Table 1 Theories used to guide the planning process and protect against type-III error, that is, an improperly designed intervention map that includes correctly identified problems that should not actually be addressed because significantly large improvements in health outcomes would not be achieved by making small changes in the environment

1

Systems Theory [38, 50–52, 57–59]

Describes a nested structure of factors affecting health including physical, social and cultural. What emerges is a nested structure of environments that allows for multiple influences both vertically across levels and horizontally within each level. This complex web or system of causation is a rich context for intervention.

Applied to the political and economic system, legal framework, enforcement agencies, established patterns of social organization, public administration, and demographics. Also, the many potential combinations of educational, social, political, regulatory and organizational supports to improve health.

Used to provide framework for mapping relationships between stakeholders, reduce complexity and look for the most effective leverage points within this web in order to develop effective multilevel interventions.

2

Social Network Theory [60]

Describes social networks that consist of nodes (individuals, groups, or organizations) and are joined by ties (relationships among nodes). A community is a network of networks in which the nodes of the larger network comprise smaller-scale networks.

Applied to the political and economic system, legal framework, enforcement agencies, established patterns of social organization, public administration, and demographics. Also, the many potential combinations of educational, social, political, regulatory and organizational supports to improve health.

Used to engage stakeholders based on their potential to secure benefits by virtue of membership in social networks or other social structures. The Social Network approach was also used to reduce complexity and look for the most effective leverage points within this web of causation to develop opportunities for effective multilevel interventions.

3

Stakeholder Theory [61]

Acknowledges stakeholders who differ in their social, political, and ethical characteristics; goals, interests; and types and amounts of power. Health promoters, their organizations, and the communities with which they work are frequently external stakeholders and exist outside the “focal organization” but have a direct interest in what that organization does.

Applied to the political and economic system, legal framework, enforcement agencies, established patterns of social organization, public administration, and demographics. Also, the many potential combinations of educational, social, political, regulatory and organizational supports to improve health.

Used to identify, map, and bring together stakeholders who may differ from each other in their social, political, and economic goals and interests and types and amounts of power.

4

Empowerment Theory [62]

Describes how to transfer power (a process) and the consequences of that process (an outcome). Empowerment Theory assumes that when health problems revolve around relational power processes then who holds power and how it is exercised can be used to guide health intervention strategies.

Applied to marginalized communities undergoing assimilation into dominant market driven societies.

Used to create a new social contract between health and other sectors to advance human development, sustainability, and equity, as well as improve health outcomes. Reduce inequalities and social gradients to improve health and well-being for everyone.

5

Community Participation Theory [63–66]

Describes a complex and context specific approach that seeks to maximize the benefits of social relationships and the efficient use of social capital. Social capital can be placed at the individual level, the community level or societal level.

Applied to situations where it is necessary to overcome difficulties imposed by a lack of consent or engagement by disenfranchised communities that discourage the creation of new knowledge in neglected areas of health.

Used to engage and include marginalized and disadvantaged populations, empower people, mobilize resources and energy. Also used to develop holistic and integrated approaches to public health problems. Achieve better decisions and more effective services and ensure the ownership and sustainability of programs.

6

Grassroots or Community Organizing Theory [66, 67]

Describes an approach to policy change that is made through collective action by members of the community addressing problems affecting their lives. Leadership is provided by a distinct group of individuals directly affected by an issue. Public health practitioners act as “conveners” or in a “capacity-builder” role rather than the “driver” role.

Applied to situations where it is necessary to overcome difficulties imposed by a lack of consent or engagement by disenfranchised communities that discourage the creation of new knowledge in neglected areas of health.

Used to increase democracy as it applies to health. Combat exclusion of marginalized and disadvantaged populations. Empower people, mobilize resources and energy. Develop holistic and integrated approaches to public health problems. Achieve better decisions and more effective services and ensure the ownership and sustainability of programs.

7

Advocacy Theory [67]

Describes actions that can be taken to bring about change on behalf of another population. Public health advocacy, often confused with activism, is rooted in democratic principles and practices and includes cooperation as well as confrontation.

Essential when working with communities undergoing assimilation when acculturation has taken place but institutional assimilation has not or is incomplete.

Advocacy ensures that the rights of disenfranchised individuals are protected, that institutions work the way they should, and that legislation and policy reflect the interests of the people.

8

Media Advocacy [68, 69]

Describes a set of tactics and the strategic use of the media to support community organizers’ efforts to advance social or public health policies.

Targets policy makers and those who can be mobilized to influence them since they can control the environments that either promote health or foster disease.

Used as a forum to surface issues, identify topics for discussion, and set the agenda for policymakers and the public.

9

Agenda Building Theory [38]

Defines issues that merit active and serious consideration by political decision and policy makers. Agenda building is the process of moving an issue to the systemic and institutional agenda for action.

Applied using the outside-initiative model to policy makers and those who can be mobilized to influence them since they can control the environments that either promote health or foster disease.

Used to develop strong high-level policy processes at the interface between health, well-being and economic development.

10

Multiple Streams Theory [71]

The Multiple Streams Theory distinguishes between seperate discourses that determine global health, e.g. biomedicine, public health, economism, human rights, security.

Applied to situations in which the determinants of health and well-being lie outside the health sector and are socially and economically formed.

Used to create a new social contract between health and other sectors to advance human development, sustainability, and equity, as well as improve health outcomes. Reduce inequalities and social gradients to improve health and well-being for everyone.

11

Consequentialist Theory [69]

This theory judges the rightness or wrongness of an action based on the consequence that action has. In contrast, non-consequentialist theory judges an action based on the properties intrinsic to the action, not its consequences.

It could be argued that when applied to economics the SLMP satisfies the criterion for being right according to the consequentialist theory if it benefits the greater good and harms only a small number of people.

The implication for human rights is that even though the SLMP provides a benefit to a great number of people, the health and well-being of indigenous communities, which is a protected human right, will always trump economic development.