Contextual Conditioning Research Articles

Drivers of Spatiotemporal Patterns of Riparian Forest NDVI Along a Hydroclimatic Gradient

ABSTRACTIn the context of rising global temperatures and their impact on weather patterns and water cycles, understanding the relationship between vegetation and hydroclimatic forcing is critical. Riparian forests are highly vulnerable to hydroclimatic variability, which can significantly affect water availability in the soil on which they primarily depend. Along large rivers, hydroclimatic forcings can vary, resulting in different vegetative responses depending on the local climatic context and site conditions. To explore this, we studied riparian forest greenness along a 512‐km river corridor with a 3° latitudinal gradient, analysing the relative contributions of climate (latitude, season, temperature, precipitation) and local hydrological conditions (groundwater). Here, we show that riparian forests along a latitudinal gradient respond differently to hydroclimatic controls, with vegetative dynamics that can be attenuated or accentuated by local site conditions. We combined Sentinel‐2 satellite Normalised Difference Vegetation Index (NDVI) data over seven years (2016–2022) with hydroclimatic data to examine riparian forest greenness responses to latitudinal, seasonal and interannual hydroclimatic variability. We found contrasting hydroclimatic controls across the latitudinal gradient, with the northernmost sites predominantly controlled by temperature, while those further south are limited by water availability. In addition, we identified temperature as the primary driver of NDVI throughout the growing season, either positively or negatively. Late season precipitation and high phreatic water availability positively influenced NDVI, emphasising the role of local conditions in governing riparian forest resilience. This study enhances understanding of climate controls on riparian tree greenness, which is critical for designing effective landscape‐scale riparian ecosystem management and restoration strategies.

8.N. Scientific session: Transferability and adaptation of vaccination interventions: Learning from underserved communities

Abstract Removing barriers in the health system that make it difficult for cultural, religious or ethnic minorities to access vaccinations is an urgent concern in order to prevent infectious diseases in the future. Childhood vaccine uptake for MMR and HPV in most underserved communities is lower than in the general population. The project RIVER-EU (Reducing Inequalities in Vaccine uptake in the European region - Engaging Underserved communities) engages the migrant community in Greece, females with a Turkish or Moroccan migration background in the Netherlands, the Ukrainian minority in Poland and marginalized Roma communities in Slovakia to remove health system barriers to vaccination. Barriers include, e.g., lack of culturally and linguistically appropriate information, financial barriers, insufficient capacities, coordination and delivery of health care. Based on a Participatory Action Research (PAR) approach we selected and adapted potentially transferable evidence-based interventions in partnership with the communities. First, we pre-selected 6 useful interventions from a realist review on 36 effective vaccine uptake interventions. Second, we assessed them in depth for their transferability. Building a bridge between evidence on interventions and community needs is not an easy task: We involved various stakeholders in a longitudinal process under consideration of contextual conditions in the primary intervention context and the context of the respective underserved community. We co-created knowledge through 25 workshops and 39 interviews or focus groups for decision-making and determining need for adaptation of selected interventions. The aim of this workshop is to present the results of this co-creative process in each country. Special attention is payed to facilitators and barriers for transferability of evidence-based interventions from the perspective of underserved communities, and contextual commonalities and differences that lead to a specific intervention tailoring. This workshop will contribute to an improved understanding of how to consider contextual needs underserved communities have to remove health system barriers to vaccination on the one hand and suitable evidence on interventions to improve their situation on the other hand. The workshop will include five presentations of eight minutes and a questions and answers session to involve the audience. First, an introductory presentation on transferability of interventions for HPV and MMR vaccine uptake to underserved communities in specific contexts will be given. Then each country will present the intervention(s) to address health system barriers adapted to their context. Thereby, we will underline common key elements that have potential for transferability in all countries. After all presentations, we will discuss the need for context-based decision-making on evidence-based interventions and intervention tailoring to improve vaccine uptake for cultural, religious or ethnic minorities. Key messages • Improving vaccine uptake in underserved communities requires local solutions with tailored interventions. Trusted partnerships with various stakeholders are key to reducing health system barriers. • Participatory approaches to evidence-informed decision-making build bridges between evidence on interventions and needs of underserved communities to understand the transferability of interventions.

