The need for new perspectives on good practice to address complex public health problems in Europe
Abstract
Across Europe, authorities are persistently questioning the capacity of disease prevention and health promotion programmes and policies to bring about positive changes to the population health; a question that has gained much prominence as austerity measures take their toll. Practitioners are therefore required to defend investment in a given intervention against its costs and benefits; a requirement that stands as a major challenge. In this presentation, we look at two contrasting perspectives (i.e. research-based vs practice-based perspective) on what makes an intervention enter the realm of best practice and argue for an alternative vision of programme planning and evaluation to improve the transferability of actions to other populations.
The research-based perspective produces knowledge on good practice by applying rigorous methodological techniques that isolate the programme from its external environment to achieve high internal validity. A requirement for a successful transfer of the programme to another setting is to preserve its integrity. However this kind of ‘boutique programmes' have in many instances proven disappointing when replicated in other milieu; a situation that has brought a number of scholars to account for other neglected programme components such as context, mechanisms, functions, and to give its lettre de noblesse back to practice-based interventions. Programmes emerging from the field are seen as more amenable to transfer as they are solutions stemming from real-life practice, reflecting actual access to resources and set of constraints. Capturing their specific components would allow for their diffusion.
We conclude, by calling for an alternative approach to identification and diffusion of best practice across Europe that includes guiding principles to public health interventions. This is necessary as the current economic crisis and rising social inequities are major threats to the health of the European population.