Conference Publication Details
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Darlington, E., Mannix McNamara, P. and Jourdan, D.
European Conference on Educational Research (ECER)
Enhancing the efficacy of health education interventions: moving the spotlight from implementation fidelity to quality of the implementation process
2017
August
Published
1
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 Introduction                     

Health education programmes in various settings (workplace, sport club, school, hospital) are considered as effective means to improve the health of the population. Research has clearly endeavoured to provide evidence of successes, however results from programme implementation remain unclear and challenging to evaluate. Furthermore, demonstrating a positive and sustainable impact on health inequalities is difficult. The level of complexity of the factors impacting the effectiveness of prevention programmes led many authors to consider evaluation results with caution. In addition to these difficulties in the assessment of prevention programmes’ effectiveness, the issues of scaling up and transferability are still rarely examined.

Transferability and scaling up of prevention interventions are still laborious

In existing literature, tools and framework, developed for programme evaluation, are often (not always) grounded in a linear programme fidelity perspective. It is assumed that when it comes to the evaluation of implementation one of two options exist: a) either the programme is delivered as planned or not; and b) either it delivers expected outcomes, or not. Conversely however, implementation is argued as being a complex process, which defies such linear one-dimensional thinking. Multiple and interwoven contextual factors are at play, which relate, not only to the nature of the intervention, but also and more importantly to the different contexts of implementation.This complexity sets two challenges for the development of successful intervention programmes. The first challenge pertains to transferability, because within such variability and with limited options to control for them, streamlined outcomes are in reality difficult to predict. The second, is specific to wider replication of interventions which cannot be taken for granted because the determinants involved are numerous, variable and contextually influenced.

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