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Open Access Commentary

Health promotion and the randomised controlled trial: a square peg in a round hole?

Ruth Freeman

BMC Oral Health 2009, 9:1  doi:10.1186/1472-6831-9-1

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Yes, but...

Anthony Staines   (2010-11-04 10:21)  DCU email

Dear Dr Freeman,
I found your paper interesting and stimulating, and I am now using it with a class of students. I generally agree with your perspective, but I do have a but..

With my health policy hat on I have to constantly justify expenditure on health promotion. Without good supporting evidence nothing will be funded. It is very challenging to produce good evidence of the effectiveness of health promotion without some explicit comparison, however biased this may be.

A point we constantly emphasize with our clinical students is that practice guidelines are 'for the guidance of the wise, and the obedience of fools'. Might there be a useful analogy here, where health promotion interventions in a community build on the evidence, but use the community voice to say where, whether, when and how that evidence gets deployed in a program?

This is a common concept in clinical work, but I have not encountered it very explicitly in the health promotion literature. This may, of course, merely reflect my own ignorance.

Best wishes,

Anthony Staines

Competing interests

None

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