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Hi Janet and all, I’m near Sheffield, and have been lucky enough to recently get a scholarship (start in Oct) to study my obsession (the use of competitions in enterprise education). I’d really welcome the opportunity to take part in a conversation/informal seminar etc. I’ve found this thread really interesting. Although my field is education, not health, and I’m a total realist novice, the initial realist influenced study I’ve been doing are leading me to spend a lot of time thinking about the disconnect between the ambitions/problem framing in policy, and the activity prescribed as a result (competitions are now recommended for all kids aged 11-18 in England to help them be more enterprising /work ready etc). Though our fields are different, the things you mention below: how people see a problem and the agendas that get set, and determining the nature of the problem, are of great interest. I’d be really grateful to be in the loop, if that’s possible. Thanks and best wishes, Catherine Brentnall From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards [mailto:[log in to unmask]] On Behalf Of Janet L Harris Sent: 06 July 2017 08:43 To: [log in to unmask] Subject: Re: 'realist diagnostic evaluation' of problems, not interventions- any examples? Hi Jo and Amanda Good to hear from you! After the conference in October I had to go on sick leave - torn rotator cuffs, no typing allowed. There was a huge backlog of emails to get through so all the realist networking went on hold. I don't know of any resources on Realist Diagnostic Evaluation but for a long time I've been fascinated by problem framing. I can understand why Ray feels he is banging on about it, I can't seem to get anyone interested and was starting to think I was the only one who thought it was really important. Anyway in my Fellowship I've had a chance to look at it further and I'm writing up one of my projects as a case study where the original problem formulation led to the development of an evaluation question/impact evaluation that weren't useful for informing programme development. There are papers written in the field of policy, many have cited Diane Stone<http://www.uvm.edu/~dguber/POLS293/articles/stone.pdf>'s work on the relationship between how people see a problem and the agendas that get set. In strategic management, Marjorie Lyles (1988) seemed to trigger a strand of enquiry with her article on strategic problem formulation and decision making models. Markus Baer (2013) 'Microfoundations of strategic problem formulation' calls it 'collaborative structured enquiry'. Some people came at it from the perspective of eliciting views of problems from stakeholders (Bryson et al (2003) 'What to do when stakeholders matter' ). Another perspective is John Lavis et al who are using deliberative dialogue to look at whether policymakers' opinions about the problem align with the research evidence - this is aimed at knowledge translation. So the literature is not in any one field. But I would love the opportunity to chat about it. Do you think we might be able to get together - maybe a very informal seminar to share what we know and are trying to do? You are very welcome in Sheffield or I could pop over to Nottingham. Best wishes Janet Janet Harris NIHR Knowledge Mobilisation Research Fellow Reader in Knowledge Mobilisation University of Sheffield School of Health and Related Research (ScHARR) 30 Regent Street Sheffield S1 4DA England +44 (0)114 222 2980 See our Masters programmes in Management and Leadership: MSc in International Health Management and Leadership by distance learning **New for September 2014**; and our MPH in Management and Leadership http://www.sheffield.ac.uk/scharr/prospective_students/masters/ihml On 5 July 2017 at 11:36, Joanne Howe <[log in to unmask]<mailto:[log in to unmask]>> wrote: Hi all, Here at the University of Nottingham we have a small but growing group of researchers (PhD and post doc) using realist methods. There are two of us (myself and a colleague) who think our own RE projects may fit into Ray’s description of a “Realist Diagnostic Evaluation” as we are not evaluating an intervention - more looking at the problem that exists in practice. In essence we are conducting this RE to determine the nature of the problem, this may or may not result in the development of an intervention in time. Currently we are referring to our studies as “Pre Realist Evaluation projects” but we wonder if there is any more information out there on Realist Diagnostic Evaluations. Ray has mentioned that he has been banging on about this type of research for a while and we would both be grateful if anyone could point us in the direction of any resources on this topic so that we may explore the area further. Thanks Jo and Amanda From: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>> on behalf of Janet L Harris <[log in to unmask]<mailto:[log in to unmask]>> Reply-To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]<mailto:[log in to unmask]>>, Janet L Harris <[log in to unmask]<mailto:[log in to