title: A scoping review of unintended harm associated with public health interventions: towards a typology and an understanding of underlying factors.
abstract: OBJECTIVE
  Unintended harm theory as related to public health interventions (PHI) is under developed, with harm evaluation and reporting often absent or incomplete. This review presents a typology for, and underlying factors linked to, PHI-associated unintended harm.
  
  
  METHODS
  This scoping review was conducted electronically and includes articles from 1992 to June of 2013. Out of 2,490 originally identified titles, 26 full-text articles were included that discussed unintended harm associated with PHI. An iterative data analysis process was utilized to identify both a typology and underlying factors associated with unintended harm.
  
  
  RESULTS
  A typology of PHI-associated unintended harm was identified: (1) physical; (2) psychosocial; (3) economic; (4) cultural and (5) environmental. Five underlying factors associated with PHI unintended harm emerged: (1) limited and/or poor quality evidence; (2) prevention of one extreme leads to another (boomerang effects); (3) lack of community engagement; (4) ignoring root causes; and (5) higher-income country PHI implementation in a lower- or middle-income country.
  
  
  CONCLUSIONS
  PHI planning and evaluation frameworks may benefit from the consideration and potential incorporation of the unintended harm typology and underlying factors.
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada, lallen@ucalgary.ca.
authors.forename: L K
authors.initials: LK
authors.lastname: Allen-Scott
authors.forename: J M
authors.initials: JM
authors.lastname: Hatfield
authors.forename: L
authors.initials: L
authors.lastname: McIntyre
mesh_terms: D006293:Health Promotion; D006801:Humans; D008962:Models, Theoretical; D015980:Public Health Practice; D018570:Risk Assessment; D012449:Safety