Targeting health and social need is an important theme in the Northern Ireland Regional Strategy, Health and Well-being into the Next Millennium: A regional strategy for health and social well-being, 1997-2002 (Department of Health and Social Services for Northern Ireland, 1996), which is concerned with addressing inequalities in health status and social well-being. This paper describes a project which assessed the contribution made by nurses, midwives and health visitors to targeting health and social need (THSN). While there is a considerable body of research and information on variations in health and social well-being, few evaluative research interventions improve the health of disadvantaged groups. The initial project was commissioned by the Department of Health and Social Services (DHSS) for one year, had a timetable that covered three phases and was jointly conducted by the schools of nursing at The Queen's University of Belfast and the University of Ulster.
In the first phase a survey questionnaire was distributed to a purposive sample of nurses working with both community and voluntary groups to assess their contribution to THSN (n=1000). The paper describes the results from the 392 questionnaires returned (a response rate of almost 40%) and the work carried out in phase 2 of the study, in which the responses were analysed to allow further investigation. By using selection criteria devised by the Project Advisory Board, the interventions were reduced to 22. In an overview of each of these, a number of characteristics kept recurring that could serve to define aspects of 'good practice'.
The results highlight nursing competencies gained through their work, the lessons learnt and the problems and difficulties encountered. Importantly, the 22 case studies demonstrate the efforts made by nurses and health professionals to change behaviour, practice, the community and the environment.
The paper concludes that the use of qualitative research opens the door to measures of social position that reflect the ways in which people define themselves and the relationships which sustain them. Although there is still some way to go in understanding the different approaches to evaluation, an environment which fosters the monitoring and assessment of practice might be created in the future within the nursing community.
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