ACTION RESEARCH - A STRATEGY FOR EVALUATION OF MEDICAL INTERVENTIONS

Medical intervention commonly addresses issues which can rarely be con trolled and measured experimentally. The zeal for standardization of t he intervention may lead to premature closure of a development process , in which the intervention method and its implementation are omitted from systematic evaluation. However, evaluation strategies other than the experimental ones do exist and can overcome these limitations. Act ion research is presented as an alternative approach for evaluation of medical interventions. This strategy denotes the study of a social si tuation, intended to improve the quality of action. The two central co ncerns-improvements in practice and increased knowledge and understand ing-are linked together in an integrated and dynamic cycle of activiti es, in which each phase learns from the previous one and in turn shape s the next. The stages of research involve problem identification, pla nning, action and evaluation. A model for medical action research, int ended to facilitate evaluation of every step, is presented and discuss ed, illustrated by an example from primary health care research. Evalu ation must account for the following elements of the process: problem identification, summarizing previous experience, determining the aims of intervention, planning and development of the intervention method, design and articulation of the intervention strategy, implementation o f action, and redefining the problem. Potentials and limitations of th e action research strategy are discussed.