In the last decade, researchers have discovered the need for theoretical innovation in public health practice (Green, 2000; Glanz & Bishop, 2010). Most theoretical knowledge has largely centered on specific fields of public health, such as behavioral psychology and biomedical science (Glanz & Bishop, 2010). Some researchers have also focused theory development on public health administration (Green, 2000). The growth of evidence-based practice has contributed to the growth of theory in public health by improving its quality and cost-effectiveness (Green, 2000). Nonetheless, broadly, theory is important in the public health practice because of the reasons outlined below
Why Theory is Important in Public Health Practice
Planning and Delivery of Health Services
Planning and delivery of health services are important processes in public health management. Theory contributes to their efficacy by guiding program-planning processes (Green, 2000). This way, health workers are able to formulate effective plans for health care service delivery. Public health interventions that emerge in this way should have demonstrable impact on affected communities, or associated organizations (Glanz, Rimer, & Viswanath, 2008).
Creation of Evidence-based Practice
Undeniably, health promotion relies on evidence-based practice (Green, 2000). However, without theoretical inputs, public health interventions would be nothing more than a menu of proven interventions that lack a guiding framework for their choice. Theories help public health officials to select proper evidence-based practices when choosing health interventions because they emanate from evidence-based research (Green, 2000). Therefore, public health workers could formulate effective interventions that rely on past practice/evidence. Existing academic literature and national policy documents have used such theory to develop their contents (Green, 2000). Therefore, theoretical frameworks help to merge general principles of public health practice with context-specific factors that would improve the efficacy of public health programs (Glanz & Bishop, 2010).
Health administration practices in public health (such as program implementation processes) depend on the successful adoption of a theoretical framework. Without it, there would be ineffective results from such practices (Glanz & Bishop, 2010). Therefore, theory-based health administration practices are more likely to succeed than those that do not rely on the same basis (Green, 2000). In sum, theory improves health administration practices.
How Public Health Workers could incorporate Theory into Public Health Campaigns
Based on the above-mentioned contributions of theory to public health programs, researchers say theory is useful in developing public health campaigns for several reasons (Glanz et al., 2008). This section of the paper explains how theories could improve efforts by public health workers to manage Ebola in Sierra Leone.
Formulating a Public Health Campaign
Theoretical frameworks would help public health workers to understand important factors to consider when developing an effective public health campaign to educate rural communities in Sierra Leone about the spread of Ebola. Here, theory would help practitioners to know whether all necessary elements of a public health program exist (Glanz et al., 2008). For example, it would be difficult to formulate a program for educating people about possible methods of Ebola infection if public health workers do not understand the social determinants that underlie community practices, which lead to the spread of the disease. Providing people with information about why they are vulnerable to infection could be an inadequate strategy if people do not have the skills to prevent them from being infected. An effective public health program should point this out. In this regard, theory would help to improve the design of public health programs, thereby making them more effective in reducing Ebola infections.
Determining Effective Strategies
Different social, economic and political factors made it difficult for public health workers to formulate one public health strategy for reaching multiple audiences in Sierra Leone. Theory helps to streamline this process by making it easy for these professionals to know which strategies work best for specific audiences (Green, 2000). This way, health workers would be able to formulate effective and successful public health campaigns by reducing their margins of error (Glanz & Bishop, 2010). Similarly, they are bound to enjoy increased cooperation with local communities, in public health management, because they would understand the needs of local communities.
Evaluation of Health Programs
Health workers in Sierra Leone reported successes and failures in managing Ebola. In some areas, they experienced resistance from local communities, while in other areas they received support from community shareholders. Variations in success levels show failures in their approach. Theory helps to explain why these failures exist. Through its contributions, it helps public health researchers to understand the contextual factors and mechanisms that contributed to the success, or failure, of the health interventions. By doing so, public health workers would know how to improve their campaigns and lower their chances of failure. Comprehensively, based on the details highlighted in this paper, theory provides an effective framework for studying public health problems and developing appropriate guidelines for developing public health interventions. Its importance also spreads to end-stage program evaluation processes that are essential for evaluating the successes and failures of public health programs. Therefore, in the context of the Sierra Leone health crisis, adopting a theoretical framework in public health management would have helped to solve the complex issues associated with managing the crisis because a simple input-output model could not work.
Glanz, K., & Bishop, D. B. (2010). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399–418.
Glanz, K., Rimer, B. K., & Viswanath, K. (Eds). (2008). Health behavior and health education: Theory, research, and practice (4th ed.). San Francisco, CA: John Wiley & Sons.
Green, J. (2000). The role of theory in evidence-based health promotion practice. Health Educ. Res, 15(2), 125-129.