Zeitschrift für Evaluation: Issue 2/2026, 25. Volume

Measuring effects in health promotion and prevention is inherently complex. Using the well-established micro-meso-macro structure, this article examines key challenges: even at the micro level, the long-term nature of desired effects and limited resources present significant difficulties for effect measurement. At the meso level, the complex causal pathways and high context-dependency complicate evaluation. At the macro level, measuring societal impacts poses fundamental methodological challenges due to numerous external factors. Divergent expectations and unclear definitions of societal benefit add further challenges. Approaches to address these issues include focusing on outcomes, using theory-based models, applying mixed-methods designs and developing simulation-based estimations. The case of Health Promotion Switzerland, a leading national institution in this field, illustrates how these challenges can be addressed in practice.

Keywords
Gesundheitsförderung, Prävention, Wirkungsevaluation, Wirkungsmessung