[Evaluation of empowerment: health promotion practitioners' perceptions and concepts. Results of a qualitative study in Australia].

BACKGROUND

Although the concepts of participation and empowerment are hallmarks of the WHO vision of health promotion, it is acknowledged that they are difficult to evaluate. Devising adequate study designs, indicators and methods for the assessment of participation and empowerment should take into account the experiences, concerns, working conditions and constraints of health promotion practitioners.

METHODS

Semi-structured interviews were conducted with 17 experienced practitioners in community-based health promotion in New South Wales, Australia. The interviews covered benefits of and barriers to the evaluation of empowerment, key indicators and methodological aspects. Interview transcripts were examined using thematic content analysis.

RESULTS AND DISCUSSION

The idea of evaluating empowerment is supported by health promotion practitioners, provided that empowerment is part of the programme logic and/or programme theory. The interviews highlighted the importance of a receptive environment for evaluation of empowerment and participation to take root. The resistence of health authorities towards empowerment indicators is a great challenge for funding of evaluations. Community members are to be included in the evaluation process, al-though it is not always easy to do so in a representative way and empowering approach. The best methods to capture whether empowerment has occurred in a programme are qualitative ones. The positive experiences that the interview partners made with innovative qualitative methods encourage further investment in developing new research designs.