Evaluating the Fabreville Heart Health Program in Laval, Canada: a dialogue between two paradigms, positivism and constructivism.

https://arctichealth.org/en/permalink/ahliterature185380
Source
Health Promot Int. 2003 Jun;18(2):127-34
Publication Type
Article
Date
Jun-2003
Author
Minh Nguyet Nguyen
Joanne Otis
Author Affiliation
Public Health Department of Laval, Quebec, Canada. nguyet_nguyen@ssss.gouv.qc.ca
Source
Health Promot Int. 2003 Jun;18(2):127-34
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Cardiovascular Diseases - prevention & control
Community Health Services - organization & administration - standards
Consumer Participation
Focus Groups
Health Behavior
Health Care Coalitions
Health Education - organization & administration - standards
Health promotion - organization & administration - standards
Humans
Primary prevention - methods
Program Evaluation - methods
Quebec
Abstract
As part of the Canadian Federal-Provincial Initiative in Heart Health, the goal of the Fabreville Heart Health Program was to sensitize a district of Laval, Quebec's second most populous city, to heart-healthy behaviours. The program was planned and implemented by a committee composed of Fabreville community leaders and professionals from the Public Health Department. Between 1992 and 1994, intervention objectives were defined by the department in terms of changing individual behaviours associated with cardiovascular risk factors, namely diet, sedentariness and smoking, as well as adapting physical and social environments to facilitate these changes. However, from 1994 to its conclusion in 1997, the program was re-oriented to engage the population in mobilizing their own community and taking charge of interventions themselves. Actions then became dependent on the interests and motivation of Fabreville residents to transform their lifestyles and aspects of their physical environment. The initial evaluation process, based on the positivist paradigm, was designed to measure changes in individual behaviours and certain physical environments, such as an increase in designated non-smoking areas. However, following the re-orientation towards community mobilization, it was decided that evaluation should go beyond the professional production of data to include a process of the collective construction of knowledge. Evaluation methodology then became based on the constructivist paradigm. Yet field constraints such as lack of community involvement in both leadership and process evaluation, and the need to ensure evaluation standards and fulfil sponsor obligations, compelled the Public Health Department to return to using a certain number of positivist methods. The ensuing inter-paradigm dialogue helped broaden the scope of evaluation and contributed to gaining a more in-depth understanding of the processes and outcomes of community mobilization.
PubMed ID
12746384 View in PubMed
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