Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people

Douglas, Flora; Gray, Denise; Teijlingen, Edwin van

doi:10.1186/1472-6963-10-49

Cited by 16 publications

(10 citation statements)

References 24 publications

(25 reference statements)

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“…The Theory of Change (ToC) approach was developed by the Roundtable on Community Change (Aspen Institute, USA) to evaluate complex community-based change interventions [6]. Mostly applied to programme evaluation, it seeks to establish the links between intervention, context and outcome [7-9] through development and testing of logic models [10]. …”

Section: Introductionmentioning

confidence: 99%

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

et al. 2010

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BackgroundThis paper presents the development of a study design built on the principles of theory-driven evaluation. The theory-driven evaluation approach was used to evaluate an adolescent sexual and reproductive health intervention in Mali, Burkina Faso and Cameroon to improve continuity of care through the creation of networks of social and health care providers.Methods/designBased on our experience and the existing literature, we developed a six-step framework for the design of theory-driven evaluations, which we applied in the ex-post evaluation of the networking component of the intervention. The protocol was drafted with the input of the intervention designer. The programme theory, the central element of theory-driven evaluation, was constructed on the basis of semi-structured interviews with designers, implementers and beneficiaries and an analysis of the intervention's logical framework.DiscussionThe six-step framework proved useful as it allowed for a systematic development of the protocol. We describe the challenges at each step. We found that there is little practical guidance in the existing literature, and also a mix up of terminology of theory-driven evaluation approaches. There is a need for empirical methodological development in order to refine the tools to be used in theory driven evaluation. We conclude that ex-post evaluations of programmes can be based on such an approach if the required information on context and mechanisms is collected during the programme.

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Section: Introductionmentioning

confidence: 99%

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

et al. 2010

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“…30 , 48 , 63 , 72 , 76-107 Monitoring the implementation process strengthens the causal relationship between the intervention and observed outcomes by providing information on the facilitating intermediary links. 89 In cases where outcome indicators are unavailable, process evaluation may also act as a provisional indicator of effectiveness in view of its expected impact on outcomes. 91 For instance, monitoring the coverage of a target group for a screening programme may be used to gauge the success of the programme on top of outcome data on decreased morbidity and mortality, which may only improve after a long period and are difficult to attribute to a single intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Assessment of contextual factors ensures that the intervention is relevant to the target group’s needs and circumstances. 48 , 121 , 122 Furthermore, it also pinpoints factors that may influence the ability of the programme to achieve its desired outcome, 85 , 87 , 89 , 92-95 , 123 such as political environment and available resources. Since a best practice needs to be transferable between settings, consideration of the context during evaluation is useful in facilitating replication of the practice.…”

Section: Resultsmentioning

confidence: 99%

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

Colombani

2015

Journal of Public Health Research

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Evidence-based public health has commonly relied on findings from empirical studies, or research-based evidence. However, this paper advocates that practice-based evidence derived from programmes implemented in real-life settings is likely to be a more suitable source of evidence for inspiring and guiding public health programmes. Selection of best practices from the array of implemented programmes is one way of generating such practice-based evidence. Yet the lack of consensus on the definition and criteria for practice-based evidence and best practices has limited their application in public health so far. To address the gap in literature on practice-based evidence, this paper hence proposes measures of success for public health interventions by developing an evaluation framework for selection of best practices. The proposed framework was synthesised from a systematic literature review of peer-reviewed and grey literature on existing evaluation frameworks for public health programmes as well as processes employed by health-related organisations when selecting best practices. A best practice is firstly defined as an intervention that has shown evidence of effectiveness in a particular setting and is likely to be replicable to other situations. Regardless of the area of public health, interventions should be evaluated by their context, process and outcomes. A best practice should hence meet most, if not all, of eight identified evaluation criteria: relevance, community participation, stakeholder collaboration, ethical soundness, replicability, effectiveness, efficiency and sustainability. Ultimately, a standardised framework for selection of best practices will improve the usefulness and credibility of practice-based evidence in informing evidence-based public health interventions.Significance for public healthBest practices are a valuable source of practice-based evidence on effective public health interventions implemented in real-life settings. Yet, despite the frequent branding of interventions as best practices or good practices, there is no consensus on the definition and desirable characteristics of such best practices. Hence, this is likely to be the first systematic review on the topic of best practices in public health. Having a single widely accepted framework for selecting best practices will ensure that the selection processes by different agencies are fair and comparable, as well as enable public health workers to better appreciate and adopt best practices in different settings. Ultimately, standardisation will improve the credibility and usefulness of practice-based evidence to that of research-based evidence.

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“…Demographic and clinical data from clients, videorecording of consultations, clinic documentation, and interviews will be used to evaluate what works in the NLMC, for whom, and under what circumstances, in what respects, to what extent, and why [34]. Realistic evaluation is concerned not just with the outcomes of an intervention (in this case, a free assessment and management service for people with memory and cognitive changes) but also with the context and mechanisms of the intervention [35]- [37]. This is important because realistic evaluation "acknowledges that the outcomes of a project are confined to not only improved patient outcomes but also staff and organisational outcomes" [37], p. 235.…”

Section: Methodsmentioning

confidence: 99%

A Case Study Evaluation Protocol to Assess Processes, Effectiveness and Impact of a Nurse Practitioner-Led Memory Clinic

Bentley¹,

Minstrell²,

Bucher³

et al. 2014

Health

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The prevalence of dementia is predicted to increase significantly as the population ages and with no foreseeable cure options the burden of dementia will continue to grow. Early diagnosis provides many benefits, including timely access to appropriate support services and provision of tailored therapeutic interventions for people with dementia and their carers. Memory clinics are a key response to the need for specialist assessment and diagnosis of dementia. Multidisciplinary team memory clinics are considered the "gold standard"; however, such resource intensive clinics are likely unsustainable. The nurse-led memory clinic format may provide a primary care focused, diagnostic service for dementia that does not have the cost implications of multidisciplinary memory clinics but there is limited research using nurse practitioners. This study is exploring the potential of a nurse-led memory clinic as a primary health care approach to health promotion (brain health awareness), disease prevention (risk factor reduction) and early intervention (diagnosis and management of dementia). A realistic evaluation of a nurse practitioner-led memory clinic is described. Realistic evaluation is concerned not only with the outcomes of an intervention but also with the context and mechanisms of the intervention. We are using a mixed methods case study design to describe and evaluate the impact of the nurse practitioner-led memory clinic. The nurse practitioner in this study is an advanced practice aged care nurse who focuses on mental health, and dementia diagnosis, management and risk factor reduction. This study seeks to inform the development of an expanded scope role for nurse practitioners in assessment and referrals for dementia diagnosis. The heterogeneity of clients attending the nurse-led memory clinic will allow us to evaluate what works in the memory clinic, for whom, and under what circumstances, in what respects, and to what extent.

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Using a realist approach to evaluate smoking cessation interventions targeting pregnant women and young people

Cited by 16 publications

References 24 publications

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

How to develop a theory-driven evaluation design? Lessons learned from an adolescent sexual and reproductive health programme in West Africa

Framework for Selecting Best Practices in Public Health: A Systematic Literature Review

A Case Study Evaluation Protocol to Assess Processes, Effectiveness and Impact of a Nurse Practitioner-Led Memory Clinic

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