Abstract
The Community Action and Public Health study explored how Ontario public health practitioners interpret and implement guidance in community action. In-depth interviews were conducted with 107 public health professionals and community members in 6 Ontario health units. This report briefly describes the study methods and presents results pertaining to the measurement of success based on interviews with 67 public health professionals.
Data substantiate the view that evaluation methodologies employing quantitative measures of epidemiological outcomes inadequately capture “success” in community action, possibly attributable to an unproductive dichotomization of “process” and “outcome”. Results suggest two kinds of “success”: a) changes related to stated goals and targets; and b) more iterative and process-oriented changes, including necessary but often undocumented shifts in relationships, structures, social conditions and processes. In order to legitimize and validate results that might otherwise pass unrecognized, we suggest a methodology that records project “milestones” as successes in their own right.
Résumé
Dans notre étude sur les initiatives communautaires et la santé publique, nous avons cherché à savoir comment les praticiens de la santé publique de l’Ontario interprètent et appliquent les orientations en matière d’initiatives communautaires. Nous avons mené des entrevues approfondies auprès de 107 professionnels de la santé publique et membres de communautés relevant de six services de santé de l’Ontario. Le rapport décrit brièvement la méthode de l’étude et en présente les résultats qui ont trait aux mesures de réussite, tirés d’entrevues auprès de 67 professionnels de la santé publique.
Les résultats confirment que les méthodes d’évaluation fondées sur la mesure quantitative des résultats épidémiologiques sont insuffisantes lorsqu’il s’agit d’évaluer la « réussite » d’une initiative communautaire, peut-être parce qu’elles opèrent une dichotomie stérile entre le « processus » et le « résultat ». Il semble y avoir deux genres de réussite: a) les changements obtenus par rapport aux buts fixés et aux cibles visées; et b) les changements itératifs, davantage axés sur le processus, notamment les changements nécessaires, mais souvent mal documentés, dans les rapports humains, les structures et les conditions sociales. Pour confirmer et valider des résultats qui autrement passeraient inaperçus, nous suggérons d’employer une méthode qui considère les « jalons » d’un projet comme des réussites à part entière.
Footnotes
This research was funded by the National Health Research Development Program of Health Canada. It was also supported by the North York Community Health Promotion Research Unit, funded by the Health Systems Linked Research Grants program of the Ontario Ministry of Health, the North York Public Health Department, and the University of Toronto. The supporting organizations are not responsible for the content or opinions expressed in this article
Contributor Information
Marie A. Boutilier, Phone: 416-971-2348, FAX: 416-978-2087, Email: marie.boutilier@utoronto.ca.
Blake D. Poland, Phone: 416-978-7542, FAX: 416-978-2087, Email: blake.poland@utoronto.ca.
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