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Hi Natelie

You are the umpteenth person on this list to report being foxed by the CMO configuration. Plenty of help is available. Go through the previous strings to find excellent advice (often by GW). Look again at the RAMESES II training materials. Books. In addition to Realistic Evaluation, look at the advice on CMOs in The Science of Evaluation and Doing Realist Research (several chapters).

Alternatively, try working with one of the ‘ordinary language’ versions of the same idea. So of your programme begin by asking, guessing, hypothesising – what is it about the intervention that works for whom in what circumstances in what respects and why. Then ask yourself, speculate wildly about what is it about the intervention that doesn’t work for whom in what circumstances and why. You should be able to come up with dozens of permutations, some of which you then study in much greater detail with the expectation that your research will clarify and refine them.

This is CMO analysis. The ‘what is it’ and ‘why’ question will guide you to mechanisms. The ‘for whom’ and ‘in what’ circumstance questions are aspects of context. The ‘does it work’ and ‘in what respects’ questions are about outcomes.

RP


From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]> on behalf of Gillian Westhorp <[log in to unmask]>
Sent: 16 December 2019 23:10
To: [log in to unmask] <[log in to unmask]>
Subject: Re: If/ then... because.... ?!
 

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Hi Natalie,

 

My fear with ‘if, then, leading to’ is that it will not identify mechanisms – it will have ‘context, intermediate outcome, later outcome’ instead.

 

There are a number of ‘tricks’ to distinguish between context and mechanism.  Consider the following:

  1. Mechanisms are always processes. Contexts aren’t necessarily processes: they are more commonly the salient aspects of circumstances, situations or groups.
  2. Because mechanisms are always processes, they always involve interactions. These are interactions between elements of a system (Example: capillary action – the process by which water is drawn to the top of a tree – involves in interaction between the width of the tube and the surface tension of water.) In a policy or a program, (using Pawson and Tilley’s construct), it’s interactions between the resources provided by the intervention and the reasoning of the target people.  Here, the program (staff, activities, resources, etc) and its participants constitute the system. NB – Programs mechanisms are not just resources or just reasoning – they are an interaction between the two.
  3. Mechanisms are usually invisible (they operate at different levels of the system than the outcomes of interest, and often over different timescales).  Contexts are often (albeit not always) visible.
  4. Mechanisms directly cause outcomes. Contexts don’t. If you write the context and the outcome, you’d have to add something else for it to make sense as a causal process. If you write the mechanism and the outcome, it directly explains the causal process (but doesn’t tell you in which circumstances it will operate).
  5. Mechanisms only operate sometimes. If it’s a mechanism, you should be able to imagine circumstances in which it won’t work.

 

It’s really only a small subset of things that could be both context or mechanism at a particular level of a system, and which they operate as will depend on the particular outcome that you are considering at that moment. So throw away the CMO labels. identify the outcome of interest first, then work backwards to what causes the outcome, then backwards from that to the circumstances in which that cause works (or doesn’t).

 

Hope this helps

Cheers

Gill

 

From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]> On Behalf Of NATALIE GRINVALDS
Sent: Tuesday, 17 December 2019 12:29 AM
To: [log in to unmask]
Subject: Re: If/ then... because.... ?!

 

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Hello all

Apologies for the late reply to this conversation. I am a PhD student, initially using "IF, THEN, BECAUSE" because I am having a hard time distinguishing the context from mechanisms. I also wrote out very rough paragraphs initially without worrying if all the components were there and found this very helpful. But I do worry how to present the final set of refined theories because I am not sure they will ever fit the CMO mold. I was also considering "IF, THEN LEADING TO..." Has anyone else done this?

Thank you!

Natalie Grinvalds

 

On Fri, 6 Dec 2019 at 11:11, Tristan Price <[log in to unmask]> wrote:

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Hi Becky,

 

I’m quite a novice with all this but being fresh to it I thought I my perspective might be useful. I don’t use if then statements because I found them a little too simple to give a useful description to build on.  But when initially building CMOCs I use very, very plain English, and worry about how pithy it all sounds later. I also use first person statements from the perspective of the person in the intervention.

 

So the initial statement I produce is just a long-winded explanation of what I see from the data, including context, mechanisms and outcomes, but not identified as such. So, for example, an early CMOC I developed for doctor remediation programmes around the role of identity looked something like:

 

If a doctor feels like they are part of a community of practice, they start to associate with the values of that community of practice, and may want to behave accordingly (I am a doctor and I want to act like a doctor and be recognised as being a doctor).  If they then realise that their behaviour is out of sync with that community of practice because the intervention has highlighted the difference between their actions and the standards associated with the community of practice (I can see that I have acted in way that is not how a doctor should act)¸ then they might change their practice to accord with the values of the community (I want to change my behaviour so that it fits with my identity as a doctor), and as a result of this they accept the need to change their.