unmask]>> Date: Tuesday, 4 July 2017 at 11:20 To: "[log in to unmask]<mailto:[log in to unmask]>" <[log in to unmask]<mailto:[log in to unmask]>> Subject: Re: 'realist diagnostic evaluation' of problems, not interventions- any examples? Hi Janet and John I think there are some good examples in diabetes where research teams have started at the very beginning (before developing interventions) and asked 'what are the problems, who sees them as a problem, in these particular circumstances, and given the range of problems what are the possible solutions?' But the teams don't call this realist diagnostic evaluation. Teams using community based participatory research start by developing dialogue with local people to drill down into things that contribute to diabetes risk. The process identifies a problem, then the various dimensions of the problem. Taking physical activity as one example, local people describe environments that limit physical activity which include safety issues preventing activity, parental schedules and school schedules that limit opportunities for activity; increased availability of TV channel and computer games (sedentary activity). Moving on to food and nutrition, they list food deserts, issues with food labelling, cooking skills, etc. The aim of the process is to develop critical consciousness of how the surrounding context contributes to risk. The relationships between different sorts of risk are explored, and the understanding is used to make decisions about which problems can be addressed, and how they can be resolved. We're just completing a review which looks at whether this sort of process helps to design more relevant and appropriate interventions. The protocol is here<https://www.ncbi.nlm.nih.gov/pubmed/26530706> If you'd like some of the references showing how teams did this, feel free to get in touch - Best wishes Janet Janet Harris NIHR Knowledge Mobilisation Research Fellow Reader in Knowledge Mobilisation University of Sheffield School of Health and Related Research (ScHARR) 30 Regent Street Sheffield S1 4DA England +44 (0)114 222 2980<tel:+44%20114%20222%202980> See our Masters programmes in Management and Leadership: MSc in International Health Management and Leadership by distance learning **New for September 2014**; and our MPH in Management and Leadership http://www.sheffield.ac.uk/scharr/prospective_students/masters/ihml On 3 July 2017 at 13:30, Janet Heaton <[log in to unmask]<mailto:[log in to unmask]>> wrote: Dear all I’d be interested to hear any more thoughts on the points John raises too. I may have an opportunity to build this into a 5-year study which has two parts: the first to explore the problem of unscheduled care for diabetes in three settings and identify an intervention (or two) to reduce this by 10%; the second to then pilot and test the intervention(s) in the three settings (rural regions in three countries). Regards to all, Janet Janet Heaton Research Fellow, Rural Health and Wellbeing University of the Highlands and Islands, Scotland ________________________________ From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]<mailto:[log in to unmask]>> on behalf of John Ling <[log in to unmask]<mailto:[log in to unmask]>> Sent: 03 July 2017 09:26 To: [log in to unmask]<mailto:[log in to unmask]> Subject: 'realist diagnostic evaluation' of problems, not interventions- any examples? Dear RAMESES subscribers, In the recent thread (29/6) about the University of Exeter job, Ray Pawson mentioned the need for 'realist diagnostic evaluation', applying realist synthesis techniques to the evaluation of a 'problem', prior to evaluating interventions (or even perhaps developing them?). I wondered if there any good examples of this that the RE community might be able to share. I'm doing a masters level study examining children's experience of parental brain injury and how they might become resilient to that adversity. Hoping to develop this into a PhD proposal, perhaps using RS/RE principles. The literature describing the problem is relatively sparse and published programmes / interventions even more so. There are pockets of good practice - but these could perhaps be described as being sunk into 'usual care' as opposed to being discrete programmes. Interested to hear any thoughts about (a) using realist approaches to understand "the what, where, why and for whom" of complex problems; (b) how RS/RE approaches to 'diagnosing' problems might feed-forward into recommendations for programmes as yet un-commissioned. many thanks in advance for your time... John Ling Clinical Nurse Specialist King's College Hospital London This message and any attachment are intended solely for the addressee and may contain confidential information. If you have received this message in error, please send it back to me, and immediately delete it. Please do not use, copy or disclose the information contained in this message or in any attachment. Any views or opinions expressed by the author of this email do not necessarily reflect the views of the University of Nottingham. 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