[Towards a framework to assess the effectiveness of community-based health promotion initiatives: recent North-American developments].

The current systematic reviews to assess the effectiveness of community-based health promotion projects, be they quantitative (numerical meta-analyses) or qualitative (narrative reviews), both have significant drawbacks. Out of the work conducted for two initiatives, the developments for the Global programme on health promotion effectiveness carried at by the North American Region out of the International Union of Health Promotion and Education (IUHPE), as well as the work conducted for the ECIP (effectiveness of community interventions project) of Health Canada, a new way to approach the issue of effectiveness is proposed. Based on a "realist synthesis" epistemological position, this approach has led us to the first formulation of a framework aiming at identifying the mechanisms that explain why local programs are successful.