Table 1 Definitions of main realist... | Emerald Publishing

Table 1

Definitions of main realist evaluation concepts

Strategy	Refers to intended plans and/or actions Jagosh et al. (2013). In this study, strategies relate to the reorganization and integration of public health, health care, social care and community services, including “partner sectors” (e.g. housing, economic development, transport)
Context	Pertains to the “backdrop” of PHM initiatives Jagosh et al. (2013), i.e. the pre-existing circumstances in which the strategies are implemented (e.g. the different multilevel sociocultural, relational, economic, political or historical factors Glasgow et al. (2012)
Mechanism	Refers to the generative force that leads to outcomes and highlights changes in stakeholders' reasoning and behaviour triggered by changes in contexts; specifically, how and to what extent stakeholders used resources to try and effect change Best et al. (2012)
Outcome	Refers to (un)intended process outcomes achieved (or expected to be achieved) through strategies implemented within PHM initiatives Jagosh et al. (2013). Process outcomes are e.g. changes in knowledge, attitudes, behaviour, policies or organizational structures
Strategy–context–mechanism–outcome (SCMO) configurations	SCMO configurations are heuristics that portray the relationships between strategies, contexts, mechanisms and outcomes; used to understand why strategies work or not in certain contexts (Haynes et al., 2018). SCMOs are used to generate or refine (initial) program theories
(Initial) program theories	Are hypotheses about how a program (component) may or may not work, under what circumstances, and with what outcomes. A program theory therefore hypothesizes how a program (component) is expected to work, given contextual influences and underlying mechanisms (Pawson and Tilly, 1997; Jagosh, 2019)