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 and 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; organizational 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.
Conclusions: 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 theorization has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes.
Keywords: Complexity; conceptual framework; ecological; health promotion; health-promoting universities; healthy universities; salutogenesis; settings; systems; theory.
© 2014 the Nordic Societies of Public Health.