This article summarizes an extensive literature review addressing the question, How can we spread and sustain innovations in health service delivery and organization? It considers both content (defining and measuring the diffusion of innovation in organizations) and process (reviewing the literature in a systematic and reproducible way). This article discusses (1) a parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, (2) clear knowledge gaps where further research should be focused, and (3) a robust and transferable methodology for systematically reviewing health service policy and management. Both the model and the method should be tested more widely in a range of contexts.

/pdf/diffusion-of-innovations-in-service-organizations-systematic-232yz0xxv2.pdf

Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations

This glossary aims to clarify some of the key concepts associated with participatory action research.

https://jech.bmj.com/content/jech/60/10/854.full.pdf

Participatory action research

The increasing use of participatory research (PR) approaches to address pressing public health issues reflects PR's potential for bridging gaps between research and practice, addressing social and environmental justice and enabling people to gain control over determinants of their health. Our critical review of the PR literature culminates in the development of an integrative practice framework that features five essential domains and provides a structured process for developing and maintaining PR partnerships, designing and implementing PR efforts, and evaluating the intermediate and long-term outcomes of descriptive, etiological, and intervention PR studies. We review the empirical and nonempirical literature in the context of this practice framework to distill the key challenges and added value of PR. Advances to the practice of PR over the next decade will require establishing the effectiveness of PR in achieving health outcomes and linking PR practices, processes, and core elements to health outcomes.

/pdf/the-value-and-challenges-of-participatory-research-uvjxnbfv4p.pdf

The Value and Challenges of Participatory Research: Strengthening Its Practice*‡

▪ Abstract Collaborative partnerships (people and organizations from multiple sectors working together in common purpose) are a prominent strategy for community health improvement. This review examines evidence about the effects of collaborative partnerships on (a) community and systems change (environmental changes), (b) community-wide behavior change, and (c) more distant population-level health outcomes. We also consider the conditions and factors that may determine whether collaborative partnerships are effective. The review concludes with specific recommendations designed to enhance research and practice and to set conditions for promoting community health.

A review of collaborative partnerships as a strategy for improving community health

Despite the many accomplishments of public health, a greater attention to evidence-based approaches is warranted. This article reviews the concepts of evidence-based public health (EBPH), on which formal discourse originated about a decade ago. Key components of EBPH include making decisions on the basis of the best available scientific evidence, using data and information systems systematically, applying program-planning frameworks, engaging the community in decision making, conducting sound evaluation, and disseminating what is learned. Three types of evidence have been presented on the causes of diseases and the magnitude of risk factors, the relative impact of specific interventions, and how and under which contextual conditions interventions were implemented. Analytic tools (e.g., systematic reviews, economic evaluation) can be useful in accelerating the uptake of EBPH. Challenges and opportunities (e.g., political issues, training needs) for disseminating EBPH are reviewed. The concepts of EBPH outlined in this article hold promise to better bridge evidence and practice.

