Long term global evaluation of a national AIDS prevention strategy: the case of Switzerland.
OBJECTIVE
The Swiss Aids prevention strategy has been subject to a continuous process of evaluation for the past 12 years. This paper describes the conceptual approach, methodology, results obtained and contribution to policy-making of that evaluation.


METHODS
The evaluation is on-going, global with respect to all components of the strategy, and utilization-focused. Each successive phase of the evaluation has included 10-20 studies centred either on aspects of process, of outcome or of environmental context. Findings are synthesized at the end of each phase.


METHODS
Both quantitative and qualitative methods are used. Studies generally have one of three functions within the overall evaluation: assessment of trends through surveys or other types of repeated studies; evaluation of specific areas through a series of studies from different viewpoints; in-depth investigation or rapid assessment through one-off studies. Various methods of triangulation are used to validate findings.


RESULTS
The evaluation has allowed for: the observation of behavioural change in different populations; the availability of scientific data in controversial fields such as drug-use policy; an understanding of the diversity of public appropriation of prevention messages. Recommendations are regularly formulated and have been used by policy-makers and field workers for strategy development.


CONCLUSIONS
The global approach adopted corresponds well to the evaluation requirements of an integrated long-term prevention strategy. Cost is low relative to the extent of information provided. Such an evaluation cannot however address the question of causal relationship between the strategy and observed changes. The evaluation has contributed to the development of a culture of evaluation in Swiss AIDS prevention more generally.
Dubois-Arber
F
F
University Institute for Social and Preventive Medicine, Lausanne, Switzerland. francoise.dubois-arber@inst.hospvd.ch
Jeannin
A
A
Spencer
B
B
D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control*; D015438:Health Behavior; D006266:Health Education; D006291:Health Policy; D006801:Humans; D011314:Preventive Health Services; D015397:Program Evaluation; D013557:Switzerland