Friday, September 3, 2010

Evaluating evaluations of health promotion campaigns in the Netherlands

Nationwide health promotion campaigns are an important part of government-funded health promotion efforts. Valid evaluations of these campaigns are important, but difficult because gold standard research designs are not applicable and budget, personnel, and time for evaluation is often very tight. In the Netherlands, Health Promotion Institutes (HPIs) are responsible for these campaigns. We conducted an exploratory study among the HPIs to gain a better insight into the goals, practices, conditions, and perceived barriers regarding evaluation of these campaigns. A paper reporting this exploration was recently published in Health Promotion International.
We conducted  personal interviews with representatives of six different HPIs who had direct responsibility for the management of the evaluation of their national campaigns. Based on these interviews it became clear that the HPIs typically made use of a pre-test–post-test design with single measurements before and after the campaign without a control group. In campaign preparations, HPIs used qualitative research to pre- and pilot-test some campaign materials or activities, but true formative evaluation was rare. Accountability to their sponsors, peers, and the population at large, was an important reason for evaluation, but the most important intrinsic motivation to evaluate was to inform future campaigns. In terms of the RE-AIM (Reach Efficacy Adoption Implementation Maintenance) framework, evaluation was mostly restricted to reach and effects; hardly any evaluation of adoption, implementation, or maintenance was reported. Budget restrictions and time restraints were reported as the main barriers for more extensive formative and more elaborate interrupted time series design effect evaluation. In conclusion, our exploration indicates that evaluation of nationwide campaigns is standard procedure, but the research designs applied are weak, due to lack of time, budget and research methodology expertise. Next to additional budget and opportunities for longer-term planning, input from external experts regarding evaluation research designs and data management are needed for evaluation improvement.

Wednesday, September 1, 2010

The ENERGY project is halfway

From August 29-31 we had the 'midterm' meeting of the EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project a Framework 7 European Commission funded project coordinated by the EMGO Institute for Health and Care Research. The midterm meeting was organised by and held at the University of Oslo, department of Nutrition. Halfway through the project we have conducted a series of systematic reviews that have or will soon be submitted for publication on family environmental determinants of obesity related behavioral nutrition and physical activity, on mediators and moderators of obesity prevention intervention effects, and of economic incentives in such interventions. Secondary analyses and focus group interviews have been conducted to gain more insight in the above mentioned determinants. But maybe most importantly, in the firts 18 months a cross European school-based, family involved survey study has been conducted among more than 7000 children in 7 countries across Europe. In this survey study, school children were measured for weight, height and waist circumference, they completed questionnaires on a range of dietary , physical activity and sedentary behaviors, and a sub sample wore accelerometers to assess their physical activity more objectively and gave blood samples for further biomarker evaluation. The data set is now being checked and cleaned and will soon be ready for first analyses. A copy of the design paper van be accessed here. A protocol paper for the survey study will soon be submitted for publication. We celebrated this accomplishment with a nice Norwegian see food dinner that was further enriched with a great musical performance by a Norwegian four female vocal group.
In the second half of the project an intervention to contribute to evidence-based obesity prevention among schoolchildren in Europe will be developed and tested in five countries. The meeting was largely dedicated to the first steps of mapping this intervention.