https://www.annualreviews.org/doi/pdf/10.1146/annurev.publhealth.031308.100134

Evidence-Based Public Health: A Fundamental Concept for Public Health Practice

Evaluation continues to present health promotion researchers, practitioners, and policy makers with many challenges—conceptual, theoretical, and practical. All organizations and individuals involved in health promotion are familiar with the pressure from inside and outside the field to demonstrate that health promotion “works”. Proving that health promotion is a “worthwhile” investment for governments, non-government organizations, the community sector, and the private sector is a major external pressure on the field. Ensuring that practice is “evidence based”, of high quality, and effective is a powerful internal pressure. In many ways, it is little wonder that evaluation continues to challenge us. As this book highlights, there are multiple definitions and no general theory of health promotion. The work addresses the complex array of factors that influence the health and wellbeing of individuals, communities and populations, and practitioners and researchers in the field draw from a variety of disciplines to plan, implement, and evaluate our work. These complexities have been compounded by a growing understanding that different societies and cultures approach health promotion in general, and evaluation in particular, in different ways. In recognition of this, the book is limited to evaluation work in western, industrialised societies (p 5). The book is the outcome of the deliberations of a WHO Working Group on Health Promotion Evaluation established by the European Regional Office. It is the fourth product of the collaboration and is comprised of papers commissioned by the working group or submitted for its consideration. The members of the working group represent diverse perspectives, and came from Canada, Europe, and the United States; from governments, WHO, and the academic community; and from different evaluation backgrounds (p 3). The goal of the publication was “to stimulate and support innovative approaches to the evaluation and practice of health promotion, by reviewing the theory and best practice of evaluation and by producing guidelines and recommendations for health promotion policy-makers and practitioners, concerning evaluation of health promotion approaches”(p 3). The book includes five parts: introduction and framework, perspectives, settings, policies and systems, and a final synthesis and conclusion. The middle parts include multiple chapters, addressing conceptual, theoretical, and methodological issues. Most illustrate these using case studies. The book does not purport to be a methodology textbook—methodology is, rather, considered to be only one of the issues of importance in health promotion evaluation. The chapters focus on issues pertinent to evaluating health promotion in settings, and the aim is to influence policies and systems. A broad view is taken of what constitutes evidence, suggesting that this is entirely appropriate to health promotion (p 5–6). The quality of the chapters is uniformly high—well written, conceptually challenging but accessible, and comprehensively referenced. It is refreshing and stimulating to find a work on evaluation that is not fixated on research methodology and design. The editors/contributors clearly understand the need for rigorous research design in health promotion evaluation and for the use of evidence to guide practice, research, and policy in health promotion as in other health sciences. However, overall, the book reflects the view that methodological issues should follow, not lead, the design and implementation of health promotion and its evaluation. And there are, after all, many existing texts on research methods for health promotion evaluation. The book is intended, principally, for experienced practitioners, researchers, and policy makers—for professionals who have grappled with many of these issues in the course of our work. It is not a “how to” guide—rather, it explores the current state of the science and art in relation to contemporary health promotion and its evaluation. The chapters are relatively brief, providing an informed summary of the literature and evidence rather than an in-depth exploration of the topic. Nonetheless, the analysis and discussion are not superficial. Each of the chapters addresses a major debate in contemporary health promotion, illuminates the major points at issue, and suggests some ways forward. For this reviewer, the chapters on “what counts as evidence”, on “evaluation of quality of life”, on “policy networks for health”, on “evaluation of countrywide health promotion policies”, and on “investment for health” were of particular interest. The book concludes with recommendations for health promotion policy makers about ways to foster more appropriate evaluations of health promotion, and with a generic logic model for planning and evaluating health promotion. In light of the considerable strengths of the book, the recommendations were somewhat disappointing. This is, perhaps, because they could be written only for an international audience. But there was little new in the recommendations although, taken as a set of principles for good practice they do provide a useful guide. The generic logic model for planning and evaluating health promotion, however, is a useful, if complex contribution to the field in general and evaluation in particular. The quest for a comprehensive logic model that describes and explains the complex array of factors that influence the health of individuals and populations is likely to continue for some time to come. This refinement, though, will assist practitioners, researchers and policy makers to review our practice and to at least design more appropriate, effective evaluations. The contributors have outlined conceptual, theoretical, and practical issues that must be addressed if we are to improve the quality and range of evaluation of health promotion initiatives to change settings, policies and systems. There are, of course, many remaining questions with regard to the practice of health promotion evaluation. Reading the book highlights the large gap between the technical capacity that is available to guide and undertake effective evaluation and the relatively limited application of this in practice. The book did not seek to address this gap, although the recommendations to policy makers essentially seek to bridge it. But much more will be needed if the ideas and challenges presented in the book are to be translated into action. The systematic, routine adoption of the recommendations is, itself, a variation on a health promotion intervention, and the evaluation of methods to ensure this a further challenge. In all, the book is highly recommended as a conceptual guide to contemporary health promotion evaluation.

https://www.euro.who.int/__data/assets/pdf_file/0007/108934/E73455.pdf

Evaluation in health promotion : principles and perspectives

A framework for health promotion evaluation.

Evaluation in health promotion: synthesis and recommendations.

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Evaluation in health promotion : principles and perspectives

A framework for health promotion evaluation.

Evaluation in health promotion: synthesis and recommendations.