If We Measure it, They Will Come: A Realist Evaluation Approach in a Therapeutic Jurisprudence Context

2021 ◽  
Author(s):  
Carrie J. Petrucci
Keyword(s):  
Realist Evaluation ◽  
Therapeutic Jurisprudence ◽  
Evaluation Approach

scholarly journals The contribution of realist evaluation to critical analysis of the effectiveness of entrepreneurship education competitions

2018 ◽  
Vol 32 (6) ◽  
pp. 405-417 ◽  
Author(s):  
Catherine Brentnall ◽  
Iván Diego Rodríguez ◽  
Nigel Culkin
Keyword(s):  
Knowledge Production ◽  
Meta Analysis ◽  
Entrepreneurship Education ◽  
Realist Evaluation ◽  
Professional Experience ◽  
Scientific Evaluation ◽  
Randomized Controlled ◽  
Evaluation Approach ◽  
Evidenced Based ◽  
Evaluation Approaches

The purpose of this article is to explore the effectiveness of entrepreneurship education (EE) programmes through the lens of realist evaluation (RE). The interest of the authoring team – a practitioner–academic mix with professional experience including developing EE in primary and secondary schools – lies with EE competitions, a type of intervention recommended for and delivered to students and pupils of all ages. RE is a theory-driven philosophy, methodology and adaptable logic of enquiry with which to conceptualize and analyse such programmes. In this study, we undertake an act of ‘organized scepticism’, as described by evidenced-based policy academic Ray Pawson, to identify and question the declared outcomes of EE competitions in European policy over a 10-year period. However, our contribution goes beyond the application of an evaluation approach, novel to EE. We argue that, while education generally, and EE specifically, appears committed to emulating ‘gold standard’ scientific evaluation approaches (e.g. randomized controlled trials, systematic review and meta-analysis), the field of evidenced-based policymaking has moved on. Now, alternative methodological strategies are being embraced and RE in particular has evolved as an approach which better aligns knowledge production with the reality of complex, socially contingent programmes. By using this approach, we not only establish that education and psychology theories challenge the outcomes of EE competitions declared in policy, but also demonstrate the wider relevance of RE to the appraisal and refinement of the theorizing and practice of entrepreneurship programmes and interventions.

scholarly journals Youth Access to Cigarettes Across Seven European Countries: A Mixed-Methods Study

2019 ◽  
Vol 22 (11) ◽  
pp. 1989-1996 ◽  
Author(s):  
Paulien A W Nuyts ◽  
Rebecca M F Hewer ◽  
Mirte A G Kuipers ◽  
Vincent Lorant ◽  
Adeline Grard ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Young People ◽  
Realist Evaluation ◽  
Mixed Methods Study ◽  
European Countries ◽  
Programme Theory ◽  
Vending Machines ◽  
Evaluation Approach ◽  
Policy Interventions ◽  
Minimum Age

Abstract Background Despite widespread age-of-sale restrictions on tobacco, adolescents continue to obtain cigarettes and experiment with smoking. This mixed-methods study aimed to understand how European adolescents access cigarettes and how the policy context may influence this process, using a realist evaluation approach. This is the first study to assess access to cigarettes across various European contexts. Methods A survey of 4104 students was combined with qualitative data from focus groups among 319 adolescents aged 14–19 across seven European countries. Data were synthesized to explore mechanisms via which young people obtain cigarettes despite age-of-sale restrictions. Results While purchasing cigarettes from supermarkets was widely regarded as difficult, many participants purchased cigarettes from noncompliant retailers (often in smaller shops or cafes). Other contra-mechanisms included circumventing age checks, proxy purchases, and/or social sources. Dominant forms of access differed across the seven contexts, with direct purchases more common where perceived enforcement was low (eg, Belgium) and proxy purchases more important where perceived enforcement of age-of-sale laws was high (eg, Finland). The effectiveness of age-of-sale restrictions in reducing youth access appears to be influenced by a range of contextual factors including retailer compliance, the availability of vending machines, and the specific minimum age-of-sale. Conclusions Our findings illustrate the relevance of programme theory in understanding the contra-mechanisms that undermine the effectiveness of age-of-sale laws in discouraging youth smoking. Young people’s access to cigarettes could be further limited by addressing these contra-mechanisms, including an increase in the legal sales age (particularly in Belgium), banning vending machines, and strengthening enforcement. Implications Despite widespread implementation of age-of-sale laws, a substantial proportion of minors continue to access cigarettes. Young people use a number of contra-mechanisms to circumvent age-of-sale restrictions. These include accessing cigarettes via social sources, proxy sales or by circumventing age checks. Our findings show that in contexts where perceived enforcement of age-of-sale restrictions is high, young people are more reliant on irregular forms of access such as proxy sales. Young people’s access to cigarettes may be further reduced by policy interventions that address these contra-mechanisms—for example, banning vending machines, strengthening enforcement of age-of-sale laws, and increasing the minimum age-of-sale.

