Community action success in public health: Are we using a ruler to measurea sphere?

The Community Action and Public Health study explored how Ontario public he ath practitioners interpret and implement guidance in community action, in- depth interviews were conducted with 107 public health professionals and co mmunity members in 6 Ontario heath units. This report briefly describes the study methods and presents results pertaining to the measurement of succes s based on interviews with 67 public heath professionals. Data substantiate the view that evaluation methodologies employing quantitative measures of epidemiological outcomes inadequately capture "success" in community action , possibly attributable to an unproductive dichotomization of "process" and "outcome". Results suggest two kinds of "success": a) changes related to s tared goals and targets; and b) more iterative and process-oriented changes , including necessary but often undocumented shifts in relationships, struc tures, social conditions and processes. In order to legitimize and validate results that might otherwise pass unrecognized, we suggest a methodology t hat records project "milestones" as successes in their own right.