Realist evaluation of health promotion interventions: a scoping review

Lay Summary This scoping review aims to critically examine current practices of realist evaluation in the field of health promotion with respect to four core features of an approach appropriate for evaluating health promotion initiatives, namely the need to accommodate the complex nature of health promotion interventions; drawing on a variety of disciplines and a broad range of information-gathering procedures; involving stakeholders in the evaluation; and building capacity for addressing health promotion concerns. Seventeen articles met the inclusion criteria. These were classified into two types of studies: those aiming to build an initial program theory, and those aiming to test an initial program theory. Our results suggest that the use of a realist evaluation approach in the field of health promotion is guided mainly by the need to accommodate the complex nature of health promotion interventions. Our searches identified a lack of participative practice and capacity-building intention in current practice. Our examination of the data collection and analysis methods points to some common practices in using multi-methods. Perspectives on more meaningful practices of realist evaluation and on more relevant evaluation practices of the effectiveness of health promotion have been identified. This scoping review aims to give a narrative account of existing realist evaluation practices in health promotion. Realist evaluations of health promotion interventions published between 2010 and 2021 were identified by searching five academic databases: Embase, Pubmed, PsycINFO, ScienceDirect and Scopus. A data-charting form was created based on the characteristics of realist evaluation and four core features of an approach appropriate for evaluating health promotion interventions. Seventeen articles met the inclusion criteria. These were classified into two types of studies: those aiming to build an initial program theory and those aiming to test an initial program theory. Our results revealed a great variety of realist evaluation practices and uncovered a growing interest in realist evaluation over the years. Our searches identified a lack of participative practice and capacity-building intention. Our examination of the data collection and analysis methods points to some common practices in using multi-methods. Perspectives on realist evaluation practices and on assessing the effectiveness of health promotion have been identified.