The case for including reach as a key element of program theory

Area of Science:

• Public Health
• Health Equity
• Program Evaluation

Background:

• Logic models and results frameworks are crucial for public health initiatives.
• Current frameworks often lack explicit consideration of 'reach,' impacting initiative effectiveness and equity.
• This oversight can lead to narrow impact assessments and bias against equitable outcomes.

Purpose of the Study:

• To highlight the necessity of incorporating 'reach' into public health logic models and results frameworks.
• To identify the negative consequences of neglecting reach in program design and evaluation.
• To present an alternative approach that explicitly integrates reach to enhance health equity.

Main Methods:

• Conceptual analysis of existing logic models and results frameworks in public health.
• Examination of the impact of 'reach' on initiative scope and equity considerations.
• Description of an alternative approach emphasizing explicit reach in program theory and logic depictions.

Main Results:

• Lack of explicit reach consideration leads to a constricted understanding of impact chains.
• Initiatives may be favored based on narrow efficiency rather than broad engagement.
• Neglecting reach introduces bias against health and social equity goals.

Conclusions:

• Explicitly defining and integrating 'reach' in logic models and results frameworks is essential for public health.
• This approach can mitigate biases and improve the equity focus of public health initiatives.
• Considering reach promotes wider engagement and more equitable health and social systems.