Abstract
The chapter is focused mainly on the intervention research and evaluation of actions aimed at strengthening and supporting health assets as a way of producing healthy communities and individuals. There is a need to re-think traditional assumptions related to evaluating the effectiveness of health interventions aimed at strengthening health assets as opposed to eliminating or curing diseases. Working from a concrete example of a 4-year collaborative project in Canada aimed at developing a framework for evaluating the effectiveness of community interventions to promote health and build community capacity. The chapter introduces a series of profound methodological challenges that this type of evaluation research presents, along with a discussion of the attempt to use a ‘realist synthesis’ approach to addressing these challenges.
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Notes
- 1.
It should be noted by way of caveat that often people understand the term evaluation to apply to the concept of effectiveness more generically. However, due to two developments in the literature, we want to emphasize this contrast: first, because of the rise of the systematic review, ‘evidence review’ or ‘synthesis’ are used more often in relation to questions of effectiveness; second, the types of methodological problems that arise in doing evidence syntheses are sui generis and need to be distinguished from the methodological debates within evaluation as a separate topic.
- 2.
This is not the same as statistical measures of “heterogeneity” of data which tend to avoid the conceptual problem of identity and theoretical homology.
- 3.
Formally, if we cannot be sure that category X represents the class x 1…..x n, where all x’s are equal, then X cannot be a putative cause of anything.
- 4.
Pawson’s term is, as admitted by the author, an umbrella concept that tries to capture a variety of approaches that meet up with similar methodological problems. “Meta-analysis” and “narrative review ” are therefore not symmetrical terms; the former is a fully developed and standardized methodological approach, whereas the latter is simply a useful label for an array of differing and even mutually incompatible approaches. Furthermore, there have been recent advances in the narrative review approach that address some of Pawson’s critique, particularly work by Jennie Popay and colleagues.
- 5.
This is a somewhat ironic criticism, as the main thrust of the author’s argument is that, meta-analysis tends towards a “stainless steel” law of review, where: “the more rigorous the review, the less evidence there will be to suggest that the intervention is effective” (Petticrew 2003: pp. 757–758).
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Hills, M., Carroll, S., Desjardins, S. (2010). Assets Based Interventions: Evaluating and Synthesizing Evidence of the Effectiveness of the Assets Based Approach to Health Promotion. In: Morgan, A., Davies, M., Ziglio, E. (eds) Health Assets in a Global Context. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-5921-8_5
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