 

Later on, using some reading on reference group theory, I ended up describing the mechanism as “normative enticement”, to describe the pull of wanting to belong to a community of practice. There were also related CMOCs that came of this related to a mechanism of dissonance.

 

My point is that in the early stages of developing a programme theory, I have personally found it really useful to describe in  paragraph what I am seeing in the data from a realist perspective (that interventions change contexts and contexts make things happen which then and produces outcomes) without getting caught up on which bit is which, and without worrying about how it all sounds. And they can say in that simple form for as long as I needed.

 

 

Best wishes,

 

Tristan

 

 

Dr Tristan Price

 

Email: [log in to unmask]                                                            

 

Research Fellow, RESTORE, Faculty of Medicine and Dentistry,  C203 Portland Square, University of Plymouth, PL4 8AA, Telephone: +44 (0) 1752 586838                                                                    

                                                          

Lecturer in Clinical Education, Postgraduate Team, Foor 2, Express Diagnostics, Plymouth Science Park, PL6 8BU, Telephone: +44 (0) 1752 437421

 

 

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From: Realist and Meta-narrative Evidence Synthesis: Evolving Standards <[log in to unmask]> On Behalf Of Kev Harris
Sent: 06 December 2019 09:08
To: [log in to unmask]
Subject: Re: If/ then... because.... ?!

 

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Hi Becky 

 

I’m sure more of the realist heavyweights will pitch in with a much better insight but ...

 

For what it’s worth from me I do like using if then and because statements but for me there is danger that they don’t consider context. I’m sure when we write them that we do have context in mind but making it explicit is important. 

 

Recently I have been playing around with this with my students ... 

 

I’ve used the iceberg (which Justin uses a lot) or a tree to show the picture of reality.. higher up the iceberg (what we can see) I write “if we do this (in this set of circumstances/ environment (taking into consideration Ray’s layers of context) then this will happen ...

 

I then go further down the iceberg beneath the surface to articulate the because elements which may be resource and reasoning elements. Some of these mechanisms are more visible than others and some hidden perhaps and that’s where you can make the colour more murky. 

 

I’ve been trying to do this with my students and practitioners I work with in the field because the CMMO can be quite challenging to use and make sense of. It’s merely experimenting at the moment so may get shot down which I don’t mind and there may well be someone out there who is already doing this ( apologies if I’ve missed something ). 

 

 

 

Kind Regards

 

Dr Kevin Harris SFHEA

Course Leader, Sport Coaching and Development  | School of Sport Health and Social Science

Southampton Solent University | East Park Terrace | Southampton SO14 0YN

T: 023 8201 3520 (ext. 3520) | 

 

 

 

 

 

   Disclaimer

 

 

 

On 6 Dec 2019, at 08:43, Rebecca Hardwick <[log in to unmask]> wrote:



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Dear RAMESESIANS, 

 

I’ve been thinking about how useful (or not) writing out If Then propositions is when building initial program theory, and I’m keen to hear what others think and do. 

 

And also, do you know of any projects (and papers) which used If/Then statements which I could read? 

Thanks in advance, 

Becky 

 


Rebecca Hardwick
Post Doctoral Research Associate
 
College of Indigenous Futures, Arts & Society
T: +61 8 8946 7491
E: 
[log in to unmask]
W: 
cdu.edu.au
 

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Charles Darwin University acknowledges the traditional custodians across the lands on which we live and work, and we pay our respects to Elders both past and present.
CRICOS Provider No. 00300K (NT/VIC)Rebecca Hardwick

Post Doctoral Research Associate
 
College of Indigenous Futures, Arts & Society
T: +61 8 8946 7491
E: 
[log in to unmask]
W: 
cdu.edu.au
 

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Charles Darwin University acknowledges the traditional custodians across the lands on which we live and work, and we pay our respects to Elders both past and present.
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Kind regards

 

Natalie

 

Natalie Grinvalds, MPH, BS, CHES

 

Doctoral Student

SHU Wellness Consultant

Fitness Instructor

 

National Centre for Sport & Exercise Medicine – Sheffield &

The Centre for Sport and Exercise Science

Sheffield Hallam University

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