Amy’s been evaluating some potential graduate students, churning up some of her own graduate school missives, and is starting to realize what all writers must face: was that really insightful or just bullshit using fancy words?
I’ve been wondering the same thing about this paper one of our Canadian friends came across, that attempts to look at the possible harms of public health interventions, what the UK authors call ‘dark logic models.’
Seems to me the model has potential use in evaluating the cult-like clean-cook-chill-separate mantra in the absence of choosing wisely – sourcing food from safe sources.
I also don’t like the use of dick fingers in writing or talking.
Although it might be assumed that most public health programmes involving social or behavioural rather than clinical interventions are unlikely to be iatrogenic, it is well established that they can sometimes cause serious harms. However, the assessment of adverse effects remains a neglected topic in evaluations of public health interventions.
In this paper, we first argue for the importance of evaluations of public health interventions not only aiming to examine potential harms but also the mechanisms that might underlie these harms so that they might be avoided in the future. Second, we examine empirically whether protocols for the evaluation of public health interventions do examine harmful outcomes and underlying mechanisms and, if so, how. Third, we suggest a new process by which evaluators might develop ‘dark logic models’ to guide the evaluation of potential harms and underlying mechanisms, which includes: theorisation of agency-structure interactions; building comparative understanding across similar interventions via reciprocal and refutational translation; and consultation with local actors to identify how mechanisms might be derailed, leading to harmful consequences.
We refer to the evaluation of a youth work intervention which unexpectedly appeared to increase the rate of teenage pregnancy it was aiming to reduce, and apply our proposed process retrospectively to see how this might have strengthened the evaluation.
We conclude that the theorisation of dark logic models is critical to prevent replication of harms. It is not intended to replace but rather to inform empirical evaluation.
Journal of Epidemiology & Community Health
Chris Bonell, Farah Jamal, G J Melendez-Torres, and Steven Summins
http://jech.bmj.com/content/early/2014/11/17/jech-2014-204671