The effectiveness of human impact assessment in the Finnish Healthy Cities Network.
OBJECTIVE
To develop a framework for analysing the effectiveness of prospective assessment and to apply the framework to human impact assessments (HuIA) carried out in the Finnish Healthy Cities Network.


METHODS
The framework was formed by synthesizing and developing the themes that emerged from the published literature on effectiveness. The research material consists of interviews with people who participated in the assessment process in the municipalities (19 interviews). The research material also included assessment documents, proceedings of working meetings, municipal policy documents, background material and project reports produced in the municipalities studied. The research datasets were examined by content analysis.


RESULTS
HuIA increased the decision-makers' awareness of effects and functioned as a tool for empowerment. The latter was apparent, for instance, in the social welfare and healthcare sector, finding a role for itself in decisively co-ordinating interdisciplinary work and actively seeking to alleviate identified negative effects. The assessment process also opened up the planning process, committed various actors to the decision, helped select the right alternative and promoted social learning.


CONCLUSIONS
From the viewpoint of preparation and decision-making, the effectiveness of a HuIA increases when assessment becomes a recurring process and an integral part of an organization's activities. Integration of an assessment into permanent structures or activities, such as drawing up programmes or preparing strategies, helps the results of the assessment to be seen more clearly. From the viewpoint of decision-making, it is also important to strengthen the decision-makers' expertise in prospective assessment. When the effectiveness of HuIA is looked at in a new way (i.e. from the viewpoint of goal achievement, decision-making or learning), a more comprehensive interpretation can be given.
Kauppinen
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The National Research and Development Centre for Welfare and Health (STAKES), P.O. Box 220, 00530 Helsinki, Finland.
Nelimarkka
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Perttilä
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D002958:City Planning / Q000458:organization & administration*; D018672:Community Health Planning / Q000458:organization & administration*; D003256:Community Participation; D003659:Decision Making, Organizational; D003710:Demography; D004777:Environment; D005387:Finland; D040361:Healthy People Programs / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D009937:Organizational Objectives; D011209:Power, Psychological; D016730:Program Development; D012922:Social Change; D014504:Urban Health