A realist synthesis is designed to find out what is known already about an area of interest or a particular topic and to make sure we make best use of previous work.
This early work will gather information about what community-led organisations (CLOs) are trying to achieve, how programmes work and for whom, how people respond to CLO activities, and what difference it makes to their health and wellbeing.
The results of the synthesis will inform stakeholder interviews and workshops.
Policy analysis will identify the factors and structures that might enhance or act as barriers to CLOs’ goals and their effects on participants’.
Techniques will include analysis of local and national policy documents and stakeholder interviews in England, Northern Ireland and Scotland.
Stakeholder interviews will explore how CLOs work and how changes in health and wellbeing come about, for different participants in different circumstances. Interviews will inform the policy analysis by asking those working in and with CLOs about ‘what works’ and their experiences of the barriers and enablers to improved health and wellbeing for their participants.
Analysis of interviews will be combined with findings from the realist synthesis and the policy analysis to generate ‘programme theories’ about what works, for whom and in what circumstances. These theories will be tested in phase 2 of the project.
Stakeholder workshops at different stages of the research will bring together CLO staff, volunteers and practitioners with expertise and experience in how CLOs work to achieve their goals.
At different stages workshops will have different objectives. Initially they will be used to develop programme theories (what works for whom and in what circumstances). The research team will present the findings of our evidence review, policy analysis and interviews and ‘try out’ theories. Later workshops will review data to see whether theories were confirmed, refuted or need to be refined.
A photovoice exercise will work with community participants to capture and curate images of what creates and prevents good health and wellbeing in their communities.
The photographs will be displayed in a photographic exhibition in community spaces.
Q methodology is designed to study shared perspectives. Participants are guided through a card sort exercise. Each card is printed with a statement and sorters arrange cards onto a grid according to their agreement with the statements.
Analysis groups together those people whose card sorts were similar (correlated) and finds shared points of view.
In this study we will use Q techniques to explore the mechanisms that lead to different health and wellbeing outcomes.
People who participate in the activities of their local CLOs will be asked to complete questionnaires that measure their health and wellbeing using established questionnaire tools. We will compare scores before and after taking part in CLO programmes.
In this part of the study we will be testing out our programme theories and refining them. By examining the questionnaire data for patterns, we will see whether our theories were confirmed, in terms of what works, for whom and in what circumstances.
Economic evaluation compares the resources used (costs) and outcomes (benefits) of different courses of action. Resource use can be measured using money or represented in other ways. Benefits might be health improvements or other kinds of benefits.
Building on the questionnaire study, we will examine patterns in our data – in terms of how contexts affect CLOs activities, what mechanisms lead to which outcomes for different groups – and measuring the costs and benefits associated with different CLOs, activities and health and wellbeing outcomes for participants.
Sustainability & Scale
Community led organisations (CLOs) often depend on a variety of income streams to deliver activities and services in their communities.
We will document the sources of income and make recommendations about the sustainability of CLOs. Where we have identified activities that lead to health and wellbeing improvements we will consider whether these could be scaled up or transferred to other settings.