This article has a twofold agenda. First, it examines lessons from qualitative evaluative research on a community intervention in stroke rehabilitation. Second, it focuses on more general, fundamental questions in evaluation, particularly in healthcare. This involves addressing the domination of a relatively narrow range of positivist research approaches in much medical research and how this limits understanding. While in the medical field randomized controlled trials are regarded as the gold standard, evaluations that rely on quantitative methods and measuring outcomes alone are inadequate. General themes addressed include: the relative neglect of nonpositivist, qualitative and process-orientated evaluation; the recognition of key distinctions in healthcare evaluation research; the need for greater attention to mixed and combined methods in evaluation; and the recognition of barriers to and key challenges in developing combined methods. This agenda suggests a need for more pluralist mentalities in research funding, evaluation and publication.
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