Connecting health administration theory to practice: Competing public health narratives and their consequences for health research, policy, and administration

The often cited need to bridge theory and practice transcends every administrative field. Within public health administration, despite a seemingly shared understanding of what public health is and does, various professionals, organizations, and policies appear at times to have distinct ways of viewing and comprehending public health issues. These differing understandings exhibit the various paradigms from which participants approach public health. Such paradigms result from the underlying narratives each group employs for making sense of their environments, capabilities, and responsibilities. Therefore, different professionals, organizations, and policies have and transmit alternative narratives for understanding and explaining different public health topics. Public health administrators who are cognizant of such competing narratives can capitalize on the narrative connections between theory and practice in order to most effectively respond to specific public health needs. Although a narrative understanding of public health has transportability and applicability to various public health topics, childhood obesity provides a timely and relevant means for illustrating the ways competing public health narratives inform theory, research, policy, and practice. This work combines Burrell and Morgan's sociological paradigms with van der Maesen and Nijhuis's theoretical perspectives of public health to reveal how four prominent theoretical narratives approach the topic of childhood obesity along the lines of problem recognition, problem definition, policy selection, policy administration, and policy/program evaluation. Through this type of praxis, health administrators can determine potential policy failures, potential best practices, and promising models for future activities that would otherwise be taken for granted within their particular narratives of public health.