The need to promote healthy active ageing in
order to offset the impact of an ageing population
on national resources and ensure a high
quality of life in older age is well recognized. In
2001, the English Department of Health established
a national pre-retirement health initiative
involving the development of eight pilot
projects. A national evaluation using a ‘theories
of change’ approach embedded within a realistic
evaluation design was commissioned to draw
out the lessons from across the projects. In this
article we describe the methods used to identify
and test out the projects’ theories of change,
and the results obtained. The theories of change
identified revolved mainly around engaging
clients and empowering them to take action
through the provision of information. Two
projects also saw providing opportunities for
social interaction as a means to engaging and
empowering clients. Theory testing indicated
that health improvement services could be
effectively targeted at people in mid-life and
that service settings and style played an important
part in engagement. In particular contexts,