An Evaluation Framework for Health Promotion: Theory, Quality and Effectiveness1

There is increasing demand for evaluation work funded by public agencies to become more focused on demonstrating effectiveness. Focusing evaluation on outcomes and effectiveness meets the information needs of strategic planners and policy makers, but other stakeholders involved in managing, delivering or using public services and programmes may use other assessment criteria, such as improving the quality of programmes or programme design. The necessity and value of these other criteria are in danger of being obscured. Acknowledging the legitimacy of the range of stakeholder perspectives, this article presents a framework for evaluation that has been developed over a number of years within the context of evaluating health promotion programmes as part of the work of a national health promotion agency. It argues for an approach to evaluation which recognizes the contributions of theory and quality as well as effectiveness in programme development. The Health Education Board for Scotland (HEBS) framework for evaluation – and the analysis that informed it – demonstrates that there are many stages and forms of evaluation which contribute to the development of effective interventions. While outcome evaluations and effectiveness reviews tend to be the prized evaluation products for those concerned with policy and strategic planning, these forms of evaluation are just ‘the tip of the iceberg’ of what is required to build a sound evidence base, bringing together the full range of evaluation needs from the perspectives of all the different stakeholder groups.