developing a framework for a program theorybased approach to evaluating policy processes and outcomes: health in all policies in south australia

Background: the importance of evaluating policy processes to achieve health equity is well recognised but such evaluation encounters methodological, theoretical and political challenges. this paper describes how a program theory-based evaluation framework can be developed and tested, using the example of an evaluation of the south australian health in all policies (hiap) initiative. methods: a framework of the theorised components and relationships of the hiap initiative was produced to guide evaluation. the framework was the product of a collaborative, iterative process underpinned by a policy-research partnership and drew on social and political science theory and relevant policy literature. results: the process engaged key stakeholders to capture both hiap specific and broader bureaucratic knowledge and was informed by a number of social and political science theories. the framework provides a basis for exploring the interactions between framework components and how they shape policy-making and public policy. it also enables an assessment of hiap’s success in integrating health and equity considerations in policies, thereby laying a foundation for predicting the impacts of resulting policies. conclusion: the use of a program theory-based evaluation framework developed through a consultative process and informed by social and political science theory has accommodated the complexity of public policy-making. the framework allows for examination of hiap processes and impacts, and for the tracking of contribution towards distal outcomes through the explicit articulation of the underpinning program theory.