The purpose of this study was to develop a measurement system for the evaluation of health promotion training courses offered by German statutory health insurance companies. In a field test, N=1 671 participants from 212 youth and adult courses for the promotion of either physical activity, coping with stress or nutritional improvement were included. 80% were female. Participants were questioned in a pre-post-design with a three month follow-up. The questionnaires covered health behaviour and health status. Participants' compliance and psychometric quality of the measurement instruments were good. On average, the health insurance companies assigned participants to different interventions adequately according to the participant's individual health problems. The health promotion courses triggered improvements of high effect sizes for health behaviour patterns, of moderate effect sizes for physical complaints, subjective health ratings, and health-related quality of life. Effects decreased after the end of the intervention but remained significantly above the initial values. BMI values continued their improvement after the end of the training courses. Thus, health promotion training courses generated stable health improvements of practically relevant effect sizes. The interventions provided good support and health improvements for all subgroups of participants, regardless of age, gender and educational background. Thus, the health promotion curricula of the health insurance companies offer a ubiquitous and easily accessible but effective intervention for health promotion in Germany, although men are clearly underrepresented among the participants. The trainings may be recommended and used by other health-care suppliers. The evaluation toolkit provides practical and valid instruments for a routine evaluation of health promotion trainings. It should be applied within random sampling designs.

The Hamburg University Hospital (UKE), together with the German Federal Centre for Health Education (BZgA), conducted a nationwide screening of obesity-related care. The screening was composed of two stages: Firstly, a short questionnaire of 150 items was developed and validated by experts. It comprised 14 summary criteria, derived from obesity care guidelines. The most important aspects of the providers' services were surveyed. This resulted in a description of intervention quality in 492 institutions or programs on a national level, controlled for representativity, and analyses of quality in specific institutional types. Secondly, a sample of 38 interventions was selected, using cluster analysis, and assessed in depth by means of the quality assurance system QIP (Quality in Prevention), extended to include obesity-related criteria from medical guidelines. The main results of the survey were as follows: Only 51.4 % of the guideline-based quality criteria were met by an average program. The costs of the various programs differed vastly but predicted the intervention quality only to a moderate degree. Two thirds of the programs were offered by outpatient care institutions. The screening documented that there was a lack of setting-related projects. On the basis of the findings, a registration system for projects and programs, based upon evidence-based quality criteria, is proposed. Furthermore, outpatient services and projects should be strengthened, and setting-based interventions should be developed, enhanced by a national strategy of obesity prevention on several policy levels, according to WHO recommendations.

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