What are the benefits and risks of using return on investment to defend public health programs?

Return on investment (ROI) is an economic measure used to indicate how much economic benefit is derived from a program in relation to its costs. Interest in the use of ROI in public health has grown substantially over recent years. Given its potential influence on resource allocation, it is crucial to understand the benefits and the risks of using ROI to defend public health programs. In this paper, we explore those benefits and risks. We present two recent examples of ROI use in public health in the United States and Canada and conclude with a series of proposals to minimize the risks associated with using ROI to defend public health interventions

Managing tensions between evaluation and research: illustrative cases of developmental evaluation in the context of research

Developmental evaluation (DE), essentially conceptualized by Patton over the past 30 years, is a promising evaluative approach intended to support social innovation and the deployment of complex interventions. Its use is often justified by the complex nature of the interventions being evaluated and the need to produce useful results in real time. Despite its potential advantages, DE appears not to have been very widely used in research. The authors of this article decided to use this emergent approach in two evaluative research projects in health promotion. This article, coming out of their experiences, aims to assess the appropriateness of DE in research and describes issues related to its use. First, DE is presented, along with the potential advantages of its use in research. This is followed by a discussion of tensions related its application encountered in two studies carried out by the authors. The key issues are related to the links between academic and evaluative objectives, the dual role of researcher and consultant, and the temporality of the process. Finally, weighing the advantages of DE against its challenges, the authors conclude with a diagnosis regarding the application of this approach in research

What really matters in pediatric chronic pain rehabilitation? Results of a multi-stakeholder nominal group technique study

Abstract : Purpose: To prioritize outcome domains sensitive to the needs of the various stakeholders involved in rehabilitation programs designed for youth with pain-related disability using the International Classification of Function Child and Youth version. Materials and Methods: A 5-step nominal group technique was conducted with 13 stakeholders, including 2 youth with pain-related disability, 2 parents, 5 clinicians, 2 teachers, and 2 healthcare managers. Once identified by content thematic analysis and International Classification of Function linking, 15 outcome domains were ranked. Priority rank scores were then weighted. Results: Six outcome domains were prioritized: 1) activities of daily living, 2) participation in meaningful activities, 3) social roles and relationships, 4) mood and affect, 5) school engagement, and 6) self-efficacy. Discrepancies in ranking existed; parents and youth attributed importance to pain, sleep, and program satisfaction whereas clinicians and mangers underscored pain–related fear and family functioning. When compared, prioritized domain associated with three PedIMMPACT recommendations, and aligned with the activity and participation components of the International Classification of Function for Child and Youth. Conclusion: These findings emphasize the importance of integrating various perspectives, including those of youth with pain-related disability and other important stakeholders and adopting a broader conceptualization of disability and function when selecting key rehabilitation evaluation outcome for this population

How can both the intervention and its evaluation fulfill health promotion principles? an example from a professional development program

The emergence over the past 20 years of health promotion discourse poses a specific challenge to public health professionals, who must come to terms with new roles and new intervention strategies. Professional development is, among other things, a lever for action to be emphasized in order to meet these challenges. To respond to the specific training needs of public health professionals, a team from the Direction de santé publique de Montréal (Montreal Public Health Department) in Quebec, Canada, established in 2009 the Health Promotion Laboratory, an innovative professional development project. An evaluative component, which supports the project’s implementation by providing feedback, is also integrated into the project. This article seeks to demonstrate that it is possible to integrate the basic principles of health promotion into a professional development program and its evaluation. To this end, it presents an analytical reading of both the intervention and its evaluation component in light of the cardinal principles in this field. Initiatives such as the Health Promotion Laboratory and its evaluation are essential to consolidate the foundations of professional development and its assessment by concretely integrating health promotion discourse into these practices

Defining, illustrating and reflecting on logic analysis with an example from a professional development program

Program designers and evaluators should make a point of testing the validity of a program's intervention theory before investing either in implementation or in any type of evaluation. In this context, logic analysis can be a particularly useful option, since it can be used to test the plausibility of a program's intervention theory using scientific knowledge. Professional development in public health is one field among several that would truly benefit from logic analysis, as it appears to be generally lacking in theorization and evaluation. This article presents the application of this analysis method to an innovative public health professional development program, the Health Promotion Laboratory. More specifically, this paper aims to (1) define the logic analysis approach and differentiate it from similar evaluative methods; (2) illustrate the application of this method by a concrete example (logic analysis of a professional development program); and (3) reflect on the requirements of each phase of logic analysis, as well as on the advantages and disadvantages of such an evaluation method. Using logic analysis to evaluate the Health Promotion Laboratory showed that, generally speaking, the program's intervention theory appeared to have been well designed. By testing and critically discussing logic analysis, this article also contributes to further improving and clarifying the method

Collaborative learning processes in the context of a public health professional development program : a case study

The health promotion laboratory (HPL – Canada) is a public health professional development program building on a collaborative learning approach in order to support long-term practice change in local health services teams. This study aims to analyse the collaborative learning processes of two teams involved in the program during the first year of implementation. Based on a multiple case study design involving observations, interviews, and documentary sources, the study: (1) describes the learning process by which each team built a common understanding of the problem at hand and developed an intervention to address it; (2) identifies factors that facilitated or hindered these processes; and (3) proposes a cross-case explanation of the collaborative learning process in the HPL. The results demonstrate that the two teams learned by expanding their repertoire of actions, albeit experiencing different processes. Results point to the central role of shared mental models and key influencing factors, such as commitment and participation (team cohesion), team climate (psychological safety), and leadership style. Unlike previous studies on team learning that concentrated on existing teams in organisations, the current research studied purposely created teams working at transforming their practices and showed that they can successfully learn if specific conditions are achieved