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Two proponents of theory-based approaches to evaluation that have found favour in the UK in recent years are Theories of Change and Realistic Evaluation. In this article we share our evolving views on the points of connection and digression between the approaches based on our reading of the theory-based evaluation literature and our practice experience. We provide a background to the two approaches that emphasizes the importance of programme context in understanding how complex programmes lead to changes in outcomes.We then explore some of the differences in how `theory' is conceptualized and used within the two approaches and consider how knowledge is generated and cumulated in subtly different ways depending on the approach that is taken. Finally, we offer our thoughts on what this means for evaluators on the ground seeking an appropriate framework for their practice.

Theory-based evaluation approaches are becoming increasingly popular in the evaluation of comprehensive community initiatives. Such an approach, Theory of Change (ToC), has been used in the external evaluations of two of four Scottish Health Demonstration projects. This article provides an empirically based analysis of the issues raised in the process of articulating a project's ToC. It then considers the value of the approach in relation to sharpening planning, providing formative feedback, improving performance management, guiding internal and external evaluation, judging impact and reducing problems of attribution. A conclusion is reached that, whilst such approaches are by no means a panacea, they offer one useful framework within which to negotiate a range of evaluation practice decisions.

AbstractThis article draws from our mixed methods study of forced marriage (FM) in Scotland focusing on policy and practice responses to FM in Scotland using the concepts of candidacy and structural competency. Through an analysis of FM policy in six case-study areas, interviews with Child or Adult Protection Leads and twenty-one interviews with a range of welfare professionals, we discuss the conceptual, emotional and practical challenges of responding to FM. Despite a standard Scottish Government policy and statutory framework, the varied policy and professional responses to FM across local authorities demonstrate a need for practitioners to be fully cognisant of the ways in which structural inequalities play out in individual lives. The four key themes explored in this article are as follows: (i) patchy ownership of FM policy at a local level; (ii) 'race anxiety'; (iii) event versus process-based understandings of FM and (iv) the challenges of protecting adults experiencing FM who have capacity. These themes are highly relevant to social work practice and offer a significant and original analysis of the ways in which structural, social and cultural factors shape practitioner understanding, response and support of victims of FM.

English
This article discusses the gap between rhetoric and reality in evidence-based policy making using data derived from external evaluations of two of Scotland's national Health Demonstration Projects. More specifically, it reports on the extent to which policy makers used evidence to commission the projects, and on the type of evidence that they expected to flow from them to feed into future government strategy. Using primary data, this article confirms that policy decisions are made on the basis of factors that go beyond research evidence and suggests that both policy makers and evaluators would gain from more explicit acknowledgement of what lies beneath the veneer of evidence-based policy making.

AbstractPrevious studies suggest that group work would yield conceptual gains in physics if tasks specifically promoted dialogue about the factors which determine observed outcomes. This might be done by constraining task items to present critical tests of the effects of individual factors; and, additionally, by requiring participants to generate or select explicit rules about those effects. In order to test this hypothesis, groups of primary school children were asked to work on one of four versions of a task concerning object flotation: Random (i.e. a control in which there were no task constraints), Critical Tests, Rule Generation, and Rule Selection. Learning was assessed via change between a pre‐test and two post‐tests. Although the effect was delayed, children from the Random and Rule Generation conditions showed an increased awareness of relevant factors which was strongly related to prior group activity. This gain was absent in the Critical Tests and Rule Selection conditions. The results indicate that group dialogue can be productively shaped by task design, but also that its effects may take time to appear, and are negated by overmuch external direction of attention.

It is known that population health is socially and politically determined. A gap, however, between the evidence and policy (where behavioural approaches dominate) is evident. This study used semi-structured interviews in two deindustrialised areas in Scotland to explore understandings of the causes of (ill)health in local communities. Using Raphael's Discourses of Social Health Determinants (2011), we found that participants typically had highly integrated explanations of health, including vivid articulation of links between politics, policies, deindustrialisation, damage to community fabric and impacts on health. This understanding contrasts with that identified by research elsewhere. We posit explanations for our findings and discuss their implications.

AbstractIn the context of a long‐standing academic acceptance of the socially structured nature of health inequalities, there has been a growing literature that critically examines policies that aim to reduce them. This has demonstrated inadequate policy assessment of the nature of the problem of health inequalities and correspondingly partial solutions that privilege interventions that focus on individual lifestyle solutions over more structural approaches. Much of the research that has been undertaken in this field to explore competing theories of inequalities has analyzed national policy documents or the views of senior policy advisers rather than practitioners.This study uses Raphael's 'seven discourses of the social determinants of health' to understand the implicit theories of health inequalities of both practitioners and policymakers working within a single health care system as they talk about different policy typologies. To help penetrate potentially well‐rehearsed discourses about health inequalities, it tests a visual method of stimulating discussion about how different types of policy might operate to narrow/widen existing gaps in outcomes. Building on Raphael, it finds that individuals' theories of health inequalities contain co‐existing although not synthesized material and behavioural explanations and that, although the social patterning of material disadvantage was recognized, the role of power and politics is underplayed. Variations between participants did not align with role (policy/practice) and using visual methods to represent the impact of different policy types on health inequalities, though challenging for participants, stimulated reflection about a subject matter that has otherwise become rather stagnant.

Domestic abuse policy increasingly uses language which indicates that abuse is patterned according to structural factors. However, practicing according to these structural accounts of abuse is problematic because of the policy and organisational contexts that practitioners work within and, we argue, because the implications of the structured nature of victims' experiences is not fully understood by all practitioners.We ask whether women's differential use and experiences of services with a remit to address abuse can be illuminated using two theoretical perspectives – 'candidacy' and intersectionality. We report the findings of a literature synthesis that investigates how these improve our understanding of women's help-seeking and service utilisation and of the responses that they receive. Both concepts were highly congruent with the literature and we conclude that, together, candidacy and intersectionality offer a means of enhancing knowledge of how the political becomes enacted in the personal. Embedding such knowledge within practice repertoires offers the potential to develop more nuanced structural understandings of women's experiences and constraints.

AbstractAcross the public sector there is concern that service uptake is inequitably distributed by socio‐economic circumstances and that public provision exacerbates the existence of inequalities either because services are not allocated by need or because of differential patterns of uptake between the most and least affluent groups.A concept that offers potential to understand access and utilization is 'candidacy' which has been used to explain access to, and utilization of, healthcare. The concept suggests that an individual's identification of his or her 'candidacy' for health services is structurally, culturally, organizationally and professionally constructed, and helps to explain why those in deprived circumstances make less use of services than the more affluent.In this article we assess the fit of candidacy to other public services using a Critical Interpretive Synthesis of three case studies literatures relating to: domestic abuse, higher education and environmental services.We find high levels of congruence between 'candidacy' and the sampled literatures on access/utilization of services. We find, however, that the concept needs to be refined. In particular, we distinguish between micro, meso and macro factors that play into the identification, sustaining and resolution of candidacy, and demonstrate the plural nature of candidacies. We argue that this refined model of candidacy should be tested empirically beyond and within health. More specifically, in the current economic context, we suggest that it becomes imperative to better understand how access to public services is influenced by multiple factors including changing discourses of deservedness and fairness, and by stringent reductions in the public purse.