Potential Explanations for the Limited Empirical Evidence in Support of Theory in Health Promotion

Abstract

Persuasive arguments for the use of theory have been influential in health promotion. The benefits of theory are expected to be substantial for the improvement of interventions and scientific advancement of the discipline. However, the empirical evidence indicating that those benefits has been realized is murky. This can be attributed to the confounding in the evaluation studies. An additional contributing explanation is that the field has yet to broadly recognize that many of its conceptual devices that are treated as theory function more as models, thus biasing the assessments. Further, all theories of any evidentiary status are given equal treatment in the analyses. These reasons can help explain why the body of evidence to support the use of theory in the development of interventions has not coalesced around a definitive conclusion. Other fields have harnessed scientific theory to provide powerful tools for engineering and understanding the world. Many of the conceptual devices labelled as a theory in health promotion may not possess the characteristics of theory that are needed to provide those benefits. A refined and comprehensive characterization of theory in health promotion can ultimately benefit the field through an improved alignment between theory’s promises and realized successes.

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