Evidence-based public health leadership development: A systematic review and urgent call to include psychological theory (2026)

Objectives:
Public health leadership is key to addressing complex healthcare and societal challenges. There is a lack of consensus regarding the optimal structure, content, methods, timings and evaluations of leadership development in this vital aspect of public health practice. Our aim was to systematically review and synthesise the current empirical evidence on the effectiveness of public health leadership development interventions, including the use of psychological theory.

Study design:
This study employed a systematic review design.

Methods:
This review was developed and is reported following PRISMA guidelines.

Results:
After de-duplication and abstract screening, the search identified 20 papers for full data extraction. Studies were published between 2007 and 2025, conducted across a range of geographic settings. Sample sizes ranged from 7 participants to more than 1500 in large national organisation settings. Four broad categories of leadership development intervention types were identified and synthesised into three sub-groups: individual-, organisational- and system-level findings, including population health outcomes. Only three studies referenced the use of psychological theory to underpin their interventions.

Conclusions:
Effective public health leadership development appears to be less about isolated interventions and more about ecosystems that combine training, coaching and team practices with supportive organisational cultures and structures, underpinned by improving equity and digital accessibility. We are concerned about the disparate and underdeveloped state of the evidence, and the paucity of application of psychological theory: Coaching Psychology, the science of workplacea performance and wellbeing, is likely to be well placed to provide this. Public health is underpinned by a rigorous commitment to evidence-based practice: we believe that it is urgently time to apply the same rigour to the practice of developing public health leadership in order to address the complex health and geo-political challenges we face.

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