Sports-based positive youth development (SB-PYD) programs are health promotion programs that intentionally use sports to build life skills and leadership capacity among young people at risk of social exclusion. The defining characteristics of SB-PYD programs are that they are strengths-based, holistic, and use sports as a vehicle to maximize young people’s health, social, and educational outcomes. SB-PYD programs aim to enhance modifiable social determinants of health (such as social inclusion) by explicitly addressing three Ottawa charter action areas; strengthening community action, developing personal skills, and creating supportive environments. These programs have been increasingly implemented since the early 2000s to address the United Nations’ sustainable development goals. Despite their growth, research indicates that SB-PYD programs are often designed, implemented, and evaluated without evidence-based theories of change. An evidence-based theory of change is a visual depiction of a program’s assumptions, activities, contextual factors, and outcomes supported by scientific findings. A lack of evidence-based theory of change becomes problematic at the implementation phase when practitioners are trying to determine if their programs should be adapted or fixed. Without an evidence-based theory of change, practitioners are making changes based on their intuition, which limits program outcomes. However, the process of developing a theory of change is time-consuming and resource intensive. Multiple calls to action have been made for SB-PYD practitioners who have successfully developed evidence-based theories of change to share their process with others in the field. This will provide a blueprint for other SB-PYD practitioners to develop and articulate their own theories of change to optimize program development and adaptation. Traditional translational research models assume the development of an evidence-based theory of change is the first step in a linear process of developing a sustainable health promotion program. However, in the 2010s, researchers started to observe that the development and adaptation of health promotion programs was rarely a linear process in reality, and that case studies are needed to provide empirical support for this claim. It is valuable for SB-PYD practitioners to consider the benefits of using translational research to develop and revise evidence-based theories of change for programs at any stage of implementation to maximize their public health impact.