The innovative practice that resulted from the Ottawa Charter challenges public health knowledge about programming and evaluation. Specifically, there is a need to formulate program theory that embraces social determinants of health and local actors' mobilization for social change. Likewise, it is imperative to develop a theory of evaluation that fosters reflexive understanding of public health programs engaged in social change. We believe advances in contemporary social theory that are founded on a critique of modernity and that articulate a coherent theory of practice should be considered when addressing these critical challenges.

This article proposes a sociologically informed theoretical and methodological framework to address the complexity of public health interventions (PHI). It first proposes three arguments in favour of using the Actor-Network Theory (ANT) for the framework. ANT: (1) deals with systems made of human and non-human entities and proposes a relational view of action; (2) provides an understanding of the intervention-context interactions and (3) is a tool for opening the intervention's black box. Three principles derived from ANT addressing theoretical problems with conceptualisation of PHI as complex systems are proposed: (1) to focus on the process of connecting the network entities instead of their stabilised form; (2) both human and non-human entities composing networks have performative capacities and (3) network and intervention shape one another. Three methodological guidelines are further derived: (1) the researcher's task consists in documenting the events that transform the network and intervention; (2) events must be ordered chronologically to represent the intervention's evolution and (3) a broad range of data is needed to capture complex interventions' evolution. Using ANT as a guide, this paper helps reconcile technicist and social views of PHI and provides a mean to integrate process and effect studies of interventions.

After 25 years of intersectoral practice to increase health promotion resources, there is little scientific literature linking analysis of processes to observation of effects. Applying Actor-Network Theory, this article examines how the effects of intersectoral action are produced and can be attributed to its processes. A prospective multiple case study (2013-2016) was conducted on Neighbourhood Committees (NCs) in Montreal (Canada). Three NCs were studied using four kinds of data: direct observation notes of meetings and events, documents, logbooks and interviews. Systemic modelling of local intersectoral action was used for data collection and analysis. The results show that the transformations in living environments were produced by sequences of a limited number of 'transitory outcomes' that mark the progression of intersectoral action up to its effects. The list of transitory outcomes identified make up three functions in the production of change: (i) network setup and governance; (ii) self-representing and influencing others; (iii) aligning necessary actors and resources. The production of effects follows a systemic model wherein unique configurations of transitory outcomes, adapted to the different contexts where interactions are occurring, represent the change processes that lead to the effects.

L'amélioration des conditions de vie représente, pour la Commission de l'OMS sur les déterminants sociaux de la santé, la première priorité pour la réduction des inégalités sociales de santé 1 . Puisque la plupart de ces conditions (éducation, logement, alimentation, environnement urbain) relève d'autres secteurs que celui de la santé, la poursuite d'un tel objectif requiert que les acteurs de santé publique s'engagent dans des actions en partenariat avec les acteurs intersectoriels pertinents. Or, un frein important à une argumentation convaincante sur l'action en partenariat est le manque d'outils valides pour en évaluer la qualité [2][3][4][5] . En réponse à cette lacune, cet article présente les fondements théoriques et la méthodologie d'élaboration et de validation de l'Outil diagnostique de l'action en partenariat, de même que le type de diagnostic qu'il produit. L'article conclut avec une discussion sur sa validité. Cet outil est conçu pour apprécier les processus de l'action collective de réseaux d'acteurs autour des dimensions clés de son efficacité.