How to evaluate small-scale interventions in deprived neighborhoods?

BACKGROUND: In deprived neighborhoods there is not only an accumulation of public health problems, but also an accumulation of small-scale interventions to address these problems. For evidence based public health policy it is important to know which interventions are most effective. However, many small-scale interventions are not well evaluated because standard research methods are not sufficient to provide information about the vulnerable target group. Therefore in the IGLO Utrecht study we developed an evaluation method for small scale interventions in the living environment of deprived neighborhoods. METHODS: Principles from the quadruple helix approach were combined with core components of a methodology for reaching a hard to reach population. This was applied in three studies in a deprived neighborhood in Utrecht: health evaluation of the renovation of a social housing flat, a study about redevelopment in the neighborhood and a study about health-related reasons to visit nature. The intervention and the geographical area of the expected effect on residents health were discussed with professionals. Details about the personal approach, choice of words in the announcement letter and questionnaire were developed in collaboration with an advisory group of residents. RESULTS: Linking the study to the intervention in the neighorhood was helpful in making contact with residents. The response rate of the questionnaire was 49% (86/174) with reach out by telephone, 34% (140/414) with a combination of telephone and door-to-door and 31% (64/209) with a reach out door-to-door. Participants were representative for the neighborhood regarding migration background and education level. Field notes about the informal contact provided additional information to the questionnaires. CONCLUSIONS: Close collaboration with professionals and residents contributes to a high response in the health evaluation of small-scale interventions. The personal approach is very time-consuming. KEY MESSAGES: • Close collaboration with professionals and residents contributes to a targeted approach and higher response in the health evaluation of small scale interventions in deprived neighborhoods. • A thorough evaluation of small-scale interventions in deprived neighborhoods is possible, when enough time, budget and capacity can be made available.