Health promotion research: dilemmas and challenges

OBJECTIVE: To analyse dilemmas and challenges in health promotion research, and to generate ideas for future development. METHOD: The analysis is based on authors' experiences in working in the field of research and action in health promotion and on experiences of others as found in literature. RESULTS: The assumptions underlying scientific research as based in the biomedical design are difficult to meet in community-based health promotion research. Dilemmas are identified in relation to the possibility of defining the independent and dependent variables beforehand and the intermingling of these variables (the intervention and outcome dilemma), the difficulty in quantifying the desired outcomes (the number dilemma), and the problem of diffusion of the programme to the control group (the control group dilemma). CONCLUSION: Research in health promotion has specific reasons to reconsider the approach towards research, the selection of outcome variables, and research techniques. Strategies and methods to make activities and their outcomes clear are discussed and criteria to judge confidence and applicability of research findings are presented.