Responsive evaluation in health promotion: its value for ambiguous contexts.

Responsive evaluation offers a perspective in which evaluation is reframed from the assessment of program interventions on the basis of policymakers' goals to an engagement with all stakeholders about the value and meaning of their practice. This article argues for this perspective both generally and more particularly in relation to health promotion. Responsive evaluation is especially appropriate in health promotion contexts characterized by a high degree of ambiguity. Ambiguity refers to the absence of or contradictory interpretations about what needs to, can and should be done, when and where. Ambiguity is high in the case of non-routine programs, lack of knowledge about success indicators, collaborative and community based programs and the absence of consensus among stakeholders. In health promotion contexts marked by a low degree of ambiguity random controlled trials (RCTs) and quantitative methods are to be considered. This implies the evaluators should assess the degree of ambiguity of a situation before deciding about an appropriate design.