Disease prevention and health promotion programs: benefits, implementation, quality assurance and open questions - a summary of the evidence

Abstract

Aim: Disease prevention and health promotion programs are standardized behavioral interventions that may be combined with contextual interventions. With optimized methods, they offer proven efficacy, efficiency, transparency, manageability, and rapid transfer of knowledge. Subject and methods: This review summarizes their central barriers and success factors based on current research. Results: Important barriers to effective use of disease prevention and health promotion programs are low implementation fidelity, exaggerated flexibility subject to political change, inadequately trained and overworked personnel, disregard of context, change of implementation frameworks, lack of supportive contextual interventions, a plethora of programs, scarce resources and weak organizational support, resistance to social technologies, choices based on marketing criteria instead of effectiveness, and research gaps. Solutions include robust intervention plans, clear and comprehensive manuals, definition of intervention core and periphery, organizational and leadership support, qualification of users, systematic adaptation to local conditions, and quality assurance/monitoring of acceptance and effectiveness. Conclusion: Both users and decision-makers should demand proof of effectiveness of program choices and should adhere to quality assurance procedures during implementation. Program development and evaluation should ensure (1) the definition of core intervention components, (2) instructions for adaptation of programs to specific contexts, (3) basic data on resources required for implementation, and (4) evidence of program effectiveness.