Evaluating Structural Change Approaches to Health Promotion

An Exploratory Scoping Review of a Decade of U.S. Progress

Yuka Asada, Lisa Lieberman, Leah C. Neubauer, Rosie Hanneke, Michael C. Fagen

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

Structural change approaches—also known as policy and environmental changes—are becoming increasingly common in health promotion, yet our understanding of how to evaluate them is still limited. An exploratory scoping review of the literature was conducted to understand approaches and methods used to evaluate structural change interventions in health promotion and public health literature. Two analysts—along with health sciences librarian consultation—searched PubMed, Web of Science, and EMBASE for peer-reviewed U.S.-based, English language studies published between 2005 and 2016. Data were extracted on the use of evaluation frameworks, study designs, duration of evaluations, measurement levels, and measurement types. Forty-five articles were included for the review. Notably, the majority (73%) of studies did not report application of a specific evaluation framework. Studies used a wide range of designs, including process evaluations, quasi- or nonexperimental designs, and purely descriptive approaches. In addition, 15.6% of studies only measured outcomes at the individual level. Last, 60% of studies combined more than one measurement type (e.g., site observation + focus groups) to evaluate interventions. Future directions for evaluating structural change approaches to health promotion include more widespread use and reporting of evaluation frameworks, developing validated tools that measure structural change, and shifting the focus to health-directed approaches, including an expanded consideration for evaluation designs that address health inequities.

Original languageEnglish
Pages (from-to)153-166
Number of pages14
JournalHealth Education and Behavior
Volume45
Issue number2
DOIs
StatePublished - 1 Apr 2018

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Health Promotion
Health
Environmental Policy
Librarians
Focus Groups
PubMed
Evaluation
Structural Change
Language
Public Health
Observation

Keywords

  • evaluation
  • health policy
  • health promotion
  • measurement issues
  • research design

Cite this

Asada, Yuka ; Lieberman, Lisa ; Neubauer, Leah C. ; Hanneke, Rosie ; Fagen, Michael C. / Evaluating Structural Change Approaches to Health Promotion : An Exploratory Scoping Review of a Decade of U.S. Progress. In: Health Education and Behavior. 2018 ; Vol. 45, No. 2. pp. 153-166.
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Evaluating Structural Change Approaches to Health Promotion : An Exploratory Scoping Review of a Decade of U.S. Progress. / Asada, Yuka; Lieberman, Lisa; Neubauer, Leah C.; Hanneke, Rosie; Fagen, Michael C.

In: Health Education and Behavior, Vol. 45, No. 2, 01.04.2018, p. 153-166.

Research output: Contribution to journalArticleResearchpeer-review

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