Conducting a systems-informed evaluation to assess impacts of Local Health and Global Profits

Abstract

The aim of this evaluation is to assess how, and to what extent, LHGP enhances and builds the capacity of local authorities and other stakeholders to address upstream, particularly commercial, determinants of health and health equity. Our evaluation approach is adaptive and systems-informed and is being conducted in three phases. Phase 1 (completed) was a ‘pre-evaluation’, involving interviews with academic and practice-based consortium members (n = 19) to develop a programme-level theory of change (ToC) that identifies LHGP’s potential systemic contributions. This ToC has been used to guide evaluation planning and prioritise research questions in subsequent phases. Phase 2 represents the first stage of the main evaluation and is characterised by breadth. We are synthesising findings across the consortium’s work packages; evaluating LHGP’s systems approaches; identifying resources and support systems (co-)produced through LHGP; and assessing initial stakeholder responses. In each site, we are developing a systems-informed set of hypotheses for change, based on what local stakeholders plan as a result of their engagement with LHGP. Phase 3 is the final phase and comprises an in-depth evaluation of four local authority sites. For each, we will follow up on the change hypotheses identified in Phase 2 to examine how these unfold over time, and whether emergent factors shape developments. We will develop ‘contribution stories’ for each site, focusing on embedding and sustaining change, barriers and enablers, and how system responses, within local systems or beyond, may amplify or dampen LHGP’s contribution and associated impacts. We will also examine LHGP’s influence beyond the eight case study sites, on regional and national stakeholders and systems. This presentation will describe our systems-informed evaluation approach, present the programme-level ToC, and reflect on methodological innovations and challenges associated with conducting an adaptive evaluation.