without making implicit value judgments (NRC, 1978, 1996). The solution to this dilemma ideally lies in the development and application of new approaches for integrating scientific considerations with social and normative considerations in a transparent, fair, and competent manner (Renn et al., 1995; NRC, 1996; Klinke and Renn, 2002).

Although randomized controlled trials (RCTs) are the gold standard for testing interventions in clinical and public health research, it is not always feasible, appropriate, or ethical to use that methodology in conducting population-based research; furthermore, RCTs may not always illuminate the complexity of some population-based prevention strategies (Robinson et al., 1998; Briss et al., 2000).

Therefore, the evidence base regarding public health prevention efforts often involves the integration of a range of research methodologies. Several health promotion and disease prevention initiatives have implemented comprehensive population health programs using a broader integrated approach to the evidence. For example, Table 3-4 illustrates the different approaches required for guiding the design of individual and community-based approaches to CVD prevention (Osaka Declaration, 2001).