Evaluating the participatory process in a community-based heart health project

被引:65
作者
Naylor, PJ
Wharf-Higgins, J
Blair, L
Green, L
O'Connor, B
机构
[1] British Columbia Minist Hlth, Prevent Hlth Branch, Victoria, BC V8X 3X3, Canada
[2] N Shore Hlth Reg, N Vancouver, BC V7M 1A2, Canada
[3] Ctr Dis Control & Prevent, Off Smoking & Hlth, US Dept Hlth & Human Serv, Atlanta, GA USA
[4] Univ Victoria, Sch Phys Educ, Victoria, BC V8W 3P1, Canada
关键词
participatory research; heart health; health promotion; evaluation; Canada;
D O I
10.1016/S0277-9536(01)00247-7
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This paper presents the evaluation of a participatory research process used in a community-based heart health project, the British Columbia Heart Health Demonstration Project. The project utilized both a population heart health approach and a community mobilization model for taking action on heart health. A participatory evaluation plan was selected to: allow for participation in decision-making, incorporate the community perspective. enhance utilization of data, increase skills and capacities at the community level and enhance the responsiveness of the project team to emerging issues. Six elements common to participatory research were synthesized from the literature and rating scales were developed. Project participants across three project levels (investigative team, community project management committee members, community and provincial project coordinators) were asked to rate each of the elements and then explain their ratings during a focus group interview. Ratings were averaged and plotted on a 'sextagram' to illustrate the extent of participation in the research project. Patterns and themes that emerged from the transcripts and fieldnotes, regarding issues that influenced each rating. were categorized according to the framework of participatory research. Ratings and descriptions of participation on each element varied across project levels. The ratings of participation for the elements of sustainability and resource mobilization were uniformly low reflecting the large dependence on external funds. Participants involved at the community level perceived a greater level of participation in the identification of need and definition of goals and activities. Critical issues identified were related to the predominance of the external funding source, the imposition of funding agency guidelines on the communities, the amount of guidance by experts and the data collection methods. The analysis highlighted the responsiveness of the project to feedback over time and increases in the capacity of communities over time. Critical issues in the evaluation of participation were: differentiating stakeholder participation in program activities from research activities, variations in the meaning of community and participation among interviewees. the complexity of evaluating the extent of participation in a multi-level project and the evolution of participation over a 5 year time span. A definitive conclusion about the level of participation was elusive, however, the methodology afforded a contextual understanding of the assessments of participation and of participation itself and provides a foundation for evaluating and improving future participatory research initiatives. (C) 2002 Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:1173 / 1187
页数:15
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