A sound conceptual framework can bring order to this complex environment and provide a roadmap for systematically addressing the multiple determinants of the behavior in question.
This limits knowledge about the multiple determinants of the utilization of health services.
For example, for the topic of cell membrane fluidity, there are multiple determinants influencing the degree of fluidity, including lipid composition, protein content, and temperature.
Besides a context-specific approach, an intrapersonal approach may also help to understand the multiple determinants operating in the different settings with which this behaviour is most prevalent [ 22].
Larger studies, incorporating multiple determinants identified in the pathogenesis of OA, may be able to extract the relative roles of these varied factors.
Importantly, risk factors for CVD reflect the complex interplay between genetic and environmental factors and demonstrate the complexity of the multiple determinants of disease.
What realist evaluation can do is to stimulate the researcher to describe a detailed picture of the causal web that includes the multiple determinants and to categorise these as intervention, underlying mechanism or essential context factor.
These potential solutions may involve multiple sectors outside the traditional health system, thus recognizing the multiple determinants that influence population health status.
In the twenty-first century, behavioral science has come to an integration of the agency of the individual patient or clinician with recognition of the multiple determinants of individuals' choices and behaviors.
Some challenges are raised by the complex mosaic of federal and state regulatory decisions, differences in the implementation of those decisions at more local levels, the multiple determinants of disease, and temporal lags between exposure and ultimate health outcomes (National Research Council 2007).
