An epidemic of orthodoxy? Design and methodology in the evaluation of the effectiveness of HIV health promotion

Abstract

This paper examines the epidemic of orthodoxy affecting the evaluation of current health promotion work. This has resulted in the privileging of certain methods, in particular, experimental method and the randomized control trial. Problems identified by public health researchers are discussed but the major focus of our critique concerns the ways in which the experimental method and, especially, the randomized control trial, assume that the audience of any health promotion message comprises a number of asocial individuals who occupy non-discursive space in ahistorical time. An alternative approach is advocated which focuses attention on the programme of health promotion and education rather than on any one individual health promotion initiative or intervention. Attention is also given to educational and health promotion practices; it is here, we argue, that some of the answers to ‘what works’ are to be sought. We illustrate our argument with reference to a number of recent Australian health promotion campaigns, including ‘Condoms Every Time’ and ‘Negotiated Safety’ .