: Realism is a scientiﬁc epistemology (position of a community of researchers addressing the philosophical aspects of the scientific question: How do we know what we know? that is said to be realistic about evidence gathering, given the limits of human capacity in garnering the truth of phenomena throughobservation, perception, and interpretation (Sayer, 2000). The philosophy of realism ponders on the fallibilityof knowledge, bringing attention to the limits of both logical empiricism (e.g., as it manifests in the logic of randomized controlled trials and reviews of such) and constructivism as approaches to knowledge synthesis.Realism would suggest that one limitation of empiricism is that it sets aside important causal explanations if they are not immediately linked to observable evidence. On the other hand, constructivism, whichemphasizes explanatory theories and mainly in terms of human or cultural interpretation, does not pursuean objective assessment of evidence that is deemed (by realism) to be foundational to a comprehensiveunderstanding of causality. Realist modes of research reﬂect a mix of these two epistemologies by posingthe kinds of questions that seek out the truth of matters, while at the same time operating from a view of the historically, socially, and linguistically contingent nature of human knowledge.
Realist Methodology or Realist review (RR)
: RR is an approach to synthesizing quantitative, qualitative, or mixed methods research,based on a realist logic of enquiry. It answers questions of the general format
what worked, for whom andin what circumstances, how and why?
Initially designed to assess social policy, programs, and interventions,RR originated from a perceived inadequacy of usual empirical methods for evaluating social programs(Pawson, 2006b). Pawson is critique of empiricism brings into question the applicability of empirical methodsto assess causality (i.e., assessment of cause and effect) for social phenomena found in open systems. Insystematic reviews of randomized controlled trials, for example, causality is investigated by counting therepeated occurrence of cause and effect across a number of cases. In contrast, realists point out the causal mechanisms (Astbury and Leeuw, 2010) involved in investigated phenomena. Realists argue that searchingfor causal mechanisms is more appropriate for investigating social phenomena in open systems (e.g., healthprograms in community-based settings) than for investigating material phenomena in controlled trials (e.g.,pharmaceutical testing), because the former are open to an inﬁnite array of in ﬂuences that impactoutcomes, whereas the latter have been placed in studies designed to control extraneous and unknown inﬂuences and to account for effects of known, interjected in ﬂuences.
: A complex intervention can be understood as a program (often multiple interacting component interventions that offers resources or information, or enforces actions upon a targetgroup (e.g., a population sample) and is built on implicit or explicit logic that such efforts will lead topositive change in or for that group. Complexity arises from the following: (a) the volitions of the targetgroup; (b) their implementation in local (community or institutional) settings, which bring an array of uncontrollable contextual variables that exercise an impact on outcomes in addition to the interventionitself; and (c) emergent phenomena, where an outcome might change the underlying context and producefeedback that alters the prior implementation.
Middle-range theory (MRT)
: MRT is an implicit or explicit explanatory theory that can be used to explain specific parts of programs and interventions. Middle-range means that it can be tested with the observable data and isnot abstract to the point of addressing larger social or cultural forces (i.e., grand theories) (Merton, 1967). MRT issought throughout the review and may initially help to shape the review protocols.
Context, mechanism, and outcome (CMO) conﬁgurations : CMO conﬁguring is a heuristic used to generatecausative explanations pertaining to outcomes in the observed data. The process draws out and reﬂects onthe relationship of context, mechanism, and outcome of interest in a particular program. A CMOconﬁguration may pertain either to the whole program or only to certain aspects. One CMO may beembedded in another or conﬁgured in a series (in which the outcome of one CMO becomes the context forthe next in the chain of implementation steps). Conﬁguring CMOs is a basis for generating and/or reﬁningthe theory that becomes the ﬁnal product of the review. A simple example of a CMO conﬁguration is asfollows: A community experiences a high level of unemployment to which an employment training programis offered in a remote part of town (context). But the program has low enrollment and high attrition, andfew people are trained (outcome). The reason is that people feel disillusioned by the lack of effort byprogram planners to ensure adequate public transportation to the venue (mechanism).
: Context often pertains to the backdrop of programs and research. For example, in our review of participatory research, it pertains to the conditions connected to the development of research partnerships. Asthese conditions change over time, the context may reﬂect aspects of those changes while the program isimplemented. Examples of context include cultural norms and history of the community in which a program isimplemented, the nature and scope of existing social networks, or built program infrastructure. They can also betrust-building processes, geographic location (e.g., rural or urban), types of funding sources, and otheropportunities or constraints. Context can be broadly understood as any condition that triggers and/or modiﬁes the mechanism.
: A mechanism is the generative force that leads to outcomes. It often but not always denotes thereasoning (cognitive or emotional) of the various actors in relation to the work, challenges, and successes of thepartnership. Mechanisms are linked to, but not synonymous with, the programs strategies (e.g., a strategy maybe an intended plan of action, whereas a mechanism involves the participants reaction or response to theintentional offer of incentives or resources). Identifying the mechanisms advances the synthesis beyonddescribing what happened to theorizing why it happened, for whom, and under what circumstances
: Outcomes are either intended or unintended and can be proximal, intermediate, or ﬁnal. Examplesof PR outcomes from our review include the following: increased self-empowerment, participant enrolment,higher education opportunities, acquisition of skills and knowledge, development of program infrastructure,and enriched research processes. Examples of intervention outcomes are improved health status, increaseduse of health services, and enhanced research results.
: Demi-regularity means semipredictable patterns or pathways of program functioning. The termwas coined by Lawson (1997), who argued that human choice or agency manifests in a semipredictable manner semi because variations in patterns of behavior can be attributed partly to contextual differences from onesetting to another.
: This concept means inference to the best explanation It involves an iterative process of examining evidence and developing hunches or ideas about the causal factors linked to that evidence
ที่มา Jagosh, J., Pluye, P., Wong, G., Cargo, M., Salsberg, J., Bush, P. L., Herbert, C. P., Green, L. W., Greenhalgh, T., & Macaulay, A. C. (2014). Critical reflections on realist review: insights from customizing the methodology to the needs of participatory research assessment. Research synthesis methods, 5(2), 131–141. https://doi.org/10.1002/jrsm.1099