European Healthy Cities evaluation: conceptual framework and methodology.

Area of Science:

• Public Health
• Urban Health
• Health Policy Evaluation

Background:

• The Fifth Phase of the World Health Organization (WHO) European Healthy Cities Network (2009-2014) involved 99 designated cities.
• Cities in the network commit to specific values, systems, and aspirations for improving urban health.
• Evaluating this diverse network requires a robust and adaptable methodological framework.

Purpose of the Study:

• To present the methodology, programme logic, and conceptual framework for evaluating the WHO European Healthy Cities Network's Fifth Phase.
• To establish the foundational principles guiding the selection of an appropriate evaluation methodology.
• To provide a basis for subsequent in-depth analyses within the supplement.

Main Methods:

• A realist synthesis methodology was employed, integrating diverse qualitative and quantitative methods.
• A structured multiple case study approach was utilized to accommodate geopolitical, demographic, and health variations.
• Data collection involved a comprehensive questionnaire, data mining (including Eurostat), and analysis of management information tools.

Main Results:

• The chosen methodology is asserted as appropriate for addressing the heterogeneity of participating cities.
• Response rates for the data collection were exceptionally high for this research scope.
• Non-response analyses confirmed the representativeness of the collected data across the diversity spectrum of the cities.

Conclusions:

• The presented framework and methodology are suitable for evaluating complex, multi-city health initiatives.
• The evaluation approach ensures data representativeness despite inherent urban diversity.
• This paper serves as a foundational resource for detailed investigations into specific aspects of the Healthy Cities programme.