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A non-conventional realist informed approach for logic model development for intervention design and implementation

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: IQBAL, Ayesha (Division of Pharmacy practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom)
  • Co-author(s): Ayesha Iqbal, Claire Anderson, Roger David Knaggs, Li Shean Toh
  • Abstract:


    Traditional lines of research enquiry in pharmacy practice research provide little or no evidence as how “complex interventions” works or not when applied in different contexts or settings. Realist evaluations are primarily designed to improve understanding about how and why an intervention works, however; realist evaluations require substantial evidence as data on outcomes 1. Realist evaluations might not be feasible in initial exploratory studies for designing and implementing a novel intervention due to lack of data on desired outcomes.


    Method: All realist evaluations are theory-based evaluations and involves testing and refining an initial programme theory. In absence of an existing programme theory, it is developed during the process of evaluation 2. However, in absence of data to develop programme theory, this study offers a “non-conventional realist informed approach” and exemplifies what will work and how by identifying relationships of causal mechanisms with strategies, without developing programme theories.


    Application (Case Study): A non-conventional realist informed methodology was adapted in an exploratory study to identify factors, explore underlying mechanisms and develop contextual strategies to show a logic model for community pharmacy intervention development and implementation in opioid optimisation in chronic non-malignant pain in Pakistan. The data collection involved focus groups and interviews with relevant stakeholders and non-participant case studies in community pharmacies. Data was analysed using inductive thematic analysis and cross case synthesis and findings were mapped to an adapted implementation science framework 3,4.


    Causal mechanisms were identified and developed using a realist informed approach and supported in providing contextual explanations for what strategies might work and how.


    A non-conventional realist informed enquiry helped the development of a logic model and provides policy makers with rich understanding of complex underlying mechanisms and assists in designing tailored strategies to develop and implement a contextualised intervention for community pharmacists in opioid optimisation.

Last update 4 October 2019

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