Abstract
Population-level health interventions are policies or programs that shift the distribution of health risk by addressing the underlying social, economic and environmental conditions. These interventions might be programs or policies designed and developed in the health sector, but they are more likely to be in sectors elsewhere, such as education, housing or employment. Population health intervention research attempts to capture the value and differential effect of these interventions, the processes by which they bring about change and the contexts within which they work best. In health research, unhelpful distinctions maintained in the past between research and evaluation have retarded the development of knowledge and led to patchy evidence about policies and programs. Myths about what can and cannot be achieved within community-level intervention research have similarly held the field back. The pathway forward integrates systematic inquiry approaches from a variety of disciplines.
Key words: Evaluation, population health intervention research, evidence-based practice, intervention research, population health
Résumé
Les interventions populationnelles de santé comprennent l’ensemble des actions qui visent à modifier la distribution des risques à la santé en ciblant les conditions sociales, économiques et environnementales qui façonnent la distribution des risques. Sous forme de programmes et politiques, ces interventions peuvent provenir du secteur de la santé mais sont aussi souvent pilotées par d’autres secteurs comme l’éducation, le logement ou l’emploi. La recherche sur les interventions de santé des populations poursuivent l’objectif de documenter la valeur et les effets de ces interventions, les processus par lesquels les changements opèrent et les conditions qui favorisent les effets. Dans le domaine de la recherche en santé, des distinctions inutiles entre la recherche et l’évaluation ont retardé le développement des connaissances sur l’intervention de santé des populations et mené à une mauvaise intégration des données de recherche pour soutenir la pratique et les décisions concernant les programmes et politiques de santé des populations. Cet article déboulonne donc certains mythes pernicieux concernant la recherche sur les interventions, notamment relativement aux coûts associés, à ses visées et à la croyance en un rôle nécessairement marginal des communautés concernées pour développer des interventions efficaces. Cet article retourne aussi comme arbitraire et injustifiée la distinction traditionnelle entre la recherche sur les interventions et la recherche évaluative. En fait cet article montre que la recherche sur les interventions a tout à gagner d’un rapprochement avec la recherche évaluative et d’une intégration des méthodes de recherche appliquée provenant d’une diversité de disciplines.
Mots clés: Évaluation, intervention pour la santé des populations, pratique fondée sur des données probantes, recherche sur les interventions, santé des populations
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