How to evaluate participatory action research for health promotion interventions: the pragmatic Emke framework
- 1Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam
- 2Health Behaviour and Chronic Diseases & Methodology, Amsterdam Public Health Research Institute
- 3Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre
Abstract
Purpose Participatory Action Research (PAR) is a promising approach to increase the effectiveness and impact of health promotion interventions. Evaluating the process of developing and implementing co-created interventions can provide important insights in barriers, facilitators and potential impact of a PAR approach. To date, a framework guiding the process evaluation of developing and implementing actions using a PAR approach is lacking. This study aimed to develop a pragmatic framework to guide the process evaluation of a PAR approach for the development and implementation of health promotion actions, as part of the Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) study. Methods The framework we developed, called the Emke framework, is primarily based on the RE-AIM framework (1999) as the RE-AIM framework has previously been successfully used to evaluate the process of conducting PAR to develop and implement actions. Additionally, the Emke framework is based on the framework of Saunders et al. (2005) which is commonly used in the process evaluation of health promotion interventions. Elements that would complement the Emke framework specifically focussing on the evaluation of PAR, were added from the Dutch PAR quality framework by Jurrius (2013) listing important requirements of conducting PAR approach with youth and the position paper by Wright et al. (2013) that describes eleven essential characteristics of high-quality PAR in health research. Results The Emke framework consists of seven elements related to the process evaluation of (1) conducting PAR and (2) the implementation of co-created actions, which are both iterative processes. These elements include: preconditions, recruitment, participants, adoption, iterative implementation, perceived effects, and sustainability. All elements are applicable to both the process evaluation of conducting PAR and implementation co-created actions, yet their application differs. Conclusions This is the first framework specifically designed to guide the process evaluation of PAR projects. Systematic process evaluations of PAR projects will gain a better understanding of barriers, facilitators and potential impact of PAR projects. We hope that the Emke framework will prove useful to researchers in future PAR projects.
Related
- Study protocol for the Collaborative Registrar Education and Training Enhancement (CREATE) project: a mixed-methods participatory study to co-design, implement and evaluate innovations to optimise GP training.
- Community-based interventions to improve hepatitis C linkage to care among people with substance use disorders in Southwest Virginia: a pragmatic sequential cohort study
- Co-designing maternal mental health interventions and implementation strategies under climate stress in Nigeria: a participatory workshop
- Health promotion interventions for ethnic minority populations living with multiple long-term conditions (H-PRIME) in OECD countries: a scoping review
- The Effectiveness of Psychological Interventions for Common mental disorders (EPIC): protocol of a pragmatic randomized waitlist-controlled superiority trial
BibTeX
@article{emke2026evaluate,
title = {{How to evaluate participatory action research for health promotion interventions: the pragmatic Emke framework}},
author = {Helga Emke and Mai Chinapaw and Coosje Dijkstra and Stef Kremers and Teatske Altenburg},
journal = {BMC Public Health},
year = {2026},
month = jul,
doi = {10.1186/s12889-026-28776-1},
url = {https://doi.org/10.1186/s12889-026-28776-1},
note = {CC BY},
}
RIS
TY - JOUR
TI - How to evaluate participatory action research for health promotion interventions: the pragmatic Emke framework
AU - Helga Emke
AU - Mai Chinapaw
AU - Coosje Dijkstra
AU - Stef Kremers
AU - Teatske Altenburg
PY - 2026
DA - 2026/07/01
JO - BMC Public Health
DO - 10.1186/s12889-026-28776-1
UR - https://doi.org/10.1186/s12889-026-28776-1
AB - Purpose Participatory Action Research (PAR) is a promising approach to increase the effectiveness and impact of health promotion interventions. Evaluating the process of developing and implementing co-created interventions can provide important insights in barriers, facilitators and potential impact of a PAR approach. To date, a framework guiding the process evaluation of developing and implementing actions using a PAR approach is lacking. This study aimed to develop a pragmatic framework to guide the process evaluation of a PAR approach for the development and implementation of health promotion actions, as part of the Lifestyle Innovations Based on Youth Knowledge and Experience (LIKE) study. Methods The framework we developed, called the Emke framework, is primarily based on the RE-AIM framework (1999) as the RE-AIM framework has previously been successfully used to evaluate the process of conducting PAR to develop and implement actions. Additionally, the Emke framework is based on the framework of Saunders et al. (2005) which is commonly used in the process evaluation of health promotion interventions. Elements that would complement the Emke framework specifically focussing on the evaluation of PAR, were added from the Dutch PAR quality framework by Jurrius (2013) listing important requirements of conducting PAR approach with youth and the position paper by Wright et al. (2013) that describes eleven essential characteristics of high-quality PAR in health research. Results The Emke framework consists of seven elements related to the process evaluation of (1) conducting PAR and (2) the implementation of co-created actions, which are both iterative processes. These elements include: preconditions, recruitment, participants, adoption, iterative implementation, perceived effects, and sustainability. All elements are applicable to both the process evaluation of conducting PAR and implementation co-created actions, yet their application differs. Conclusions This is the first framework specifically designed to guide the process evaluation of PAR projects. Systematic process evaluations of PAR projects will gain a better understanding of barriers, facilitators and potential impact of PAR projects. We hope that the Emke framework will prove useful to researchers in future PAR projects.
SN - 1471-2458
ER -