Charting the impacts of Citizens Advice Bureau activities: strategies to orchestrate a realist analytical process

Forster, Natalie, Hodgson, Philip, Dalkin, Sonia, Lhussier, Monique and Carr, Susan (2015) Charting the impacts of Citizens Advice Bureau activities: strategies to orchestrate a realist analytical process. In: UKCRC 2015, 19-20 November 2015, Edinburgh, UK.

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Abstract

Background: Although advice services to promote financial inclusion are theorised to improve health and reduce inequalities, there is limited direct evidence for their impact on health outcomes. This presentation reports on a project exploring the pathways to health impact of advice services.

Methods: Advice services are a complex intervention, in that they are individually tailored and nested in a range of other confounding interventions. Undertaking meaningful evaluation, with the often limited financial resources available, demands innovative approaches. This presentation reports on a realist evaluation of how advice interventions work, for whom, in what circumstances and why.

Results: The presentation reflects on the process of developing realist programme theories with good face validity and explanatory potential, linking the inputs of advice to a range of health outputs. Dealing with such a complex intervention, with many overlapping components and targeted at transient user groups presenting a variety of needs required an innovative approach to data management and analysis. We used the software N-Vivo in order to formulate and refine our realist theories, and keep track of the analytical process as data emerged and our familiarisation with the intervention improved. All data (exploratory interviews, reports, observations) was uploaded on the software and coded against developing theories. Detailed notes were kept of how theories evolved up to the point that they were ripe for testing through mixed data collection.

Conclusions: The use of N-Vivo to facilitate realist sense making was key in this particularly complex area. Realist thinking is characterised by a ‘toing and froing’ from data to theories until satisfactory explanatory potential is reached. This process, while being well described by now in the literature, is still considered daunting by many researchers. The use of Nvivo organise observational and exploratory data and chart theory development makes a positive addition to the field.

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