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]> on behalf of Janet L Harris <[log in to unmask]>
Reply-To: "Realist and Meta-narrative Evidence Synthesis: Evolving Standards" <[log in to unmask]>, Janet L Harris <[log in to unmask]>
Date: Tuesday, 4 July 2017 at 11:20
To: "[log in to unmask]" <[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 

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

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]> 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]> on behalf of John Ling <0000113d68481414-dmarc-reques[log in to unmask]>
Sent: 03 July 2017 09:26
To: [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

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