Evidence-based health promotion? Some methodological challenges

Abstract

The current move towards evidence-based health care has not been paralleled by equivalent developments in the field of health promotion. This paper reports on a five-year programme of work establishing an electronic register of bibliographic references to health promotion studies and developing procedures for systematically reviewing health promotion and other social intervention evaluations. The methods used to develop the register, the review procedures and the search strategies are described. Findings are presented based on the classification of 6,280 health promotion studies and a systematic review of 112 sexual health promotion interventions for young people.Well-designed evaluations of health promotion interventions are rare, and difficult to find. Most evaluations describe processes of designing and implementing interventions rather than their impact on defined behavioural or other outcomes. Authors' claims to effectiveness often neglect to take account of these methodological problems. Possible reasons for the poor state of evaluation design in health promotion are discussed.

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