Health Promotion Effectiveness

Two research projects: Building the Evidence Base for Reducing Health Disparities: An Alternative Methodology for Knowledge Synthesis and Assessing the Effectiveness of Inter-sectoral Community Efforts to Promote Health and Reduce Disparities are both well underway.

The former research project aims to support the methodological development and refinement of a 'realist synthesis' approach to synthesizing the evidence base for the effectiveness of community efforts to act on the social determinants of health and health disparities. The latter project utilizes and tests the tool. By conducting a systematic review of the effectiveness of community efforts to reduce health disparities, this research project offers focused information on complex community health interventions to reduce health disparities.

Building the Evidence Base for Reducing Health Disparities: An Alternative Methodology for Knowledge Synthesis

This research aims to support the methodological development and refinement of a 'realist synthesis' approach to synthesizing the evidence base for the effectiveness of community efforts to act on the social determinants of health and health disparities.

The research project has the following four research objectives:

  1. To further develop and refine the methodology of realist synthesis for public health and health promotion interventions.
  2. To conduct a pilot systematic review using the realist synthesis approach focused on synthesizing the evidence for the effectiveness of community efforts that impact on the social determinants of health and health disparities.
  3. To assess the generalizability and adaptability of the realist synthesis approach for health promotion and public health.
  4. To assess the practical relevance and timeliness of the realist synthesis approach for informing the policy and planning process for health promotion and public health interventions.

This project will address the need for new and innovative approaches to synthesizing evidence for the effectiveness of complex health interventions and will contribute to the ongoing search for better, more practical and more timely ways to inform policy and practice about the best available knowledge that exists concerning effective health promotion aimed at reducing health disparities and acting on the social determinants of health.

Assessing the Effectiveness of Inter-sectoral Community Efforts to Promote Health and Reduce Disparities

The research team is conducting a focused systematic review of the evidence of the effectiveness of intersectoral community efforts to promote health and reduce health disparities. This work is being conducted with the full collaboration of the Public Health Agency of Canada (PHAC) and the US Centers for Disease Control and Prevention (CDC).

There are particular methodological challenges to conducting systematic reviews in this area. Specifically, traditional approaches to systematic review, relying on a strict evidence hierarchy, create difficulty in identifying a substantive evidence base on which to conduct review analyses of community health promotion interventions. The recent joint commissioning work of the Canadian Health Services Foundation and the Service Delivery and Organization Research and Development Programme of England funded research that explores emerging alternatives to orthodox systematic review methodologies. One of the emerging strategies is termed realist, based primarily on the work of Pawson (2002a, 2002b) along with other colleagues (Pawson, Greenhalgh, Harvey & Walshe, 2005). This is acknowledged as one promising alternative approach to systematic review and will be used to guide this project.

References

Pawson, R. (2002a). Evidence-based policy: In search of a method. Evaluation 8(2),157-181.

Pawson, R. (2002b). Evidence-based policy: The Promise of 'Realist Synthesis'. Evaluation 8(3), 340-358.

Pawson, R., Greenhalgh, T., Harvey, G., & Walshe, K. (2004). Realist synthesis: An introduction - ESRC Research Methods Programme Working Paper Series: University of Manchester.