Theorizing healthy settings: a critical discussion with reference to Healthy Universities

Dooris, Mark T orcid iconORCID: 0000-0002-5986-1660, Wills, J and Newton, J (2014) Theorizing healthy settings: a critical discussion with reference to Healthy Universities. Scandinavian Journal of Public Health, 42 (15 Sup). pp. 7-16. ISSN 1403-4948

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The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research.
Aims: To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities.
Methods: A scoping literature review was undertaken between 2010-2013, identifying 26 papers that met inclusion criteria.
Findings: Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organisational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting.
Conclusion: Although distinctive, the example of Healthy Universities drew on common theoretical perspectives that have infused the settings discourse more generally. This engagement with theory was at times well-developed and at other times a passing reference. The paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorisation has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes.

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