Pulling apart the Population health intervention black box: The concept of 'mechanism' from a realist evaluation perspective
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To quote: Lacouture A., Breton E., Ridde V., Guichard A. Pulling apart the population health intervention black box: the concept of 'mechanism' from a realist evaluation perspective. 5th Annual European Public Health Conference. All Inclusive Public Health. Portomaso, St Julian's, Malta. 7-10 November 2012.
Pulling apart the Population health intervention black box: The concept of 'mechanism' from a realist evaluation perspective
- 1. Pulling apart the Population health intervention black box: The concept of mechanism from a realist evaluation perspective. Anthony Lacouture 1, Eric Breton 1, Val辿ry Ridde 2, Anne Guichard 3 1. EHESP School of Public Health, Rennes, France 2. Montreal University Hospital Research Centre CRCHUM, Montreal, Canada 3. National Institute for Prevention and Health Education INPES, Saint Denis, France To open the intervention black box, 3 reading keys M Agency Structure per mechanism (M): O Intervention black box FORCE / POWER C DYNAMIC PROCESS Generative causation RELATION / Implementation M hidden, but real INTERACTION Anteriority/History M produces outcomes (O) Temporality Interrelationships Agency/Structure M depends on context (C) M: Reasoning/Resources Existence of families of M: Reactions mechanisms Logic of intervention For Whom ? What ? Actors in Population health (PH) intervention Challenges of complex intervention (Stakeholders, researchers, practitioners) evaluation Complex nature of context-dependant Acting at different levels of intervention intervention (Practice, programme, policy) Shortfalls of (quasi) experimental Involved in different issues evaluation design Realist approach: a theory-based (Health system management, Health evaluation (Pawson & Tilley, 1997) promotion, Healthcare access) Context-Mechanism-Outcomes configuration Scoping study Defining the concept of mechanism Exploratory study of the grey and scientific No consensus about the definition literature Clarification is required for a more Conceptual analysis: term, sense, referent coherent use (Marchal et al, 2012) (Gerring, 1999; Sartori, 2009; Daigneault & Jacob, 2012) Very recent debate in PH evaluation 57 documents included (out of 1442 The proponents of the realist approach references) featuring an implicit or explicit have suggested a general methodological definition of mechanism framework rather than a strict one How ? Why ? 5th Annual European Public Health Conference 7-12 November 2012, Malta This study is a component of the AAPRISS programme carried out by: This study was funded by the French National Research Agency (ANR) Eric Breton, PhD: Eric.Breton@ehesp.fr Val辿ry Ridde, PhD: Valery.Ridde@umontreal.ca Anne Guichard, PhD: Anne.Guichard@inpes.sante.fr Anthony Lacouture, MSc: Anthony.Lacouture@ehesp.fr