scholarly journals Facebook as a Medium for the Support and Enhancement of Ambulatory Care for People With Diabetes: Qualitative Realist Evaluation of a Real-World Trial

JMIR Diabetes ◽  
10.2196/18146 ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. e18146
Author(s):  
Bryan Cleal ◽  
Ingrid Willaing ◽  
Mette T Hoybye ◽  
Henrik H Thomsen
Keyword(s):  
Social Media ◽  
Data Gathering ◽  
Realist Evaluation ◽  
Program Theory ◽  
Primary Data ◽  
Provider Communication ◽  
New Developments ◽  
Evaluation Approach ◽  
Diabetes Technology ◽  
Patient Provider Communication

Background There is a growing focus on the potential uses, benefits, and limitations of social media in the context of health care communication. In this study, we have sought to evaluate an initiative pioneered at a hospital in Denmark that uses Facebook to support and enhance patient-provider communication about diabetes. Objective This paper aims to evaluate the success of the trial according to its initial objectives and to assess its potential scalability. Methods The study was undertaken in a clinic for diabetes and hormonal diseases at a large regional hospital in Denmark. Using a realist evaluation approach, we identified 4 key components in the program theory of the initiative, which we formulated as context-mechanism-outcome configurations (eg, complex and iterative chains of causality). These configurations informed data gathering and analysis. Primary data sources were the activity and content in the Facebook group, in the form of posts, likes, and comments, and interviews with patients (n=26) and staff (n=6) at the clinic. Results New developments in diabetes technology were the most popular posts in the forum, judged by number of likes and comments. Otherwise, information specific to the clinic received the most attention. All 4 components of the program theory were compromised to varying degrees, either as a result of failings in the anticipated mechanisms of change or contextual factors derived from the mode of implementation. Conclusions Social media serves well as a conduit for imagining positive change, but this can be a strength and weakness when attempting to enact change via concrete interventions, where stakeholder expectations may be unreasonably high or incompatible. Nonetheless, such initiatives may possess intangible benefits difficult to measure in terms of cost-effectiveness.

scholarly journals Team interventions in acute hospital contexts: protocol for the evaluation of an initial programme theory using realist methods

2021 ◽  
Vol 4 ◽  
pp. 32
Author(s):  
Una Cunningham ◽  
Aoife De Brún ◽  
Mayumi Willgerodt ◽  
Erin Blakeney ◽  
Eilish McAuliffe
Keyword(s):  
Secondary Analysis ◽  
Realist Evaluation ◽  
Acute Hospital ◽  
Healthcare Team ◽  
Programme Theory ◽  
Evaluation Approach ◽  
Middle Range ◽  
Team Interventions ◽  
Structured Approach

Introduction: Literature on multi-disciplinary healthcare team interventions to improve quality and safety of care in acute hospital contexts tends to focus on evaluating the success of the intervention by assessing patient outcomes. In contrast, there is little focus on the team who delivered the intervention, how the team worked to deliver the intervention or the context in which it was delivered. In practice, there is therefore a poor understanding of why some interventions work and are sustained and why others fail. There is little emphasis in the literature on how the team delivering the intervention might impact success or failure. Given that team is the vehicle through which these interventions are introduced, it is important to understand interventions from their perspectives. This research seeks to deepen understanding of enablers and barriers for effective team interventions. Using two case studies, we will evaluate previously developed initial programme theories to understand, what worked for whom, in what conditions, why, to what extent and how? Methods and analysis: A realist evaluation approach will be employed to test the previously formed set of initial programme theories. Two multi-disciplinary acute hospital team interventions in two different geographical and organisational contexts will be identified. In case study 1, a theory based approach to interviewing will be used. In case study 2, interview transcripts obtained using a semi- structured approach for primary research purposes will undergo secondary analysis. This will enable a more sensitive look at patterns and variations in patterns of multi-disciplinary team interventions. Researchers will first iteratively interrogate each respective dataset to identify the characteristics or resources present within the specific context that influenced how the team intervention worked to produce particular outcomes. Data will then be synthesised across contexts in order to produce middle range theories and thereby more generalisable insights.

