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Action Evaluation of Health Programmes and Changes: A Handbook for a User-Focused Approach
  1. H Davies
  1. Professor of Health Care Policy & Management, University of St Andrews, St Andrews, Fife KY16 9AL, UK; hd{at}

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Evaluation has never been higher on the agenda. Policies and programmes in health care change faster than ever, yet the methodological demands of rigorous evaluations lead to them becoming more complex, time consuming, and often distant from everyday service experience. Too often, by the time evaluation information becomes available, things have moved on and the information lacks saliency. What distinguishes this text is both its plurality of approaches and its focus on the end users of evaluation information. In this sense, the book concentrates on what it terms “action evaluation”—evaluations designed to inform, in realistic time scales, policy, managerial and practice questions.

The text is in three parts. First, Øvretveit discusses the overall design requirements for evaluations of policies and programme changes, then he introduces the tools needed to develop evaluations, before finally exploring some of the specific issues that arise in evaluation implementation—for example, data gathering or ethics. The book fills an obvious need by offering a very practical step by step guide at each stage. Each section is highly structured, with good use being made of tables and figures. A bulleted summary rounds off each chapter, enabling quick review of the material covered. The book is completed by a handy glossary of terms complete with definitions.

This is an undoubtedly practical book, and Øvretveit does a good job in positioning his action evaluation approach compared with pure research or more standard evaluation methods. Being relentlessly pragmatic, however, the book is rather light in two interrelated areas—qualitative methods receive fairly scant attention and there is almost no mention of how theory can help develop more meaningful evaluations of wider applicability. This is disappointing when the complexity of healthcare policies and programmes, and the ways in which they interact with the social context of their delivery, provides great scope for theory driven approaches. Work such as that described in Realistic Evaluation by Pawson and Tilley (Sage, 1997) provides a nice counterpoint to this text. Nonetheless, for would-be evaluators, Øvretveit’s book provides clear and practicable guidance on evaluation, highlighting both the potential and the pitfalls.