Cited by 896Evaluation and Performance AssessmentAdvanced Causal Inference TechniquesHealth Policy Implementation Science

What’s in a mechanism? Development of a key concept in realist evaluation

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Dalkin, Sonia Michelle, Greenhalgh, Joanne, Jones, Diana, Cunningham, Bill, Lhussier, Monique·2015·Implementation Science

Abstract

BACKGROUND: The idea that underlying, generative mechanisms give rise to causal regularities has become a guiding principle across many social and natural science disciplines. A specific form of this enquiry, realist evaluation is gaining momentum in the evaluation of complex social interventions. It focuses on 'what works, how, in which conditions and for whom' using context, mechanism and outcome configurations as opposed to asking whether an intervention 'works'. Realist evaluation can be difficult to codify and requires considerable researcher reflection and creativity. As such there is often confusion when operationalising the method in practice. This article aims to clarify and further develop the concept of mechanism in realist evaluation and in doing so aid the learning of those operationalising the methodology. DISCUSSION: Using a social science illustration, we argue that disaggregating the concept of mechanism into its constituent parts helps to understand the difference between the resources offered by the intervention and the ways in which this changes the reasoning of participants. This in turn helps to distinguish between a context and mechanism. The notion of mechanisms 'firing' in social science research is explored, with discussions surrounding how this may stifle researchers' realist thinking. We underline the importance of conceptualising mechanisms as operating on a continuum, rather than as an 'on/off' switch. The discussions in this article will hopefully progress and operationalise realist methods. This development is likely to occur due to the infancy of the methodology and its recent increased profile and use in social science research. The arguments we present have been tested and are explained throughout the article using a social science illustration, evidencing their usability and value.

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Authors
Dalkin, S. M., Greenhalgh, J., Jones, D., Cunningham, B., & Lhussier, M.
Affiliations
  • University of Leeds (GB)
  • Northumbria University (GB)
Corresponding author
Dalkin, Sonia Michelle
Venue
Implementation Science
Published
2015-04-16
Volume
10
Issue
1
Pages
49-49
ISSN
1748-5908 (ISSN-L)
OpenAlex
W1978372683
Cited by
896
References
6
Citations by year
2026: 107 · 2025: 78 · 2024: 119 · 2023: 94 · 2022: 77 · 2021: 163 · 2020: 88 · 2019: 66 · 2018: 49 · 2017: 30 · 2016: 18 · 2015: 4
FWCI
38.62
Type
journal article
Language
en
Open access
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • Northumbria Research Link (Northumbria University) (acceptedVersion)
  • Northumbria Research Link (Northumbria University) (submittedVersion)
Funders
  • Northumbria University
  • Medical Research Council (MR/K02325X/1)
Topics
  • Social Sciences › Decision Sciences › Management Science and Operations Research › Evaluation and Performance Assessment
  • Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
realist evaluation, mechanisms, context-mechanism-outcome configurations, causal regularities, researcher self-reflection
MeSH terms
Health Services Research, Humans, Palliative Care, Social Sciences, Program Evaluation

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