Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, the University of Melbourne VIC 3010, Australia.
BMC Public Health. 2011 Sep 30;11:749. doi: 10.1186/1471-2458-11-749.
For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation) need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. As an initial response to this problem, we used two non-invasive methods to evaluate a community-directed health promotion program, which aimed to improve nutrition and physical activity for members of the Aboriginal community of the Goulburn-Murray region of northern Victoria, Australia. The study addressed two main questions. First, for members of an Aboriginal sporting club, what changes were made to the nutrition environment in which they meet and how is this related to national guidelines for minimising the risk of chronic disease? Second, to what degree was the overall health promotion program aligned with an ecological model of health promotion that addresses physical, social and policy environments as well as individual knowledge and behaviour?
Rather than monitoring individual outcomes, evaluation methods reported on here assessed change in the nutrition environment (sports club food supply) as a facilitator of dietary change and the 'ecological' nature of the overall program (that is, its complexity with respect to numbers of targets, settings and strategies).
There were favourable changes towards the provision of a food supply consistent with Australian guidelines at the sports club. The ecological analysis indicated that the design and implementation of the program were consistent with an ecological model of health promotion.
The evaluation was useful for assessing the impact of the program on the nutrition environment and for understanding the ecological nature of program activities.
为了使原住民和托雷斯海峡岛民社区的健康促进活动取得成效，干预措施（及其评估）需要在复杂的社会环境中运作，并尊重土著知识、文化和社会系统。目前，从业者缺乏能够捕捉到这种复杂性的文化上适当的评估方法。作为对这个问题的初步回应，我们使用了两种非侵入性方法来评估一个社区主导的健康促进计划，该计划旨在改善澳大利亚维多利亚州北部古尔本市-默雷地区的原住民社区成员的营养和身体活动。该研究主要解决了两个问题。首先，对于一个原住民体育俱乐部的成员，他们在见面时的营养环境发生了哪些变化，以及这与减少慢性病风险的国家指南有何关联？其次，健康促进计划在多大程度上符合健康促进的生态模式，该模式涉及身体、社会和政策环境以及个人知识和行为？
这里报告的评估方法不是监测个人结果，而是评估营养环境（体育俱乐部的食物供应）的变化，以促进饮食变化，以及整体计划的“生态”性质（即，涉及目标、环境和策略的数量的复杂性）。
体育俱乐部的食物供应朝着符合澳大利亚指南的方向发生了有利的变化。生态分析表明，该计划的设计和实施符合健康促进的生态模式。
评估对于评估计划对营养环境的影响以及理解计划活动的生态性质是有用的。
