Getting beyond outcomes: a realist approach to help understand the impact of a nutritional intervention during smoking cessation

Mackenzie, Mhairi; Koshy, P.; Leslie, W. S.; Lean, Mike; Hankey, Catherine

doi:10.1038/ejcn.2009.38

Cited by 15 publications

(31 citation statements)

References 51 publications

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“…Details of the selection process are provided in Figure 2. In two cases [27],[28], the article identified in the initial search provided a description of a realist evaluation associated with a randomized controlled trial. Additional information about these projects and application of the RE approach was sought by identifying additional publications pertaining to these trials [29]-[31].…”

Section: Resultsmentioning

confidence: 99%

“…Articles retrieved for inclusion were published in the years between 2007 and 2013. Of the 14 studies identified, 6 were protocols that contained descriptions of proposed rather than completed research [28],[33]-[37]. In general, there did not appear to be any specific preference in terms of healthcare setting or type of knowledge translation intervention studied.…”

Section: Resultsmentioning

confidence: 99%

“…Mackenzie et al . 2009 [28],[30],[31]UKProtocol (RCT)/EvaluationLocal health or community centresImplementation of an evidence-based intervention to improve smoking cessation by improving weight management through nutritional/lifestyle interventionWilliams et al . 2013 [38]UKEvaluationHospitalIntermediary program (where intermediary was defined as ` a linking agent, facilitator, change agent, champion or opinion leader ')Ward et al .…”

Section: Resultsmentioning

confidence: 99%

“…Nine of the included studies made reference to C-M-O configurations in reporting the application of realist evaluations [28],[32],[33],[36]-[38],[40],[41],[43]. Four of these were study protocols that provided detailed descriptions of initial investigations that included searches of existing literature, interviews and document analysis intended to inform identification of contextual factors, possible underlying mechanisms and outcome patterns that could be used to develop C-M-O configurations from which to generate study hypotheses [28],[33],[36],[37].…”

Section: Resultsmentioning

confidence: 99%

“…Four of these were study protocols that provided detailed descriptions of initial investigations that included searches of existing literature, interviews and document analysis intended to inform identification of contextual factors, possible underlying mechanisms and outcome patterns that could be used to develop C-M-O configurations from which to generate study hypotheses [28],[33],[36],[37]. The report provided by Mackenzie and colleagues [28] presented the results of this first stage of evaluation and also provided examples of proposed C-M-O configurations. For example, `participants who are motivated and share a good rapport' (context) may `share ideas, experiences and support one another' (mechanism), which may be associated with a smoking cessation and improved weight management (outcome) [28].…”

Section: Resultsmentioning

confidence: 99%

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Using realist evaluation to open the black box of knowledge translation: a state-of-the-art review

2014

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BackgroundIn knowledge translation, complex interventions may be implemented in the attempt to improve uptake of research-based knowledge in practice. Traditional evaluation efforts that focus on aggregate effectiveness represent an oversimplification of both the environment and the interventions themselves. However, theory-based approaches to evaluation, such as realist evaluation (RE), may be better-suited to examination of complex knowledge translation interventions with a view to understanding what works, for whom, and under what conditions. It is the aim of the present state-of-the-art review to examine current literature with regard to the use of RE in the assessment of knowledge translation interventions implemented within healthcare environments.MethodsMultiple online databases were searched from 1997 through June 2013. Primary studies examining the application or implementation of knowledge translation interventions within healthcare settings and using RE were selected for inclusion. Varying applications of RE across studies were examined in terms of a) reporting of core elements of RE, and b) potential feasibility of this evaluation method.ResultsA total of 14 studies (6 study protocols), published between 2007 and 2013, were identified for inclusion. Projects were initiated in a variety of healthcare settings and represented a range of interventions. While a majority of authors mentioned context (C), mechanism (M) and outcome (O), a minority reported the development of C-M-O configurations or testable hypotheses based on these configurations. Four completed studies reported results that included refinement of proposed C-M-O configurations and offered explanations within the RE framework. In the few studies offering insight regarding challenges associated with the use of RE, difficulties were expressed regarding the definition of both mechanisms and contextual factors. Overall, RE was perceived as time-consuming and resource intensive.ConclusionsThe use of RE in knowledge translation is relatively new; however, theory-building approaches to the examination of complex interventions in this area may be increasing as researchers attempt to identify what works, for whom and under what circumstances. Completion of the RE cycle may be challenging, particularly in the development of C-M-O configurations; however, as researchers approach challenges and explore innovations in its application, rich and detailed accounts may improve feasibility.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0115-y) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Using realist evaluation to open the black box of knowledge translation: a state-of-the-art review

2014

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A Review of Life-Course Familial and Lifestyle Factors of Smoking Initiation and Cessation

Day

2013

Curr Cardiovasc Risk Rep

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Systems approaches to public service delivery: methods and frameworks

Mansoor,

Williams

2023

J. Pub. Pol.

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Researchers and practitioners are increasingly embracing systems approaches to deal with the complexity of public service delivery and policy evaluation. However, there is little agreement on what exactly constitutes a systems approach, conceptually or methodologically. We review and critically synthesize systems literature from the fields of health, education, and infrastructure. We argue that the common theoretical core of systems approaches is the idea that multi-dimensional complementarities between a policy and other aspects of the policy context are the first-order problem of policy design and evaluation. We distinguish between macro-systems approaches, which focus on the collective coherence of a set of policies or institutions, and micro-systems approaches, which focus on how a single policy interacts with the context in which it operates. We develop a typology of micro-systems approaches and discuss their relationship to standard impact evaluation methods as well as to work in external validity, implementation science, and complexity theory.

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Getting beyond outcomes: a realist approach to help understand the impact of a nutritional intervention during smoking cessation

Cited by 15 publications

References 51 publications

Using realist evaluation to open the black box of knowledge translation: a state-of-the-art review

Using realist evaluation to open the black box of knowledge translation: a state-of-the-art review

A Review of Life-Course Familial and Lifestyle Factors of Smoking Initiation and Cessation

Systems approaches to public service delivery: methods and frameworks

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