Skip to main content

Table 3 Individual Case Study Site Context-Mechanism-Outcome Results

From: Evidence use in equity focused health impact assessment: a realist evaluation

Case Study Site Contextual factors Mechanisma Outcomes related to use of evidence
PHU A Organizational support for and interaction with knowledge broker Increased practitioner confidence; trust in knowledge broker More likely to use academic evidence source in the future (self-report)
Real or perceived lack of time or skill to interpret evidence Unable to “identify with” academic sources;
(i.e., lack of consonance)
Limited use of academic evidence (i.e., references) in EFHIA
Familiarity with practical evidence (i.e., local surveillance, personal experience) Safety and trust using own knowledge Preferential use of practical evidence to complete EFHIA
PHU B Set organizational direction for program action Seeking alignment of evidence with desired action Positive attitudinal change toward evidence (all sources)
Real or perceived evidence characteristics of local data (reliable/relevant) Evidence use experienced as positive “return on investment”;
(i.e., good correspondence)
Use of practical evidence (i.e., local surveillance, personal experience)
Real or perceived evidence characteristics of academic data (difficult to access/not directly relevant) Evidence use experienced as negative “return on investment”;
(i.e., poor correspondence)
Limited use of academic evidence
PHU C Unclear expectations or unclear EFHIA mandate Hesitancy or acquiescence to existing knowledge Limited evidence sought
PHU D Policy role in organization (non-clinical; non front-line service delivery oriented) Strongly held individual and role-based evidence-use values Increase use of academic evidence
  1. aMechanisms are cognitive or emotional responses related to context that “turn on” the minds of program participants and stakeholders in such a way as to make them want to achieve the outcomes of the program. [7]