Abstract
BackgroundWe have recently described a protocol for a study that aims to build a theory of neighbourhood context and postnatal depression. That protocol proposed a critical realist Explanatory Theory Building Method comprising of an: (1) emergent phase, (2) construction phase, and (3) confirmatory phase. A concurrent triangulated mixed method multilevel cross-sectional study design was described. The protocol also described in detail the Theory Construction Phase which will be presented here.MethodsThe Theory Construction Phase will include: (1) defining stratified levels; (2) analytic resolution; (3) abductive reasoning; (4) comparative analysis (triangulation); (5) retroduction; (6) postulate and proposition development; (7) comparison and assessment of theories; and (8) conceptual frameworks and model development.Theory constructionThe stratified levels of analysis in this study were predominantly social and psychological. The abductive analysis used the theoretical frames of: Stress Process; Social Isolation; Social Exclusion; Social Services; Social Capital, Acculturation Theory and Global-economic level mechanisms. Realist propositions are presented for each analysis of triangulated data. Inference to best explanation is used to assess and compare theories. A conceptual framework of maternal depression, stress and context is presented that includes examples of mechanisms at psychological, social, cultural and global-economic levels. Stress was identified as a necessary mechanism that has the tendency to cause several outcomes including depression, anxiety, and health harming behaviours. The conceptual framework subsequently included conditional mechanisms identified through the retroduction including the stressors of isolation and expectations and buffers of social support and trust.ConclusionThe meta-theory of critical realism is used here to generate and construct social epidemiological theory using stratified ontology and both abductive and retroductive analysis. The findings will be applied to the development of a middle range theory and subsequent programme theory for local perinatal child and family interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-2729-9) contains supplementary material, which is available to authorized users.
Highlights
We have recently described a protocol for a study that aims to build a theory of neighbourhood context and postnatal depression
The findings will be applied to the development of a middle range theory and subsequent programme theory for local perinatal child and family interventions
We have previously reported on individual level psychosocial predictors of postnatal depression in South Western Sydney and proposed that “the findings were consistent with group-level socioeconomic deprivation, neighbourhood environment, social networks and ethnic diversity having causal effects on postnatal depressive
Summary
We have recently described a protocol for a study that aims to build a theory of neighbourhood context and postnatal depression. Drawing on recent criticism of social epidemiological studies and multi-level studies in particular (Muntaner 1999; Krieger 2001; O’Campo 2003; Carpiano and Daley 2006; Raphael 2006) we have used a realist explanatory theory building method (Eastwood et al 2014). The purpose of this manuscript is to report on the findings of the Construction Phase of the main study (Eastwood 2011)
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