1. Evaluating Health Programmes
By Geoff Middleton
Lecturer: Health Promotion & Exercise
Faculty of Health Life and Social Sciences

2. Why Evaluate?
To describe and/or assess what was intended? (goals/aims/objectives/KPIs?)
May be to describe what was unintended?
What was actually implemented?
What outcomes/results where achieved?
What are the implications of the findings? (actions/recommendations?)
To answer three basic questions:
WHAT?
SO WHAT?
NOW WHAT?
Adopted from: Patton (2008)

3. Interaction of health promotion programme outcomes
Raised awareness and participation
Short-term programme impact
Social & behavioural outcomes
Health status & disease changes
Adopted from: Nutbeam & Bauman (2006)

4. Health promotion evaluation stages
PROCESS EVALUATION
Is the programme reaching the target group?
Are the participants satisfied with the programme?
INTERMEDIATE OUTCOME EVALUATION
What proportion of the target group have heard of the health promotion activities?
Has there been a change in behaviour, for example more people exercising?
FINAL OUTCOME EVALUATION
Has there been changes in health or perceived health?
Has there been long-term changes in behaviour/attitude?
Adopted from: Davies & Macdowall (2006)

5. Health promotion actions Social health outcomes
EDUCATION
Examples include patient education, school education and broadcast media communication.
SOCIAL MOBILISATION
Examples include community development, group facilitation and technical advice.
ADVOCACY
Examples include lobbying, political organisation and activism and overcoming bureaucratic inertia.
Health promotion outcomes (outcomes of the process of intervention)
HEALTH LITERACY
Measures include health-knowledge, attitude, motivation, behavioural intentions, personal skills and self efficacy.
SOCIAL ACTION & INFLUENCE
Measures include community participation, community empowerment, social norms and public opinion.
HEALTHY PUBLIC POLICY & ORGANISATIONAL PRACTICE
Measures include policy statements, legislation, regulation and resource allocation and organisational practices.
Intermediate health outcomes (programme impact or short-term outcomes)
HEALTHY LIFESTYLES
Measures include tobacco use, physical activity, food choices, alcohol and illicit drug use.
EFFECTIVE PREVENTATIVE HEALTH SERVICE
Measures include access to and provision of relevant and preventative services.
HEALTHY ENVIRONMENTS
Measures include safe physical environment, supportive economic and social conditions, suitable food supply and restricted access to alcohol/tobacco.
Social health outcomes
(long-term outcomes)
SOCIAL OUTCOMES
Measures include quality of life, functional independence, social capacity and equity.
HEALTH OUTCOMES
Measures include increased morbidity, reduced disability and avoidable mortality.
Adopted from: Nutbeam & Bauman (2006)

6. Review
Evaluation has simple principles: “What”, “So What” and “Now What”.
Health programmes should be evaluated across the spectrum of it’s activities
This will require different time-points of inquiry and different types of evaluative procedures (process, intermediate and final outcomes).
Concentrating just of the final outcomes will mean a narrow focus, and will most likely divulge programme ‘failure’.
Concentrating on evaluation at the start and throughout can inform progress, change and evolve the programme creating final outcomes of value.

7. References Contact details
Nutbeam, D., Bauman, A. (2006) Evaluation in a Nutshell: A practical guide to the evaluation of health promotion programmes. McGraw Hill: New York, USA.
Davies, M., Macdowall, W. (2006) Health Promotion Theory: Understanding Public Health. Open University Press: Maidenhead, UK.
Patton, M. (2008) Utilisation-focused Evaluation. SAGE: London, UK.
Contact details
Geoff Middleton, MSc, RNut
School of Sport, Coaching and Exercise Science
University of Lincoln
Sports Centre: 1st Floor offices
Brayford Campus
Lincoln
Lincolnshire
LN6 7TS
Tel: