Astrid Brousselle

Special Issue

Regards sur l’expérience de la Commission de révision permanente des programmes au Québec

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Pages:
394-411

This paper focuses on the work done by the Commission de révision permanente des programmes (CRPP) in Quebec. Based on a literature review, we present: 1) a description of the CRPP including the context surrounding its creation, its approach, the content of its reports as well as its recommendations; and 2) a portrait of the influence of the CRPP by exploring whether or not government decisions have taken its recommendations into account. The findings that emerge from our analysis lead us to conclude that the recommendations of the CRPP have not fully been implemented, but that they had an influence or a symbolic role in relation to the recent budget cuts undertaken by the government. They also contributed to the institutionalization of a new permanent spending review mechanism. In our discussion, we raise a number of questions, including the nature of the work of the CRPP and the linkage between review exercises and the evaluative function within government.

Linking Evaluation and Spending Reviews: Challenges and Prospects

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Pages:
297-304

The global financial crisis in 2008 was a significant watershed for governments everywhere. Diminished prospects for growth coupled with continuing demands for government interventions and chronic constraints on resources, prompted in part by the widespread adoption of variants of neo-liberalism (constrain resources to limit spending and shrink governments), have created fiscal environments where rationing expenditures among programs and policies is chronic and even acute.

Spring

Comment évaluer les effets des évaluations d'impact sur la santé : le potentiel de l'analyse de contribution

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Pages:
25-45

Health impact assessments (HIA) allow the potential impact of nonhealth-related actions (policy, project, program) on health to be analyzed. For example, municipal projects, for urban renewal or urban planning, have an impact on health drivers relating to the created environment, and thus, on public health. In the province of Quebec, the government and affiliated organizations have to comment on potential impacts; they use HIAs to ensure health is factored into public actions. We know little about HIAs' capacity to influence public policies; every policy and program is different and is often implemented only once, greatly complicating evaluation. Our goal is to analyze the potential of contribution analysis for evaluating the impact of HIAs at the municipal level. To this end, we present the HIA process as implemented in Montérégie, we identify evaluation challenges, and put forth, through contribution analysis, an evaluation strategy to analyze effects.

Spring

Les défis de l’évaluation développementale en recherche: une analyse d’implantation d’un projet «Hôpital promoteur de santé»

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Pages:
1-26

Developmental evaluation (DE), an approach developed by Patton to support the implementation of innovations, remains relatively untested in research. This article describes an attempt to apply DE as part of an implementation study of a healthpromoting hospital project in a university hospital. The article highlights the dichotomous demands of academic research and evaluation use inherent in applying DE from a research perspective, and analyzes the challenges encountered in this case. The conclusion is that DE can be used in research, provided that preliminary context analysis is done to anticipate the challenges related to integrating the demands of research and evaluation use.

Using the Results of Ecc Evaluations of Public Health Interventions: Challenges and Proposals

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Pages:
43-66

Faced with the combined pressures of ecc recession and growing healthcare costs, public health administrators recognize the value of using ecc arguments to justify public health interventions. Given the expense and the time involved in conducting new ecc evaluations, decision-makers regularly speculate on the possibility of using results from studies done in a different context. This article analyzes the potential for using the results of ecc evaluations of public health interventions in contexts other than those in which the studies were done. More specifically, it sheds light on issues of quality and transferability of analyses for public health decision-making and offers practical proposals for increasing the transferability of studies.

Special Issue

Guest Editors' Remarks: How Does Complexity Impact Evaluation? / Un mot des rédacteurs invités : En quoi la complexité a-t-elle des répercussions sur l’évaluation?

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Pages:
v-xx

Évaluer une intervention complexe : enjeux conceptuels, méthodologiques, et opérationnels

Authors:
Pages:
1-16

Theoretically, evaluation should help decision-makers address contemporary health system challenges. Paradoxically, the use of evaluation results by decision-makers remains poor, despite rapid development in the evaluation field. The level of use depends on the evaluator's ability to account for the complexity of health-care systems. The complex nature of an intervention often compels evaluators to adopt unconventional approaches to account for the roles of the players. The evaluation of a complex intervention raises conceptual, methodological, and operational challenges the evaluation has to overcome to increase the level of use of its findings by decision-makers.

Logic Analysis: Testing Program Theory to Better Evaluat e Complex Interventions

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Pages:
61-89

Evaluating complex interventions requires an understanding of the program's logic of action. Logic analysis, a specific type of program theory evaluation based on scientific knowledge, can help identify either the critical conditions for achieving desired outcomes or alternative interventions for that purpose. In this article, we outline the principles of logic analysis and its roots. We then illustrate its use with an actual evaluation case. Finally, we discuss the advantages of conducting logic analysis prior to other types of evaluations. This article will provide evaluators with both theoretical and practical information to help them in conceptualizing their evaluations.

Discussion: Practice-Based Evaluation as a Response to Adress Intervention Complexity

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Pages:
105-113

Special Issue

Synthèse - Empowerment et évaluation: quelques réflexions

Authors:
Pages:
283-290