How do you design a realist research synthesis question that is relevant and feasible?

1 Step 1: Identify the topic and scope

The first step is to identify the topic and scope of your realist research synthesis. You need to have a general idea of what intervention, problem, or phenomenon you want to explore, and what aspects of it you want to focus on. For example, you might be interested in how peer support programs work for people with mental health problems, and what factors influence their effectiveness. You also need to consider the scope of your synthesis, such as the types of evidence, settings, populations, and outcomes you want to include or exclude. This will help you narrow down your topic and avoid being overwhelmed by the amount of literature available.

2 Step 2: Define the key concepts and terms

The second step is to define the key concepts and terms that you will use in your realist research synthesis question. You need to be clear about what you mean by the intervention, the context, the mechanism, and the outcome, and how they relate to each other. You can use existing theories, frameworks, or models to guide your definitions, or develop your own based on your knowledge and experience. For example, you might use the COM-B model to define the intervention as a set of behavior change techniques, the context as the individual, social, and environmental factors that influence behavior, the mechanism as the psychological processes that mediate behavior change, and the outcome as the changes in behavior or health status.

3 Step 3: Formulate the initial question

The third step is to formulate the initial question for your realist research synthesis. You can use the PICO format to structure your question, but with some modifications to suit the realist approach. PICO stands for Population, Intervention, Comparison, and Outcome, and it helps you specify the main components of your question. However, for a realist synthesis, you also need to include the context and the mechanism, and be more flexible about the comparison and the outcome. For example, your initial question might be: For people with mental health problems (population), how do peer support programs (intervention) work (mechanism) in different settings (context), compared to other forms of support or no support (comparison), to improve their well-being and recovery (outcome)?

4 Step 4: Refine the question

The fourth step is to refine your question by making it more specific, focused, and answerable. You can do this by reviewing the literature, consulting stakeholders, or conducting preliminary analysis. You need to check if your question is relevant, feasible, and clear, and if it addresses a gap or a controversy in the existing knowledge. You might need to revise your question by adding, removing, or modifying some elements, or by rephrasing it in a different way. For example, you might refine your question by specifying the type of peer support program, the type of mental health problem, the type of setting, or the type of outcome.

5 Step 5: Test the question

The fifth step is to test your question by applying it to your search and analysis strategies. You need to see if your question helps you find and select relevant and reliable evidence, and if it allows you to extract and synthesize the data in a meaningful way. You also need to see if your question helps you answer the underlying realist question of what works, for whom, in what circumstances, how, and why. You might need to adjust your question or your strategies based on the results of your testing. For example, you might find that your question is too broad or too narrow, or that it does not capture the complexity or diversity of the evidence.

6 Step 6: Finalize the question

The final step is to finalize your question by confirming its validity, relevance, and feasibility. You need to ensure that your question reflects the purpose and scope of your realist research synthesis, and that it aligns with the expectations and needs of your audience. You also need to ensure that your question is manageable and realistic within the time and resources available. You might need to consult your supervisor, colleagues, or stakeholders for feedback and approval. For example, you might present your question as part of your proposal, protocol, or report, and justify your choices and assumptions.

7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?