Evaluation of a mass media health education campaign for tuberculosis control in Cali, Colombia
Tuberculosis is a world-wide problem in less developed countries. In this thesis I report the evaluation of impact, process and objectives of a mass media health education campaign for tuberculosis control developed in Cali, Colombia. The campaign aimed at reducing levels of prejudice against people with this disease and at increasing demand for diagnostic tests. I assessed impact on levels of prejudice using two cross sectional surveys as sources of data. I assessed impact on demand for diagnostic tests with a quasi-experimental evaluation design relying on epidemiological data. I used qualitative and quantitative techniques for assessing the process of the campaign. I used text analysis for assessing the objectives of the campaign, and for identifying the values underpinning these objectives. The results show that the campaign significantly reduced the prejudice, and increased the demand for tests. Process evaluation shows that the campaign managers applied satisfactorily the programme theory of the intervention, that around half of the population was exposed to the campaign, and that it aimed exclusively at reinforcing a medical approach to tuberculosis control, which promoted compliance with medical surveillance, instead of contributing to the creation of an educated public regarding this disease. Assessment of objectives showed that the values underpinning the campaign are Utilitarian which define the worth of human life in terms of its economic productivity. This thesis demonstrates that current evaluation models of health education, which draw only on impact and process, are inappropriate for all those who have an interest at stake in the programme in order to judge its worth and to take policy decisions. Health education programmes are responses to social problems based on a specific idea of what is worthwhile to be pursued by individuals and society. Thus, evaluation research in health education should include not only assessment of impact and process but also assessment of their objectives in order to unveil the values underpinning such responses.