There are three broad themes integrated throughout this thesis. The first relates to the development and implementation of a multimedia health care program called "Ambulances for Asthma". The second relates to program evaluation within health care and recounts the methodological challenges related to the evaluation of this program. The third portrays the self reflective evaluation journey of the author informed by auto-ethnography. Six linked projects are presented, culminating in a metaevaluation of the health promotion [process, impact and outcome (PIO)] and realist evaluation models from health care practitioner and policy maker perspectives. This thesis aims to determine which approach has greater utility, feasibility, propriety and accuracy within health care.