Abstract: | The article considers the impact of the Health Action Zone (HAZ) in Plymouth through a theory-based evaluation that combines theories of change and realistic evaluation. The study assesses the impact of 37 projects sponsored by this HAZ. The extent to which these projects used a realistic evaluation/theories of change framework and achieved their objectives are evaluated. The impact of these projects on the three main objectives of Plymouth HAZ – developing partnership working; modernising the care system; and tackling health inequalities – is assessed and explanations for the success or failure of specific projects are identified. |