title: Theorizing healthy settings: a critical discussion with reference to Healthy Universities.
abstract: The settings approach appreciates that health determinants operate in settings of everyday life. Whilst subject to conceptual development, we argue that the approach lacks a clear and coherent theoretical framework to steer policy, practice and research.
  
  
  OBJECTIVE
  To identify what theories and conceptual models have been used in relation to the implementation and evaluation of Healthy Universities.
  
  
  METHODS
  A scoping literature review was undertaken between 2010 and 2013, identifying 26 papers that met inclusion criteria.
  
  
  RESULTS
  Seven theoretical perspectives or conceptual frameworks were identified: the Ottawa Charter; a socio-ecological approach (which implicitly drew on sociological theories concerning structure and agency); salutogenesis; systems thinking; whole system change; organizational development; and a framework proposed by Dooris. These were used to address interrelated questions on the nature of a setting, how health is created in a setting, why the settings approach is a useful means of promoting health, and how health promotion can be introduced into and embedded within a setting.
  
  
  CONCLUSIONS
  Although distinctive, the example of healthy universities drew on common theoretical perspectives that have infused the settings discourse more generally this engagement with theory was at times well-developed and at other times a passing reference the paper concludes by pointing to other theories that offer value to healthy settings practice and research and by arguing that theorization has a key role to play in understanding the complexity of settings and guiding the planning, implementation and evaluation of programmes.
authors.affiliation: University of Central Lancashire, Preston, UK mtdooris@uclan.ac.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Dooris
authors.affiliation: London South Bank University, London, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Wills
authors.affiliation: London South Bank University, London, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Newton
mesh_terms: D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008962:Models, Theoretical; D006113:United Kingdom; D014495:Universities
keywords: Complexity; conceptual framework; ecological; health promotion; health-promoting universities; healthy universities; salutogenesis; settings; systems; theory