Pourquoi se préoccupe-t-on tant des données probantes en promotion de la santé?

Why do we worry about evidence in health promotion? This paper, in a sociological and historical perspective, aims at positioning the main issues linked to the idea of utilizing evidence-based practices in health promotion. It begins to do so by looking at the international evolution of health promotion and evidence-based practices, and by providing definitions for these concepts. In a second section, the paper analyzes how the evidence based practices approach has confronted the field of health promotion, especially since the second half of the 1990s. It argues that this has occurred in the context of the evaluative concerns put forward by governments all over the world, in order to downsize their publicly funded health systems. The reaction, often negative, of the health promotion field to evidence-based practices is also documented. Finally, some methodological and political issues raised by the idea of utilizing evidence-based practices in health promotion are presented. The paper concludes that this approach is far from a panacea but has potential limited utilization for certain kinds of health promotion practices. Alternative suggestions on how to establish “best practices” in this field are also offered. Copyright Birkhäuser-Verlag Basel 2003