Towards a framework for outcome assessment of health intervention: Conceptual and methodological considerations

We provide a framework for assessing the outcome of community-basedintervention programmes for the promotion of cardiovascularhealth at local level. Particular attention is therefore givento conceptual components connected with community participationin health programmes and to methodological approaches in theevaluation of cardiovascular disease (CVD)-prevention programmes.In a search of the literature covering more than 20 years (1966–1988)in 2 databases (MEDLINE and SOCA), we found that the conceptsof ‘community participation’ and ‘communityinvolvement’ have mainly been used during the latter halfof the study period. The concepts were often used interchangeablyand with no statement as to their precise meanings. The methodologicalexamination of 2 well-known community-based CVO-preventive programmesrevealed that most of the scientific papers from these programmesdealt with health behavioural and/or medical effects. The suggestedframework presented in this study is designed as a longitudinalprocess analysis focusing on critical key steps along the pathfrom input to output. The suggested research strategy is problem-orientated,inter-disciplinary and based on a multi-method approach.