Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project

Realist approaches to complex health care evaluations are increasingly used and recommended in national evaluation guidelines. However, there remains a paucity of researcher guidance on methods for elaborating and refining programme theories throughout the stages of a realist evaluation project—from...

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Main Authors: Sarah Griffiths, Hannah Wheat, Sarah Morgan-Trimmer, Lauren Weston, Alex Gude, Tomasina M. Oh, Rod Sheaff, Richard Byng
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:International Journal of Qualitative Methods
Online Access:https://doi.org/10.1177/16094069251370659
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author Sarah Griffiths
Hannah Wheat
Sarah Morgan-Trimmer
Lauren Weston
Alex Gude
Tomasina M. Oh
Rod Sheaff
Richard Byng
author_facet Sarah Griffiths
Hannah Wheat
Sarah Morgan-Trimmer
Lauren Weston
Alex Gude
Tomasina M. Oh
Rod Sheaff
Richard Byng
author_sort Sarah Griffiths
collection DOAJ
description Realist approaches to complex health care evaluations are increasingly used and recommended in national evaluation guidelines. However, there remains a paucity of researcher guidance on methods for elaborating and refining programme theories throughout the stages of a realist evaluation project—from prospective theory development to feasibility work, to full evaluation. We present a step by step worked example of a realist approach to elaborating a programme theory for a health care intervention during the feasibility phase of the Dementia PersonAlised care Team. We explain how multiple qualitative methods can be applied to elaborate initial theory, supporting a shift away from a hypothetical explanation, towards a theory of how the model works in practice. We reflect on what worked well, and problems encountered, attending to both processes and the impact of working. Details are provided on how this approach can help enhance the likelihood of the intervention working in practice—through the application of new insights to interventionists’ training resources. We argue that coding to a framework constructed of ’If-Then’ initial programme theory statements enabled researchers to develop a realist analytic mindset and elaborated programme theory, ready for a fuller evaluation of the D-PACT intervention.
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spelling doaj-art-04efd1ba67b448bc8f799c30596ae06d2025-08-26T09:03:24ZengSAGE PublishingInternational Journal of Qualitative Methods1609-40692025-08-012410.1177/16094069251370659Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT ProjectSarah GriffithsHannah WheatSarah Morgan-TrimmerLauren WestonAlex GudeTomasina M. OhRod SheaffRichard ByngRealist approaches to complex health care evaluations are increasingly used and recommended in national evaluation guidelines. However, there remains a paucity of researcher guidance on methods for elaborating and refining programme theories throughout the stages of a realist evaluation project—from prospective theory development to feasibility work, to full evaluation. We present a step by step worked example of a realist approach to elaborating a programme theory for a health care intervention during the feasibility phase of the Dementia PersonAlised care Team. We explain how multiple qualitative methods can be applied to elaborate initial theory, supporting a shift away from a hypothetical explanation, towards a theory of how the model works in practice. We reflect on what worked well, and problems encountered, attending to both processes and the impact of working. Details are provided on how this approach can help enhance the likelihood of the intervention working in practice—through the application of new insights to interventionists’ training resources. We argue that coding to a framework constructed of ’If-Then’ initial programme theory statements enabled researchers to develop a realist analytic mindset and elaborated programme theory, ready for a fuller evaluation of the D-PACT intervention.https://doi.org/10.1177/16094069251370659
spellingShingle Sarah Griffiths
Hannah Wheat
Sarah Morgan-Trimmer
Lauren Weston
Alex Gude
Tomasina M. Oh
Rod Sheaff
Richard Byng
Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
International Journal of Qualitative Methods
title Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
title_full Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
title_fullStr Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
title_full_unstemmed Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
title_short Using a Realist Informed Qualitative Approach to Elaborate Programme Theory: Experiences From the Feasibility Phase of the D-PACT Project
title_sort using a realist informed qualitative approach to elaborate programme theory experiences from the feasibility phase of the d pact project
url https://doi.org/10.1177/16094069251370659
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