scholarly journals Schools’ engagement with the Get Set London 2012 Olympic education programme: Empirical insights from schools in a non-hosting region

2017 ◽  
Vol 25 (1) ◽  
pp. 254-272 ◽  
Author(s):  
Shushu Chen ◽  
Ian Henry
Keyword(s):  
Education Programme ◽  
Realist Evaluation ◽  
Programme Implementation ◽  
Programme Theory ◽  
Local Schools ◽  
Evaluation Approach ◽  
London 2012 ◽  
Individual School ◽  
Olympic Education ◽  
The Government

During the Olympiad, an Olympic host country is required to organise and deliver an education programme to schools nationwide. Schools’ experiences of engagement with such programmes are often reported on by the government rather than being rigorously examined by academics. Moreover, there is little scientific understanding of how individual schools facilitate the programmes and why different schools engage with the same programme in different ways and to varying degrees, and generate different levels of impact. Looking at the London 2012 Olympic education programme called Get Set, this original qualitative research was undertaken to explore local schools’ experiences of involvement with the programme in a non-hosting region, Leicestershire. The paper advocates the use of programme-theory-driven evaluations (in particular a realist evaluation approach) to assess programme implementation. The results provide explanations of how and why case study schools engage more effectively or less effectively with the programme. The results identify the missing links in the programme theory, highlighting the significance of contextual factors at individual school levels, and arguing for the adoption of tailored strategies for effective programme implementation.

A Qualitative Evaluation of a Clinical Faculty Mentorship Program Using a Realist Evaluation Approach

2020 ◽  
Vol 20 (1) ◽  
pp. 104-112
Author(s):  
Corrie E. McDaniel ◽  
Sahar N. Rooholamini ◽  
Arti D. Desai ◽  
Sandeep Reddy ◽  
Susan G. Marshall
Keyword(s):  
Qualitative Evaluation ◽  
Realist Evaluation ◽  
Clinical Faculty ◽  
Mentorship Program ◽  
Evaluation Approach ◽  
Faculty Mentorship

scholarly journals Mechanisms for achieving adolescent-friendly services in Ecuador: a realist evaluation approach

2012 ◽  
Vol 5 (1) ◽  
pp. 18748 ◽  
Author(s):  
Isabel Goicolea ◽  
Anna-Britt Coe ◽  
Anna-Karin Hurtig ◽  
Miguel San Sebastian
Keyword(s):  
Realist Evaluation ◽  
Evaluation Approach

scholarly journals Realist evaluation of a complex integrated care programme: protocol for a mixed methods study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e017111 ◽  
Author(s):  
Milawaty Nurjono ◽  
Pami Shrestha ◽  
Alice Lee ◽  
Xin Ya Lim ◽  
Farah Shiraz ◽  
...  
Keyword(s):  
Health System ◽  
Integrated Care ◽  
Social Services ◽  
Primary Care Providers ◽  
Realist Evaluation ◽  
Care Providers ◽  
Programme Theory ◽  
Care Programme ◽  
Evaluation Approach ◽  
Study Results

IntroductionThe lack of understanding of how complex integrated care programmes achieve their outcomes due to the lack of acceptable methods leads to difficulties in the development, implementation, adaptation and scaling up of similar interventions. In this study, we evaluate an integrated care network, the National University Health System (NUHS) Regional Health System (RHS), consisting of acute hospitals, step down care, primary care providers, social services and community partners using a theory-driven realist evaluation approach. This study aims to examine how and for whom the NUHS-RHS works to improve healthcare utilisations, outcomes, care experiences and reduce healthcare costs. By using a realist approach that balances the needs of context-specific evaluation with international comparability, this study carries the potential to address current research gaps.Methods and analysisThis evaluation will be conducted in three research phases: (1) development of initial programme theory (IPT) underlying the NUHS-RHS; (2) testing of programme theory using empirical data; and (3) refinement of IPT. IPT was elicited and developed through reviews of programme documents, informal discussions and in-depth interviews with relevant stakeholders. Then, a convergent parallel mixed method study will be conducted to assess context (C), mechanisms (M) and outcomes (O) to test the IPT. Findings will then be analysed according to the realist evaluation formula of CMO in which findings on the context, mechanisms will be used to explain the outcomes. Finally, based on findings gathered, IPT will be refined to highlight how to improve the NUHS-RHS by detailing what works (outcome), as well as how (mechanisms) and under what conditions (context).Ethics and disseminationThe National Healthcare Group, Singapore, Domain Specific Review Board reviewed and approved this study protocol. Study results will be published in international peer-reviewed journals and presented at conferences and internally to NUHS-RHS and Ministry of Health, Singapore.

