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Evidence in gezondheidsbevordering

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Samenvatting

Om de kwaliteit van gezondheidsbevordering te waarborgen, groeit de vraag naar evidence-based interventies. Tot nu toe wordt evidence opgevat en toegepast zoals in de medische wetenschappen gebeurt, waarbij het gaat om het vaststellen van het effect van een geneesmiddel of behandeling. Deze vorm van evidence blijkt in gezondheidsbevordering vaak problemen op te leveren omdat dit soort evidence geen rekening houdt met de context. Dit bemoeilijkt de interpretatie van de resultaten en het gebruik van de uitkomsten.

In dit artikel wordt een overzicht gegeven van soorten evidence waaronder typen die wel rekenschap geven van de context. Deze contextgevoelige soorten evidence zijn beter bruikbaar voor de kwaliteitsborging van gezondheidsbevordering. Het genereren van contextgevoelige evidence vereist echter andere onderzoeksmethoden en kwaliteitscriteria. Ook het combineren van soorten evidence is nog een onontgonnen terrein.

Abstract

Evidence in health promotion

Dutch policy makers, professionals and researchers are searching for ways to improve the efficiency, quality and long-term sustainability of health promotion by promoting evidence based health promotion. This refers to the use of information derived from formal research and systematic investigation to identify the most effective health promotion actions to address health issues in given contexts and populations. However, the term “evidence-based” remains a confusing concept. We consider how and why the evidence-based health promotion movement developed and we discuss what types of evidence are available. Various initiatives have resulted in further quality improvement of the health promotion field but also face a number of bottlenecks. These bottlenecks are difficulties with the RCT-design, the time lag, the neglection of the role of context and the fact that dissemination of described effective interventions are not automatically implemented in practice. The current strategies of policy makers and intermediaries show a preference of descriptive analytical and impact evidence (context-free evidence) above theoretical, implementation and stakeholder evidence (context-sensitive and informal evidence).

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    Lenneke Vaandrager

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  1. Lenneke Vaandrager
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  2. Annemarie Wagemakers
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  3. Hans Saan
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Correspondence to Lenneke Vaandrager.

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Healthy Alternatives, Culemborg

Gezondheid en Maatschappij, Maatschappijwetenschappen, Wageningen Universiteit

Lenneke Vaandrager, Gezondheid en Maatschappij, Departement Maatschappijwetenschappen, Wageningen University. Hollandseweg 1, 6707 KN Wageningen, tel. 0317-482462

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Vaandrager, L., Wagemakers, A. & Saan, H. Evidence in gezondheidsbevordering. TVGW 88, 271–277 (2010). https://doi.org/10.1007/BF03089623

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