摘要：We propose a new approach to guide health promotion practice. Health promotion should draw on 2 related systems of reasoning: an evidential system and an ethical system. Further, there are concepts, values, and procedures inherent in both health promotion evidence and ethics, and these should be made explicit. We illustrate our approach with the exemplar of intervention in weight, and use a specific mass-media campaign to show the real-world dangers of intervening with insufficient attention to ethics and evidence. Both researchers and health promotion practitioners should work to build the capacities required for evidential and ethical deliberation in the health promotion profession. We propose a framework to formalize 2 central aspects of health promotion practice—ethics and evidence—and to guide future practice. This framework is speculative, based on our professional and academic knowledge and the literature. It entails 2 iteratively related systems of reasoning: an evidence-based system and an ethics-based system. Evidence-informed practice and ethical reasoning both aim to maximize human well-being by applying explicit evaluative frameworks. 1 Evidence and ethics are implicitly related: evidence-based practice may be more ethical, and ethically sensitive practice more effective. Health promotion practice would benefit by deliberately bringing evidence and ethics together; to specify the concepts, values, and procedures inherent in each; and to achieve this integration through a detailed study of current practices in health promotion. The definition of health promotion is contested and values driven, 2 , 3 but researchers and practitioners widely acknowledge that health promotion occurs at different levels—from standardized top-down national programs to unique grass-roots initiatives. We illustrate our arguments using a national social marketing campaign, 4 but we do not intend to imply that local programs are less worthy of examination. The need to integrate evidence and ethics in health promotion becomes especially critical when large-scale intervention for a problem is urged, but guidance for action is limited. Body weight is a good example of this discrepancy. In recent years, “overweight and obesity” has been increasingly talked about and accepted as a global problem and threat to public health. 5 – 10 This discourse has attracted political attention, with concomitant expansion in intervention. However, limited evidence or formal ethical debate is available to guide such action. Because body weight exemplifies the problems facing health promotion professionals in relation to evidence and ethics, we use intervention for this issue to illustrate our arguments. The Australian social marketing campaign we examine closely ( How Do You Measure Up? ) is focused on weight. Next, we consider the evidence and ethics of health promotion, before examining the benefits of a more integrated approach that makes values explicit.
