The refining of the programme theory, starting from the initial programme logic of the designers, to a refined programme theory incorporating insight from literature, design of the programme, and its implementation context, is explained elsewhere [ 41].
He has conducted research into stress and burnout in health professionals and is the author and designer of the Serenity Programme, an award-winning on-line therapy programme for the treatment of stress, anxiety and depression.
Further, by demonstrating the health and financial gains to be had at national level through addressing social determinants, we are also of the view that parallel, context-specific research on SDH will help to convince the curriculum designers of other programmes of the importance of SDH for their own courses.
Recommendations It is to the credit of the programme designers, namely Red Cross, Action Aid, CENCOSAD, SGAID and CAS, that the programme has been well received by the target group and community members.
In a realist approach, the evaluation begins with formulating a programme theory (integrating the assumptions of the programme designers and implementers with the existing wider knowledge or evidence on the topic and insight regarding the contextual factors that could affect the outcome).
Pial has helped small, organic farmers share knowledge, get good-quality seeds and connect with buyers, said Sandra Miranda, a biochemist and one of the programme's designers.
Our definition of attendance at the initial assessment and three or more sessions was based on a collective judgement of the intervention designers that this would provide the essential components of the programme.
An analysis of the programme theory of the intervention indicates that the designers of the intervention sought to bring about these changes through instilling a can-do attitude among the health managers.
Each item is accompanied by a number of probing questions that designers of such a programme can reflect upon.