scholarly journals How does narrative medicine impact medical trainees’ learning of professionalism? A qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chien-Da Huang ◽  
Chang-Chyi Jenq ◽  
Kuo-Chen Liao ◽  
Shu-Chung Lii ◽  
Chi-Hsien Huang ◽  
...  
Keyword(s):  
Professional Identity ◽  
Narrative Medicine ◽  
Realist Evaluation ◽  
Clinical Settings ◽  
Framework Analysis ◽  
Medical Trainees ◽  
Narrative Skills ◽  
Evaluation Approach ◽  
Qualitative Interview Study ◽  
Narrative Process

Abstract Background Narrative medicine (NM) is an approach involving narrative skills and is regarded as a model for medical humanism and effective medical practice. This study aims to explore how NM impacts medical trainees’ learning of professionalism during a clerkship in a Taiwanese clinical setting. Methods A qualitative interview study adopting a purposive sampling method was undertaken. Thirty medical trainees participated in this study, including five fifth-year medical students (MSs), ten sixth-year MSs, nine seventh-year MSs, and six postgraduate year (PGY) trainees. Thematic framework analysis was applied, and a modified realist evaluation approach was further used to analyse the interview data. Results We identified self-exploration, reflection, and awareness of professional identity as mechanisms explaining how NM impacted professionalism learning in our participants. Furthermore, empathy, communication, doctor-patient relationship and understanding patients were identified as the outcomes of the NM intervention for trainees’ learning of professionalism. Conclusions NM facilitates medical trainees’ self-exploration, reflection, and awareness of professional identity, thereby affecting their learning of professionalism in clinical settings. Adopting NM as an educational intervention in undergraduate medical education could play an important role in professionalism learning, as trainees can thereby be supported to gradually develop self-exploration and reflection capabilities and heightened awareness of professional identity reflectively through a narrative process.

scholarly journals Facebook as a Medium for the Support and Enhancement of Ambulatory Care for People With Diabetes: Qualitative Realist Evaluation of a Real-World Trial (Preprint)

2020 ◽  
Author(s):  
Bryan Cleal ◽  
Ingrid Willaing ◽  
Mette T Hoybye ◽  
Henrik H Thomsen
Keyword(s):  
Social Media ◽  
Data Gathering ◽  
Realist Evaluation ◽  
Program Theory ◽  
Primary Data ◽  
Provider Communication ◽  
New Developments ◽  
Evaluation Approach ◽  
Diabetes Technology ◽  
Patient Provider Communication

BACKGROUND There is a growing focus on the potential uses, benefits, and limitations of social media in the context of health care communication. In this study, we have sought to evaluate an initiative pioneered at a hospital in Denmark that uses Facebook to support and enhance patient-provider communication about diabetes. OBJECTIVE This paper aims to evaluate the success of the trial according to its initial objectives and to assess its potential scalability. METHODS The study was undertaken in a clinic for diabetes and hormonal diseases at a large regional hospital in Denmark. Using a realist evaluation approach, we identified 4 key components in the program theory of the initiative, which we formulated as context-mechanism-outcome configurations (eg, complex and iterative chains of causality). These configurations informed data gathering and analysis. Primary data sources were the activity and content in the Facebook group, in the form of posts, likes, and comments, and interviews with patients (n=26) and staff (n=6) at the clinic. RESULTS New developments in diabetes technology were the most popular posts in the forum, judged by number of likes and comments. Otherwise, information specific to the clinic received the most attention. All 4 components of the program theory were compromised to varying degrees, either as a result of failings in the anticipated mechanisms of change or contextual factors derived from the mode of implementation. CONCLUSIONS Social media serves well as a conduit for imagining positive change, but this can be a strength and weakness when attempting to enact change via concrete interventions, where stakeholder expectations may be unreasonably high or incompatible. Nonetheless, such initiatives may possess intangible benefits difficult to measure in terms of cost-effectiveness.

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