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Participatory evaluation as a tool for enhancing the role of self-help groups in health planning Campbell, Deborah Lee

Abstract

This dissertation explores the potential of participatoryevaluation as a tool for involving self-help groups in health promotion. To explore this potential, I engaged twenty-one women representing seventeen women's self-help groups in Vancouver in an exercise to consider how well the Vancouver/Richmond Health Board: (1) included groups such as theirs in a recent community participation process and (2) supported self-help groups as complementary health services. The Health Board was invited but did not become involved. On the whole, participants perceived that the Health Board adopted a top-down approach to community health promotion and did not include or support their groups adequately or equitably. They believed that the Health Board had failed to develop a sense of trust and camaraderie between the Board and self-help groups and that the Board's efforts to reach out to these groups did not involve planning approaches that fostered such relations. This dissertation reveals that it is not necessary to have to choose between a consensus and conflict approach to participatory evaluation. Evaluation can be placed on a continuum ranging from one extreme to the other and can adopt elements of both forms of evaluation. The grass-roots, flexible nature of our exercise enabled participants to conduct the evaluation using either or both of these stances. Our exercise was more consensus-oriented but also involved elements of the conflict approach. The nonattendance of the Health Board gave participants the opportunity and confidence to organize, to take control, to become empowered, and to act. This absence, however, made it difficult for self-helpers to work collaboratively with the Health Board during the evaluation and to share understandings and reach a consensus with them about our findings and how they can be used to make transformations in health promotion. On the other hand, our exercise enabled participants to find alternative ways to work with the Health Board in the future. In other words, we adopted an incremental rather than revolutionary strategy and, therefore, may have only temporarily compromised educative authenticity to achieve catalytic and tactical authenticity.

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