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Interesting papers

While the merits of theory-driven and realist evaluation have been widely discussed in journals on evaluation, there is relatively little documented experience with theory-driven inquiry in the domain of health services and health systems. As an illustration, some interesting papers are briefly discussed below.


Theory-driven evaluation

Birckmayer and Weiss (2000) present a review of 6 health promotion studies based on theory driven evaluation.

Mercier et al. (2000) carried out a theory-driven evaluation of drop-in activities at a YMCA Youth Center and present a clear methodology to develop and test the programme theory

Grocott et al. (2002) is an example of how TDE was applied to patient care, in this case the palliative management of malignant wounds.

Rodriguez, E. & Mead, J. (1997) describe a retrospective theory driven program evaluation to assess the complex processes and dynamics underlying the program and which influence its outcomes. They show how TDE examines the black box of processes and mechanisms and provides insights in what went wrong.

Van Belle and colleagues present a 7 step method they designed to carry out a theory-driven evaluation of an adolescent reproductive health project in West-Africa.




Theories of change

Judge and Bauld (2001) and Sullivan et al. (2002) present findings of the Theory of Change approach in an assessment of Health Action Zones in England.

MacKenzie and Blamey (2005) discuss the assessment of the Scottish Health Demonstration projects in child health and heart disease prevention

Douglas et al. (2010) develop a Theory of Change protocol for the evaluation of smoking cessation programmes for pregnant women and young people.


Realist evaluation

Evans and Killoran (2000) present the evaluation of a Health Education Authority’s Integrated Purchasing Programme and specifically of demonstration projects testing partnerships to tackle health inequalities.

Byng et al. (2005) and Byng et al. (2008) applied realist evaluation principles to evaluate a mental health programme in the NHS.

Leone (2008) presents an overview of how a MRT for an intervention can be derived from an analysis of the programme, how this MRT is translated into research questions and how analysis is done.

Ridde & Guichard (2011) focus on the mechanisms that underlie programmes to fight social inequalities in France.

Ogrinc and Batalden (2009) develop a practical evaluation framework to assess teaching programmes on improvement of care on the basis of realist evaluation principles.

Greenhalgh et al. (2009) apply realist evaluation in the assessment of the Modernisation Initiative, which aimed at whole-scale transformation in stroke, kidney and sexual health services in London.

Pommier et al. (2010) present a research protocol for evaluation of health promotion in schools.




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    TDI workshop

    On 22 and 23 November 2010, the Unit of Health Care Management, Department of Public Health (ITM), organised an international expert meeting on theory-driven evaluation.

    About 15 researchers presented research and evaluations and discussed the methodological challenges of realist evaluation, theory-driven evaluation and realist synthesis in health systems research.

    In total 30 researchers, policymakers and programme managers attended the workshop.

    About this website

    This theory-driven inquiry website is developed by the Health Care Management Unit of the Department of Public Health, Institute of Tropical Medicine, Antwerp and the Development Policy & Practice Unit of the Royal Tropical Institute, Amsterdam. We collaborate on the development and implementation of theory-driven inquiry in health systems research, and aim at stimulating a better understanding of the advantages of this approach among both researchers and policymakers. To this end, we are engaged in a number of research and evaluation studies that use TD inquiry principles.

    Institute of Tropical Medicine

    Unit of Health Care Management

    TD inquiry project evaluations
    Défi Jeunes

    TD inquiry research projects
    PhD Bruno Marchal
    PhD Pierre Blaise

    The cluster Research methodology for complexity in healthcare


    Bruno Marchal - personal page
    Guy Kegels - personal page
    Tom Hoerée
    Josefien Van Olmen - personal page
    Sara Van Belle




    Royal Tropical Institute

    Department of Development, Policy and Practice

    TD inquiry project evaluations

    Realist evaluation of ASHA program in a district (India)

    TD inquiry research projects

    Realist inquiry in capacity building
    PhD Marjolein Dieleman

    Research and evaluation methodology

    Marjolein Dieleman
    Barend Gerretsen
    Sumit Kane
    Prisca Zwanikken