In community based health promotion, with epidemics like HIV and hepatitis C, there is one constant: the environment is continually changing.
Sometimes the change reflects shifting patterns in the behaviour of affected communities. Other times, the change involves responding to new research findings about the effectiveness of novel treatment and prevention strategies.
The current ‘paradigm’ for evaluation assumes that the only source of change to be considered is the intervention being studied, so that any changes observed in knowledge or behaviour in the community must result from the program/intervention itself. In fact, this kind of research actively seeks to filter out changes that result from interactions between the program and its target community.
As we know, however, peer and community based health promotion is all about interactions between the program and the communities it works with. We also know that our target communities are highly diverse and dynamic, and we would never assume our programs are the primary drivers of change within them.
Lastly, academic research and evaluation studies take a really long time – up to several years – to publish their findings. By that time, continual changes in issues and communities often makes their findings out-of-date. Health promotion programs can’t wait years to respond to pressing needs in their communities.
But this doesn’t mean their responses are not ‘evidence based’. Instead these programs use a range of ‘evidence building’ approaches to develop preliminary responses that progressively build the knowledge needed for action.
In some cases, insights from peer-based community engagement and health promotion action may be the sector’s only source of real-time knowledge about emerging issues in rapidly changing environments. Real-time insights can also help the sector interpret changes in surveillance outcomes and place social research findings in a practical context.
When health promotion programs develop a reputation for effective action on emerging issues and package up their insights for sharing in credible formats, policy-makers and funders can come to trust and rely on their input.
The W3 approach provides a framework and tools to support health promotion programs to capture and use these insights to refine their practice and improve their influence within their community and sector environments.
The W3 project has developed a conceptual framework and practical tools to support health promotion programs to adapt their approach to emerging issues and continually refine their approach to maintain effectiveness in a constantly changing environment.