Evaluating health promotion programmes

Health promotion has developed significantly since its inception with the Lalonde Report (Lalonde 1974) and its formal promulgation by the World Health Organization through the Ottawa Charter in 1986 (WHO 1986). However, there is often a gap between policy intention and its implementation: ‘Governments mediate, through their architecture of machinery and policy, access to rights and, by extension, to services’ (Lawson et al. 2008: 3). There is a need for people with intellectual disabilities and their carers to break through this architecture to obtain the services they require. One possible bridging mechanism is the evidence and insights provided by programme evaluation. Elsewhere in this book, health promotion strategies for key health topic areas have been explored and ethical issues considered. It should be noted, however, that no matter how well developed the theoretical and practice-based elements of health promotion programmes are, we inevitably come to the key question: ‘How do we know that health promotion interventions improve the health status of people with intellectual disabilities at all levels from individual to population?’ This chapter seeks to define the concept of evaluation and identify its integral role within health promotion practice. It explores the key elements of evaluation planning and implementation in health promotion programmes, particularly as they affect people with intellectual disabilities. We also recognize that the engagement with health promotion by people with intellectual disabilities and their caregivers will have collateral effects on their significant others, those who commission and deliver health promotion programmes, and the wider community. Those who advocate for the rights of people with intellectual disabilities, as they monitor the effects of health promotion interventions on this population, will also have an interest in the nature and outcomes of evaluation