1932

Abstract

Realist synthesis is a literature review methodology for understanding how, for whom, and under what circumstances complex interventions function in complex environments. Using a heuristic called the context-mechanism-outcome (CMO) configuration, realist synthesis produces evidence-informed theories about the interactions between intervention mechanisms and their implementation contexts. Public health interventions and their effects unfold over time and develop differently in different contexts. Much of what causes programs to function remains in a realm beyond empirical measurement. By scrutinizing the theories relevant to the interventions of interest, and by enhancing the conceptualization of complex outcomes, the realist approach deprioritizes evidence hierarchies and harnesses insights from diverse data sources to generate causal understanding. The dynamic learning process that can arise in conducting a realist synthesis may generate new ideas for program development and innovation apart from what can be achieved in reviews providing a summation and aggregation of quantified evidence.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-publhealth-031816-044451
2019-04-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/publhealth/40/1/annurev-publhealth-031816-044451.html?itemId=/content/journals/10.1146/annurev-publhealth-031816-044451&mimeType=html&fmt=ahah

Literature Cited

  1. 1. 
    Ammerman A, Smith TW, Calancie L 2014. Practice-based evidence in public health: improving reach, relevance, and results. Annu. Rev. Public Health 35:47–63
    [Google Scholar]
  2. 2. 
    Armstrong R, Pettman TL, Waters E 2014. Shifting sands: from descriptions to solutions. Public Health 128:525–32
    [Google Scholar]
  3. 3. 
    Astbury B, Leeuw FL 2010. Unpacking black boxes: mechanisms and theory building in evaluation. Am. J. Eval. 31:363–81
    [Google Scholar]
  4. 4. 
    Baker PRA, Francis DP, Hairi NN, Othman S, Choo WY 2016. Interventions for preventing abuse in the elderly. Cochrane Database Syst. Rev. 2016:8CD010321
    [Google Scholar]
  5. 5. 
    Bhaskar R 1978. A Realist Theory of Science Hemel Hempstead, UK: Harvester
  6. 6. 
    Ciliska D, Thomas H, Buffett C 2008. An introduction to evidence-informed public health and a compendium of critical appraisal tools for public health practice Rep., Natl. Collab. Cent. Methods Tools., Hamilton, ON, Can. http://www.nccmt.ca/uploads/media/media/0001/01/b331668f85bc6357f262944f0aca38c14c89c5a4.pdf
  7. 7. 
    Coren E, Hossain R, Pardo Pardo J, Bakker B 2016. Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street‐connected children and young people. Cochrane Database Syst. Rev. 2016:1CD009823
    [Google Scholar]
  8. 8. 
    Crockett RA, King SE, Marteau TM, Prevost AT, Bignardi G et al. 2018. Nutritional labelling for healthier food or non‐alcoholic drink purchasing and consumption. Cochrane Database Syst. Rev. 2018:2CD009315
    [Google Scholar]
  9. 9. 
    Frazer K, McHugh J, Callinan JE, Kelleher C 2016. Impact of institutional smoking bans on reducing harms and secondhand smoke exposure. Cochrane Database Syst. Rev. 2016:5CD011856
    [Google Scholar]
  10. 10. 
    Glasgow RE, Chambers D 2012. Developing robust, sustainable, implementation systems using rigorous, rapid and relevant science. Clin. Transl. Sci. 5:148–55
    [Google Scholar]
  11. 11. 
    Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J et al. 2006. Lost in knowledge translation: time for a map?. J. Contin. Educ. Health Prof. 26:13–24
    [Google Scholar]
  12. 12. 
    Green LW 2008. Making research relevant: if it is an evidence-based practice, where's the practice-based evidence?. Fam. Pract. 25:i20–24
    [Google Scholar]
  13. 13. 
    Greenhalgh T, Wieringa S 2011. Is it time to drop the ‘knowledge translation’ metaphor? A critical literature review. J. R. Soc. Med. 104:12501–9
    [Google Scholar]
  14. 14. 
    Haig BD, Evers CW 2016. Realist Inquiry in Social Science London: Sage
  15. 15. 
    Harrison MB, Graham ID 2012. Roadmap for a participatory research-practice partnership to implement evidence. Worldviews Evid.-Based Nurs. 9:210–20
    [Google Scholar]
  16. 16. 
    Jackson L, Langille L, Lyons R, Hughes J, Martin D et al. 2009. Does moving from a high-poverty to lower-poverty neighbourhood improve mental health? A realist review of moving to opportunity. Health Place 15:961–70
    [Google Scholar]
  17. 17. 
    Jackson N, Waters E 2005. Criteria for the systematic review of health promotion and public health interventions. Health Promot. Int. 20:4367–74
    [Google Scholar]
  18. 18. 
    Jagosh J, Bush PL, Salsberg J, Macaulay AC, Greenhalgh T et al. 2015. A realist evaluation of community-based participatory research: partnership synergy, trust building and related ripple effects. BMC Public Health 15:1725
    [Google Scholar]
  19. 19. 
