Evaluation of Public Health Interventions

Evaluation encompasses the set of tools that are used to measure the effectiveness of public health programs by determining what works. Traditional evaluations in public health have focused on assessing the impact of specific program activities on defined outcomes. Evaluation is also a conceptual approach to the use of data—as part of a quality improvement process—in public health management. Public health organizations must continually improve upon the standards of evidence used in the evaluation of public health so that results can inform managerial and policy decision making. As public health interventions become more integrated within the community, collaboration in evaluation efforts is a growing imperative. Evaluation concepts and methods are of growing importance to public health organizations, as well as to education and social services programs. Increasingly, public health managers are being held accountable for their actions, and managers, elected officials, and the public are asking whether programs work, for whom, and under what conditions. Public health decision makers need to know which program variants work best, whether the public is getting the best possible value for its investment, and how to increase the impact of existing programs. These evaluation questions are being asked of long-standing programs, new activities, and proposed interventions. These developments parallel today’s emphasis on “evidence-based medicine” in clinical areas and suggest the growing role of “evidence-based management” within public health organizations. In this context, evaluation is, first of all, a set of tools that is used to improve the effectiveness of public health programs and activities by determining which programs work, and also which program variants work most effectively. These tools derive from social science and health services research and include concepts of study design, a variety of statistical methods, and 38425_CH18.495_544 4/4/07 12:00 PM Page 495