interventions are critical to addressing the health needs of Indigenous people. We reviewed published and unpublished evaluation reports between 2000 and 2005 to identify practice issues pertinent to evaluators of Aboriginal and Torres Strait Islander health promotion initiatives. While the review of the literature was not systematic it was sufficiently comprehensive to provide a snapshot of evaluation practice currently in place within the Australian context. We found that published evaluation literature infrequently referred to the utilisation of guidelines for ethical research with Aboriginal and Torres Strait Islander peoples. The implications of this are that the importance and relevance of the guidelines for evaluative research are not being widely promoted or disseminated to evaluation practitioners and the role of the guidelines for improving evaluation practice remain unclear. While many innovative health promotion programs appear to have been highly regarded and well received by communities, the evaluation studies were not always able to report conclusively on the impact and health outcomes of these interventions or programs. This was due mainly to limitations in evaluation design that in some cases were insufficiently robust to measure the complex and multifaceted interventions described. To enhance rigour, evaluators of community health promotion initiatives could utilise mixed method approaches overtly informed by appropriate ethical guidelines, together with a broader range of qualitative methods aided by critical appraisal tools to assist in the design of evaluation studies.