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Implementation Science

, 11:63

First Online: 06 May 2016Received: 09 October 2015Accepted: 20 April 2016DOI: 10.1186-s13012-016-0422-6

Cite this article as: Breuer, E., Lee, L., De Silva, M. et al. Implementation Sci 2015 11: 63. doi:10.1186-s13012-016-0422-6


BackgroundDespite the increasing popularity of the theory of change ToC approach, little is known about the extent to which ToC has been used in the design and evaluation of public health interventions. This review aims to determine how ToCs have been developed and used in the development and evaluation of public health interventions globally.

Methods We searched for papers reporting the use of -theory of change- in the development or evaluation of public health interventions in databases of peer-reviewed journal articles such as Scopus, Pubmed, PsychInfo, grey literature databases, Google and websites of development funders. We included papers of any date, language or study design. Both abstracts and full text papers were double screened. Data were extracted and narratively and quantitatively summarised.

ResultsA total of 62 papers were included in the review. Forty-nine 79 % described the development of ToC, 18 29 % described the use of ToC in the development of the intervention and 49 79 % described the use of ToC in the evaluation of the intervention. Although a large number of papers were included in the review, their descriptions of the ToC development and use in intervention design and evaluation lacked detail.

ConclusionsThe use of the ToC approach is widespread in the public health literature. Clear reporting of the ToC process and outputs is important to strengthen the body of literature on practical application of ToC in order to develop our understanding of the benefits and advantages of using ToC. We also propose a checklist for reporting on the use of ToC to ensure transparent reporting and recommend that our checklist is used and refined by authors reporting the ToC approach.

KeywordsTheory of change Intervention development Evaluation Programme theory Public health Systematic review AbbreviationsRCTrandomised controlled trial

ToCtheory of change

Electronic supplementary materialThe online version of this article doi:10.1186-s13012-016-0422-6 contains supplementary material, which is available to authorized users.

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Author: Erica Breuer - Lucy Lee - Mary De Silva - Crick Lund


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