Table 1 Four theoretical approaches for understanding the population health interventional system (ISy)
Terms | Definition | Constructs | Purpose | Specificities | Examples in the public health field | Value in understanding intervention systems |
|---|---|---|---|---|---|---|
Determinant framework | An overview of determinants and categories presumed to account for a phenomenon by acting as barriers and enablers | Environmental determinants Sociological determinants Psychological determinants Organizational determinants | Providing clues as to how the micro–meso–macro context could influence a health phenomenon | Multilevel With multiple influences Provides no explanation, only clues Derived from empirical studies of barriers and enablers | Social determinant frameworks [22] | Identifying all of the elements to be considered in understanding the system from multilevel points of view |
Classical theory | An explanatory definition of relationships between variables and the specific results of their combinations | Psychosocial constructs Structural constructs Relationships among all constructs and specific predictions, especially those formulated as mechanisms | Explaining how and why specific relationships among a set of constructs lead to specific events | Focused on the mechanisms of effects Provides some explanations Derived from fundamental work in various disciplines (psychology, sociology, political sciences, etc.) | Behavioural: social cognitive theory [26] Organizational/social: social capital theories [27] | Identifying the mechanisms of effects and the factors potentially involved in their triggering |
Process model | A deliberate simplification of a process describing how different resources could be combined to produce a change within a specific context | Variables relating to implementation (training, communication, decision, revision, etc.) May include some contextual elements influencing the delivery | Describing and/or guiding a process | Recognizing a temporal sequence and conditions of the progression of implementation endeavours More or less emphasis on the context and its influence on delivery Derived from field expertise and experimentation | The PRECEDE–PROCEED model [28] | Identifying the combination of resources and activities, as well as their sequence, needed to produce a change |
Implementation theories | A combination of classical theories and activities, with or without a temporal sequence | Implementation Constructs involved in mechanisms triggering effects Mechanisms of effects | Explaining how and why specific relationships between a set of constructs and interventional elements lead to specific events | Derived from field expertise and experimentation Derived from fundamental work in various disciplines (psychology, sociology, political sciences, etc.) | The behaviour change wheel [29] | Linking mechanistic hypotheses and the resources and activities potentially influencing them to design or understand how interventional inputs could work |