The promotion of health through planned sociopolitical change: challenges for research and policy.

The focus of health promotion is moving from the level of individuals to organizations, communities and broader social policy. Traditional quantitative methods (e.g. social surveys and experimental designs) which are variously appropriate at the level of individual behavior change require adaptation and refinement when sociopolitical change becomes the mechanism for health promotion. Because of their training and experience health services researchers and health educators (especially psychologists) are understandably resistant to necessary methodologic changes. Well designed and carefully conducted qualitative studies (e.g. ethnographic interviewing, participant observation, case studies and focus group activities) are required to complement quantitative approaches, and can fill gaps where quantitative techniques are suboptimal or even inappropriate: hard qualitative techniques can support soft quantitative methods. Their utility in process evaluation is now beyond dispute. Recent work at the New England Research Institute (NERI) is used to illustrate the role of qualitative research in the evaluation of health promotion through planned sociopolitical change.