The Pharmaceutical Journal
Vol 270 No 7232 p92
18 January 2003

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A useful, down-to-earth manual concealed by dull title and dingy cover

'Action evaluation of health programmes and changes' 1st edition, by John Øvretveit. Pp vi+246. Price £27.50. Oxford: Radcliffe Medical Press; 2002. ISBN 1 85775 925 7

Action evaluation is what research purists might call the quick and dirty approach; evaluations done to a strict brief and tight timescale to provide users (or customers) with evidence to make informed decisions. This new book, written by a professor of health policy and management at the school of public health in Gothenberg, Sweden, provides much useful ammunition to counter these criticisms. Illustrated with real life examples, it brings "user-led" health service evaluation to life and challenges the reader to decide their own viewpoint on what counts as "valid evidence" of effectiveness.

The author argues that evaluation is a type of research but it is also part of the change process. Time and again he emphasises the importance of defining the primary user and their needs. Unlike pure research, there may be hidden agendas and first-timers may be shocked to find they are thrown into "a web of intrigue and manoeuvring".

The book is divided into three main parts. The first describes the steps in planning and carrying out different types of evaluation. Chapter two sets out the key steps in a standard approach for evaluating a health service or programme and chapter three does the same for a policy change or health reform, highlighting difficulties in defining change and separating the instrument from its target. As the author says in chapter four, evaluation takes time and money away from other things which could be doing more good. Used at the planning stage, his useful Risk of Evaluation Failure Index should help prevent costly mistakes. Chapter five is a particularly good read, with its honest and humorous classification of practical problems such as vague users, gate-crashers, fuzzy or wobbly interventions, ghastly goals and the police car effect.

Part two provides the "tool kit" to help read and assess evaluation reports, choose designs and plan work. Part three covers specific subjects such as the pros and cons of different data collection methods, politics and ethics, and quality issues. An appendix provides a glossary of definitions, plus checklists and plans.

The chapter format — setting out what will be covered, covering it, then summarising it — aids learning, but makes the book rather longer than perhaps it needs to be. But this is a minor niggle about what is — as the author claims — a clear step-by-step guide to doing, commissioning or reading evaluation work. Do not be put off by the dingy grey cover and dull title of this new book! They hide a useful, down-to-earth manual.

Imogen Savage