Qualifying, operationalizing, and implementing the principles of the Supersetting approach in a complex community intervention: A principles-focused evaluation of Tingbjerg Changing Diabetes

Introduction

Evaluation of complex community-based interventions require adaptive approaches due to the dynamic and unpredictable circumstances of the real world. Principles-Focused Evaluation (P-FE) offers a framework for evaluating such interventions based on values and principles. The P-FE framework is relatively new and empirical case studies remain limited, which calls for more empirical studies on the potentials and limitations of working with and evaluating principles in complex community-based interventions. This case study presents a principles-focused evaluation (P-FE) of Tingbjerg Changing Diabetes (TCD), a long-term, community-based health promotion initiative in Copenhagen, Denmark.

Goals and Methods

Drawing on qualitative data from workshops and interviews with 7 professional stakeholders and 7 community members, the study describes 1) the process of qualifying and operationalizing the Supersetting principles in the context of a disadvantaged neighborhood and 2) examines if principles were meaningful and actionable, adhered to and leading to desired results. The study applies framework analysis to investigate implementation, adherence and impact.

Results

Findings reveal that a structured three-step co-production process between researchers and practitioners helped qualify, operationalize and implement the Supersetting principles.

While the PFE showed that principles generally were adhered to, the instrumental use of the principles was not completely clear. As such the study confirmed that the abstract and interpretive nature of principles limit their evaluative power as it makes the link between principles and impact hard to evaluate. The PFE highlights that the value of principles-focused community-development lies less in the principles as prescriptive constructs and more in the process of engaging with them, providing a shared framework for navigating the complexity of a community-based multi-stakeholder initiative.

Conclusions:

PFE is a relevant evaluation approach to complex community-based initiatives but requires a careful process of contextualization of principles as well as a structured way of working with and evaluating principles.