La Ricerca e le Politiche Sociali e Socio-Sanitarie in Emilia-Romagna - Applicazione e Approcci per la Valutazione (Research and Evaluation of Social-Health Policies in Emilia-Romagna Region - A Theory Driven Evaluation Approaches)

Abstract

This volume consists of two logically linked parts: the first deals with the second survey about social researches carried out by Regional Departments and the analysis of 25 of them in the family, childhood, adolescence area. The second part treats the evaluation of research and health promotion programmes according to the 'theory oriented' methodology.

After the first survey in 2009 of the researches carried out in Emilia-Romagna Local Authorities (Health Trusts, Municipal and Provincial Administrations and Public Trusts for Personal Services), mainly concerning social and health integration, the Social Innovation Area of the Regional Agency for Health and Social Care considers it worth to promote the same kind of survey on social researches performed in regional Social Departments. The final aim of the project that led to the two surveys is to work out guidelines and action strategies in order to steer research, to make it visible, shared and effective in planning.The comparison between priority issues, rationale, methodology adopted by the Region and Local Authorities can enrich both social operators and decision makers in order to verify the research consistency with sector planning and in Regional Social and Health Plan.

The purpose of the first part of the paper is to make this further knowledge available and to spread and complete the results of the first survey. Moreover it is important to give some development perspectives, in particular to establish a Regional Social Research Registry and interactive tools within the territory.

In 2009, 291 local researches were collected and evaluated; respectively 48 and 64 of them dealt with the themes of 'Elderly' and 'Immigration'; in the second survey 87 social regional researches were also collected; 25 of them – carried out by the Family, childhood, adolescence regional Department – were analyzed.

The introduction of the first part of the volume presents the path followed and the motivations of the regional work group of the Agency, who examined the researches. The first Chapter defines the final and specific aims of the project and the main questions for this monitoring. The second Chapter describes the frame of the Regional researches, reporting quantity, promoting Department and principal themes.

The following Chapters present the methodology adopted by the regional group and the main results and comments about the analyzed research products, especially their priorities and relevant directions. Chapters 4 and 5 respectively deal with the comparison between regional research products and the planning sector and the working perspectives on social research. The second part of the volume focuses on the issue of theory-driven evaluation approaches aimed both at developing complex programmes and supporting policy making processes. Those approaches have helped to open the 'black box' of programmes and have been developed to deal with the complexity of the programmes; since the ‘80s, they were applied to the evaluation of comprehensive health promotion place-based initiatives delivered at community level. The introduction explains how and why the Emilia-Romagna Region has decided to propose these innovative methods.

The first Chapter of the second part of the volume sums up the common points of the several theory-oriented health promotion approaches, by pointing out aims and opportunities for decision makers and professionals. In particular, different kinds of programme theories (i.e. 'explanatory theories' and 'change theories') adopted to plan, to 'investigate the programmes', to develop evaluation questions and to identify programmes and research hypothesis, are described. The second Chapter deals with theory-based evaluation (TBE), especially applied to community development projects. Criteria to select the theories are explained and some examples are reported, as the training programme for disadvantaged young people. Moreover the risk of inaccurate use of the 'programme theory' is pointed out, like programmes which do not consider gender differences.

The 'realist evaluation' (Chapter 3), developed in the Anglo-Saxon context, is explained in its basic points: the concept of programme, the complex social programmes features, the context-mechanism-outcome configuration, the concept of 'generative' causality, opposed to the simple linear causality (deterministic model, for example 'dose-response').

The realist synthesis (Chapter 4), a further development of the realist evaluation, is presented as an alternative method of systematic review aimed to synthesize evidence and research results including both qualitative and quantitative studies. It is important to identify the 'family of mechanisms', underlying for example different health promotion interventions, as locus of comparison of the realist synthesis.

The fifth Chapter illustrates the previous approaches by two recent examples: the first is an evaluation study carried out in the Emilia-Romagna Region for the 'Safe gym. Prevention and wellness' project; the second is an innovative social research about young people participation, carried out at the national level. In both cases the research objectives and hypothesis, the methods and the main results are pointed out, according to the patterns and the features of 'theory-oriented' evaluation approaches.

Conclusions sum up the benefits by these approaches and their perspectives in the Emilia-Romagna Region context. The general scheme of interpretation adopted by the regional evaluation group and criteria for a homogeneous and clear interpretation; the list of the analyzed research products, reporting for each of them bibliographical items in a database. The bibliography includes the basic reference text books or articles for the 'theory-oriented' approaches.

Note: Downloadable document is in Italian.

Keywords: theory driven, evaluation, health promotion, realist synthesis, youth participation, territorial services

JEL Classification: H43, D60