There is some consensus that better ways of evaluating complex public health programmes are needed as experimental methods are limited in explaining the 'how' and 'why' of change. Methods like 'theory-of-change,' 'realist evaluation,' and 'systems evaluation' try to give a more complete picture of change by looking at the context of the programme. However, when these methods are used to study programmes that aim to reduce health inequalities, they often miss a crucial issue: how power affects people's health and engagement with programmes. This paper addresses that gap by reporting an ethnographic study of a community health promotion programme that was informed by a social theory of power (figurational sociology). When looking at how power dynamics played out in the targeted community, we could see why residents often did not trust the people running the programme, and why local status was so important to them. When programme staff understood these power dynamics, they were better able to connect with residents and help them improve their wellbeing. We argue that combining this way of looking at power with our observational approach gives us a much clearer understanding of how complex public health programmes work and why they succeed or fail in their aims.

Knowledge transfer (KT) is essential for efficient practices among healthcare professionals and decision-makers in health and social services. To promote KT, communities of practice (CoPs) are being developed worldwide. In Quebec, a CoP has been established with a focus on implementation science and knowledge transfer practices (ISKT CoP) among members of the health and social services network from an organization linked to the Québec Ministry of health and social services. At the time of this study (in 2023), the ISKT CoP was in a developmental phase being less than a year old. Limited data are available to measure the effectiveness of CoPs, especially in a developmental phase. Hence, this study aimed to identify the success conditions and early benefits of the ISKT CoP using a Developmental Evaluation approach and an in-depth mixed-methods case study with data triangulation. Data were collected using two theoretical frameworks and a categorization. In total, sixty-five community of practice documents were analyzed, as well as the data from two interviews, the results of seven questionnaires and the discussions on the ISKT CoP forum. The main results highlight challenges facing the ISKT CoP with regard to member interactions, sharing of a common identity, and member engagement and participation. These challenges are mainly attributed to the time required to develop trusting relationships. Early positive outcomes were also observed, some members were able to expand their networks and explore collaborative opportunities, while most of the core competencies in KT were addressed by the ISKT CoP services.