    Jagosh J, Macaulay A, Pluye P, Salsberg J, Bush P et al. 2012. Uncovering the benefits of participatory research: implications of a realist review for health research and practice. Milbank Q 90:2311–46
    [Google Scholar]
  20. 20. 
    Jagosh J, Pluye P, Macaulay A, Salsberg J, Henderson J et al. 2011. Assessing the outcomes of participatory research: protocol for identifying, selecting, appraising, and synthesizing the literature for realist review. Implement. Sci. 6:24
    [Google Scholar]
  21. 21. 
    Jagosh J, Pluye P, Wong G, Cargo M, Salsberg J et al. 2013. Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment. Res. Synth. Methods 5:131–41
    [Google Scholar]
  22. 22. 
    Jenicek M 1997. Epidemiology, evidence-based medicine, and evidence-based public health. J. Epidemiol. 7:187–97
    [Google Scholar]
  23. 23. 
    Kirsh SR, Aron DC, Johnson KD, Santurri LE, Stevenson LD et al. 2017. A realist review of shared medical appointments: How, for whom, and under what circumstances do they work?. BMC Health Serv. Res. 17:113
    [Google Scholar]
  24. 24. 
    Kirst M, O'Campo P, eds. 2014. Realist review and evaluation: What do we know about what works?. Methods for Community Public Health Research: Integrated and Engaged Approaches JG Burke, SM Albert 105–28 New York: Springer
    [Google Scholar]
  25. 25. 
    Kothari A, Wathen CN 2013. A critical second look at integrated knowledge translation. Health Policy109187–91
  26. 26. 
    Lasker R, Weiss E, Miller R 2001. Partnership synergy: a practical framework for studying and strengthening the collaborative advantage. Milbank Q 79:2179–205
    [Google Scholar]
  27. 27. 
    Macaulay A, Jagosh J, Pluye P, Bush PL, Salsberg J 2014. Quantitative methods in participatory research: being sensitive to issues of scientific validity, community safety, and the academic-community relationship. Nouv. Prat. Soc. 25:2159–72
    [Google Scholar]
  28. 28. 
    Macaulay A, Jagosh J, Seller R, Henderson J, Cargo M et al. 2011. Assessing the benefits of participatory research: a rationale for a realist review. Glob. Health Promot. 18:245–48
    [Google Scholar]
  29. 29. 
    Marchal B, van Belle S, Olmen J, Hoerée T, Kegels G 2012. Is realist evaluation keeping its promise? A review of published empirical studies in the field of health systems research. Evaluation 18:192–212
    [Google Scholar]
  30. 30. 
    Marx R, Tanner‐Smith EE, Davison CM, Ufholz LA, Freeman J et al. 2017. Later school start times for supporting the education, health, and well‐being of high school students. Cochrane Database Syst. Rev. 2017:7CD009467
    [Google Scholar]
  31. 31. 
    Minkler M, Wallerstein N, eds. 2008. Community-Based Participatory Research for Health: From Process to Outcomes San Francisco: Jossey-Bass, 2nd ed..
  32. 32. 
    Moore GF, Audrey S, Barker M, Bond L, Bonell C et al. 2015. Process evaluation of complex interventions: Medical Research Council guidance. BMJ 350:h1258
    [Google Scholar]
  33. 33. 
    Mosdøl A, Lidal IB, Straumann GH, Vist GE 2017. Targeted mass media interventions promoting healthy behaviours to reduce risk of non‐communicable diseases in adult, ethnic minorities. Cochrane Database Syst. Rev. 2017:2CD011683
    [Google Scholar]
  34. 34. 
    Murphy K, Farfard P 2012. Knowledge translation and social epidemiology: taking power, politics, and values seriously. Rethinking Social Epidemiology: Towards a Science of Change P O'Campo, J Dunn 267–83 Berlin: Springer Sci. + Bus.
    [Google Scholar]
  35. 35. 
    Olsen W 2010. Editor's introduction: realist methodology—a review. Realist Methodology Vol. 1: Practical Realist Ontology, ed. W Olsen xix–xlvi Los Angeles: Sage
    [Google Scholar]
  36. 36. 
    Orton E, Whitehead J, Mhizha‐Murira J, Clarkson M, Watson MC et al. 2016. School‐based education programmes for the prevention of unintentional injuries in children and young people. Cochrane Database Syst. Rev. 2016:12CD010246
    [Google Scholar]
  37. 37. 
    Pawson R 2002. Evidence-based policy: the promise of ‘realist synthesis.’. Evaluation 8:340–58
    [Google Scholar]
  38. 38. 
    Pawson R 2006. Digging for nuggets: how ‘bad’ research can yield ‘good’ evidence. Int. J. Soc. Res. Methodol. 9:2127–42
    [Google Scholar]
  39. 39. 
    Pawson R 2006. Evidence-Based Policy: A Realist Perspective London: Sage
  40. 40. 
    Pawson R 2013. The Science of Evaluation: A Realist Manifesto London: Sage
  41. 41. 
