How can the functioning and effectiveness of networks in the settings approach of health promotion be understood, achieved and researched?

Networks in health promotion (HP) have, after the launch of WHO's Ottawa Charter [(World Health Organization (WHO) (eds). (1986) Ottawa Charter on Health Promotion. Towards A New Public Health. World Health Organization, Geneva], become a widespread tool to disseminate HP especially in conjunction with the settings approach. Despite their allegedly high importance for HP practice and more than two decades of experiences with networking so far, a sound theoretical basis to support effective planning, formation, coordination and strategy development for networks in the settings approach of HP (HPSN) is still widely missing. Brößkamp-Stone's multi-facetted interorganizational network assessment framework (2004) provides a starting point but falls short of specifying the outcomes that can be reasonably expected from the specific network type of HPSN, and the specific processes/strategies and structures that are needed to achieve them. Based on outcome models in HP, on social, managerial and health science theories of networks, settings and organizations, a sociological systems theory approach and the capacity approach in HP, this article points out why existing approaches to studying networks are insufficient for HPSN, what can be understood by their functioning and effectiveness, what preconditions there are for HPSN effectiveness and how an HPSN functioning and effectiveness framework proposed on these grounds can be used for researching networks in practice, drawing on experiences from the ‘Project on an Internationally Comparative Evaluation Study of the International Network of Health Promoting Hospitals and Health Services’ (PRICES-HPH), which was coordinated by the WHO Collaborating Centre for Health Promotion in Hospitals and Health Services (Vienna WHO-CC) from 2008 to 2012.