School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Prev Sci. 2019 Aug;20(6):959-969. doi: 10.1007/s11121-019-00997-4.
Evaluation of primary prevention and health promotion programs contributes necessary information to the evidence base for prevention programs. There is increasing demand for high-quality evaluation of program impact and effectiveness for use in public health decision making. Despite the demand for evidence and known benefits, evaluation of prevention programs can be challenging and organizations face barriers to conducting rigorous evaluation. Evaluation capacity building efforts are gaining attention in the prevention field; however, there is limited knowledge about how components of the health promotion and primary prevention system (e.g., funding, administrative arrangements, and the policy environment) may facilitate or hinder this work. We sought to identify the important influences on evaluation practice within the Australian primary prevention and health promotion system. We conducted in-depth semi-structured interviews with experienced practitioners and managers (n = 40) from government and non-government organizations, and used thematic analysis to identify the main factors that impact on prevention program evaluation. Firstly, accountability and reporting requirements impacted on evaluation, especially if expectations were poorly aligned between the funding body and prevention organization. Secondly, the funding and political context was found to directly and indirectly affect the resources available and evaluation approach. Finally, it was found that participants made use of various strategies to modify the prevention system for more favorable conditions for evaluation. We highlight the opportunities to address barriers to evaluation in the prevention system, and argue that through targeted investment, there is potential for widespread gain through improved evaluation capacity.
对初级预防和健康促进计划的评估为预防计划的循证基础提供了必要的信息。越来越需要高质量地评估计划的影响和效果，以便用于公共卫生决策。尽管对证据和已知益处有需求，但预防计划的评估可能具有挑战性，并且组织在进行严格评估方面面临障碍。在预防领域，评估能力建设工作受到关注；然而，关于健康促进和初级预防系统（例如，资金、行政安排和政策环境）的哪些组成部分可能促进或阻碍这项工作，相关知识有限。我们旨在确定澳大利亚初级预防和健康促进系统内对评估实践有重要影响的因素。我们对来自政府和非政府组织的有经验的从业者和管理人员（n=40）进行了深入的半结构化访谈，并使用主题分析来确定影响预防计划评估的主要因素。首先，问责制和报告要求会影响评估，特别是如果资金机构和预防组织之间的期望严重不一致。其次，发现资金和政治环境直接和间接地影响了可用资源和评估方法。最后，发现参与者利用各种策略来调整预防系统，为评估创造更有利的条件。我们强调了解决预防系统中评估障碍的机会，并认为通过有针对性的投资，有可能通过提高评估能力获得广泛的收益。
