Abstract Introduction/Background
The ‘Due North' Report, commissioned by Public Health England (PHE) in 2014, drew attention to the gradient in health across different social groups in England. Poor neighbourhoods in the North tend to have worse health than places with similar levels of poverty in the rest of England, with an even greater gap in health between disadvantaged and prosperous socio-economic groups in the North than in the rest of the country. The ongoing challenge of health inequalities was the focus of the ‘Marmot Review'. The Review specified high level policy objectives to tackle inequalities in the social determinants of health, and consequently lead to improvements in health and a reduction in health inequalities requiring action across all sectors of society, including specific actions by local government in support of local communities. MethodsPHE commissioned a community development programme to address health inequalities in ten community ‘pathfinder' sites across Northern England with matched funding from participating local authorities. ‘Pathfinder' sites were established to work with communities, voluntary sector, health and social care, social entrepreneurs and businesses with an ambition to create a diverse range of community led interventions to reduce health inequalities.
Results
We describe a range of approaches by embedded researchers to evaluate the Well North Programme. Rapid Cycle, Realist, Social Network Analysis, and other bespoke methodologies have been developed to implement iterative evaluation techniques in response to a dynamic theory of change model.
Conclusion
Realist methods provide a useful framework for understanding why some interventions are successful. External funding details