[Principles and problems of evaluation of results in health education]

The goals of health education are the following: 1. Increase of knowledge about physical and psychological health; diseases and their causes; and possibilities of prevention. 2. Favorable influence on attitudes concerning health problems. 3. Influence on health behavior (nutrition, smoking, way of life, exercise). In school health education and in particular in adult health education, emphasis is usually put on communication by means of lectures, brochures, newspaper articles, radio and television. However, the effectiveness of such measures is not well known. Especially, it is not clear whether the transmission of knowledge in the particular fields brings along a lasting effect on attitudes and behavior of individuals or society. Outcome evaluation in health education requires short-term, but mainly long-term studies designed according to epidemiologic principles. The groups of persons suitable for testing in accordance with the health education programs have to be compared with groups not exposed to these health education measures. Not only immediate but also long-term outcome should be evaluated. Among the difficulties inherent in such a design are the precise execution of the health education programs, the surveillance of the test and comparison groups, long-term follow-up, and especially the identification and investigation of person groups suitable for study or comparison purposes. The problems inherent in health education evaluation are illustrated by practical examples.