[Community-based health promotion--a challenge for the evaluation].
OBJECTIVE
Community-based health promotion (CBHP) aims at mobilising citizens for health-related issues in their environment, and at implementing health-promoting projects on the community level. Whereas recent political decisions support this approach, scientific studies dealing with theories and consequences of CBHP are scarce in Germany. Evaluation of CBHP could help identify (in)effective factors and elements of community programmes and thus improve future planning. In Germany, however, there is a deficit in systematic concepts and recommendations for the evaluation of CBHP. This work outlines basic ideas and core principles of CBHP and deduces implications for the assessment of health-promoting community projects.


METHODS
Based on different international models and studies and on discussions with health promotion professionals, we developed a framework for the evaluation of CBHP.


RESULTS
The proposed framework includes a guideline for CBHP programme planning. Its strategic and operational criteria can serve as a basis for a strategy evaluation. In terms of process evaluation, indicators for the dimensions (1) programme implementation and service delivery, (2) capacity building, and (3) reach of and acceptability in the target group were developed. In addition, we present different areas of OUTCOME EVALUATION; it is advisable to distinguish between measurement on the individual and on the community level. The framework further proposes strategies for the evaluation of the core principles empowerment and participation.


CONCLUSIONS
The presented framework can serve as a basis for the development of flexible and individual instruments for the evaluation of CBHP, which should not ignore the perspective of the citizens, or complex aspects like changes on the community level. Some aspects, e.g., the potential evaluation of further targets of CBHP (improvement of quality of life, reduction of social and health inequalities), the responsibility of evaluation or the effects of financial constraints, are important questions to be addressed in the future.
Loss
J
J
Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth, Germany. julika.loss@uni-bayreuth.de
Eichhorn
C
C
Gehlert
J
J
Donhauser
J
J
Wise
M
M
Nagel
E
E
D003153:Community Health Services / Q000379:methods* / Q000458:organization & administration*; D005858:Germany; D006293:Health Promotion / Q000379:methods* / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000458:organization & administration*; D015397:Program Evaluation / Q000379:methods*