    Pawson R, Bellamy J 2006. Realist synthesis: an explanatory focus for systematic review. Moving Beyond Effectiveness in Evidence Synthesis: Methodological Issues in the Synthesis of Diverse Sources of Evidence J Popay 83–94 London: Natl. Inst. Health Clin. Excell.
    [Google Scholar]
  42. 42. 
    Pawson R, Greenhalgh T, Harvey G, Walshe K 2004. Realist synthesis: an introduction ESRC Work. Pap. Ser. Econ. Soc. Res. Counc. London:
  43. 43. 
    Pawson R, Manzano-Santaella A 2012. A realist diagnostic workshop. Evaluation 18:176–91
    [Google Scholar]
  44. 44. 
    Pawson R, Owen L, Wong G 2010. Legislating for health: locating the evidence. J. Public Health Policy 31:2164–77
    [Google Scholar]
  45. 45. 
    Pawson R, Sridharan S 2010. Theory-driven evaluation of public health programmes. Evidence-Based Public Health: Effectiveness and Efficiency A Killoran, MP Kelly 43–62 Oxford: Oxford Univ. Press
    [Google Scholar]
  46. 46. 
    Pawson R, Tilley N 1997. Realistic Evaluation London: Sage
  47. 47. 
    Pawson R, Wong G, Owen L 2011. Myths, facts, and conditional truths: What is the evidence on the risks associated with smoking in cars carrying children?. CMAJ 183:10680–84
    [Google Scholar]
  48. 48. 
    Pega F, Liu SY, Walter S, Pabayo R, Saith R et al. 2017. Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low‐ and middle‐income countries. Cochrane Database Syst. Rev. 2017:11CD011135
    [Google Scholar]
  49. 49. 
    Rycroft-Malone J, Burton CR, Bucknall T, Graham ID, Hutchinson A et al. 2016. Collaboration and co-production of knowledge in healthcare: opportunities and challenges. Int. J. Health Policy Manag. 5:4221–23
    [Google Scholar]
  50. 50. 
    Rycroft-Malone J, McCormack BG, Hutchinson AM, DeCorby K, Bucknall TK et al. 2012. Realist synthesis: illustrating the method for implementation research. Implement. Sci. 7:33
    [Google Scholar]
  51. 51. 
    Sayer A 2000. Method in Social Science: A Realist Approach London: Routledge, 2nd ed..
  52. 52. 
    Schaafsma FG, Mahmud N, Reneman MF, Fassier JB, Jungbauer FHW 2016. Pre‐employment examinations for preventing injury, disease and sick leave in workers. Cochrane Database Syst. Rev. 2016:1CD008881
    [Google Scholar]
  53. 53. 
    Tabak RG, Khoong EC, Chambers DA, Brownson RC 2012. Bridging research and practice: models for dissemination and implementation research. Am. J. Prev. Med. 43:3337–50
    [Google Scholar]
  54. 54. 
    Tilley N 1993. Understanding Car Parks, Crime and CCTV: Evaluation Lessons from Safer Cities G Laycock, Police Res. Group. Crime Prev. Unit Ser. Pap. 42 London: Home Off. Police Dep.
  55. 55. 
    van der Molen HF, Basnet P, Hoonakker PLT, Lehtola MM, Lappalainen J et al. 2018. Interventions to prevent injuries in construction workers. Cochrane Database Syst. Rev. 2018:2CD006251
    [Google Scholar]
  56. 56. 
    Viswanathan M, Ammerman A, Eng E, Gartlehner G, Lohr KN et al. 2004. Community-based participatory research: assessing the evidence. Evid. Rep. Technol. Assess 2004:991–8
    [Google Scholar]
  57. 57. 
    Wallerstein N, Duran B 2010. Community-based participatory research contribution to intervention research: the intersection of science and practice to improve health equity. Am. J. Public Health 100:S1S40–46
    [Google Scholar]
  58. 58. 
    Wilson PM, Petticrew M, Calnan MW, Nazareth I 2010. Disseminating research findings: What should researchers do? A systematic scoping review of conceptual frameworks. Implement. Sci. 5:91
    [Google Scholar]
  59. 59. 
    Wolfenden L, Jones J, Williams CM, Finch M, Wyse RJ et al. 2016. Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services. Cochrane Database Syst. Rev. 2016:10CD011779
    [Google Scholar]
  60. 60. 
    Wong G, Greenhalgh T, Westhorp G, Buckingham J, Pawson R 2013. RAMESES publication standards: realist syntheses. BMC Med 11:121
    [Google Scholar]
  61. 61. 
    Wong G, Pawson R, Owen L 2011. Policy guidance on threats to legislative interventions in public health: a realist synthesis. BMC Public Health 11:222
    [Google Scholar]
  62. 62. 
    Wong G, Westhorp G, Manzano A, Greenhalgh J, Jagosh J, Greenhalgh T 2016. RAMESES II reporting standards for realist evaluations. BMC Med 14:96
    [Google Scholar]
/content/journals/10.1146/annurev-publhealth-031816-044451
Loading
/content/journals/10.1146/annurev-publhealth-031816-044451
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error