The Practice of Health Program Evaluation

By Thurston, Wilfreda E. | Canadian Journal of Public Health, July/August 2004 | Go to article overview

The Practice of Health Program Evaluation


Thurston, Wilfreda E., Canadian Journal of Public Health


The Practice of Health Program Evaluation David Grembowski. Thousand Oaks, CA: Sage Publications, 2001; 344 pp., $105 US (Cloth), $58.95 US (Paper)

This book covers the basics of evaluation of health programs from developing the research questions and selecting a design and methods to disseminating findings to the audiences that will use them. The intended audience was first and foremost graduate students in any of the health disciplines. The second audience was larger, being "program administrators, decision makers, and interest groups in public and private organizations, as well as health program evaluators and health services researchers" (p. xv). Chapter one, "Is it Worth It?", is most relevant for the second audience.

The author proposes evaluation as a three-act play: Asking the Question; Answering the Question; and Using the Answers in Decision Making. In addition to the two introductory chapters and an Epilogue, there are eight chapters. Asking the Question and Using the Answers each receive one chapter, while Answering the Question is covered in six chapters, hence, the focus is an overview of methods, principally quantitative. The section on developing research questions is particularly well developed with an emphasis on articulating the theory of causation and the theory of implementation. The reader is urged to develop immediate, intermediate and ultimate objectives.

The major weakness of the book is an attempt to cover too much for too many audiences. There is a rather simplified conceptualization of the health care system where the population served is part of the "structure" and a bias towards a rational model of decision-making, although there is a nod that evidence is only "part" of what drives policies. A very brief discussion of the "cultural context" takes a cultural sensitivity versus a cultural competence approach. …

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