PPI 2015 Unit III

This method of evaluation asks the question: ‘What works for whom in what circumstances . . . and why?’ It analyses a number of case studies, comparing the process and outcomes from a range of perspectives (such as patients, researchers, managers, funders) to identify the links between context, mechanisms and outcomes across studies. It is theory-driven, in that it starts with a theory about how a particular mechanism operates in a specific context to produce a defined outcome. The theory is used to generate a hypothesis about what aspects of the mechanism might produce change, which subgroups might benefit most readily and what resources are necessary to sustain the changes. The evaluation or study then adopts a design and methods of data collection and analysis to test these hypotheses.

Evans et al. (2014) conducted a qualitative realist evaluation and found that public involvement was associated with improvements in research design and delivery, particularly recruitment strategies and materials, and data collection tools. They identified the importance of principal investigator leadership as a key contextual factor leading to the impact of public involvement. In terms of the mechanisms of involvement, allocating staff time to facilitate involvement appeared more important than formal budgeting. Many research proposals significantly under-costed public involvement. Nurturing good interpersonal relationships was crucial to effective involvement. Payment for patients’ time and formal training appeared more significant for some types of public involvement than others. Feedback to patients on the value of their contribution was important in maintaining motivation and confidence.