Promoting ownership in local community health promotion interventions

Abstract Background A prerequisite for successful and sustainable implementation of local community health interventions is strong community ownership. Ownership is related to the level of perceived control of an intervention and its program components. Facilitation of community ownership involves engagement of the stakeholders within the community, e.g. in deciding what the problem is to whom and how to solve it. Much is known about methods to facilitate community engagement at a continuum between informing the community and community control. However, less is known about how different methods for community engagement work to foster and sustain ownership among local stakeholders. Aim To generate knowledge about how ownership is fostered or hindered among stakeholders across three different communities in a local community intervention with whole-of-community characteristics implemented to reduce overweight among children. The study also explores how synergies of ownership between various types of stakeholders at different organizational levels influence overall ownership and implementation of the intervention. Methods The study is designed as a multiple case study based on Robert K. Yin’s principles for case study evaluation. The study takes place in three different Danish Municipalities with different local contextual conditions. Various data sources are collected including sources of qualitative data comprising document analysis, observations, and interviews with key stakeholders. Preliminary results An influential contextual factor on local ownership is that implementation of the intervention and commitment to this in 10 years is a top-down decision at the policy level. Local stakeholders find the goals of the intervention meaningful to their day-to-day practices. However, they also experience a shortage of resources for participating and lack trust in higher management stakeholders to take shared leadership when the implementation phase ends. Key messages • Ownership is influenced by the degree of engagement. • Ownership is influence by the synergy of ownership between different stakeholders.

Regenerative businesses' role in industrial symbiosis realisation

AbstractIndustrial symbiosis (IS) provides a strategy for more resource‐efficient economies, potentially contributing to several SDGs. However, many potentials remain unrealised as realisation is given low priority in companies. This paper explores the role of companies that incorporate IS in their core business strategy, termed regenerative businesses (RBs). Five cases were followed for four years using a contextualistic approach. Results suggest that RBs are crucial in IS realisations that go beyond low‐hanging fruit, as they engage in ‘pre‐realisation development’, motivate others, work persistently to overcome barriers, and, in some cases, mobilise support from public champions. The paper also proposes that RBs not only engage in local realisations but can diffuse and scale up solutions. As RBs are found to be dependent on contextual conditions and, in some cases, collaboration with public actors, support for RBs can be a strategy for the promotion of IS.

Adult day programs and their effects on individuals with dementia and their caregivers (ADAPT-DemCare): a realist synthesis to develop program theories on the how and why

BackgroundAdult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.MethodsWe identified 14 literature reviews (including 329 references published between 1975 and 2021) on adult day programs. From this initial pool of studies, we will include those that focused on day program attendees with dementia or meaningful cognitive impairment, and/or their caregivers, and that report how day program contexts (C) and mechanisms (M) bring about outcomes (O) for attendees and caregivers. We will extract CMO statements (i.e., narratives that explain how and why day programs do or do not bring about certain outcomes for whom and under what circumstances). Using additional focused searches, citation mapping, citation tracking, and discussions with our researcher and expert team members, we will identify additional references. CMO statements will be synthesized, transformed into hypotheses, and linked and visualized to form program theories. Using focus groups and the James Lind Alliance Priority Setting Partnership method, we will discuss and prioritize our CMO statements and refine our program theories with 32 experts (older adults, caregivers, Alzheimer societies, caregiver organizations, day program staff and managers, and health system and policy decision makers). DiscussionBy identifying essential elements and processes of day programs and related knowledge gaps, this study will generate much-needed knowledge to leverage the full potential of day programs so they can provide appropriate care, preventing premature institutionalization, and unnecessary acute and primary care use. This will ultimately improve the quality of life of persons with dementia and their caregivers, alleviate caregiver burden, and reduce social costs. Systematic review registrationPROSPERO CRD42024504030

Converging mothers' employment trajectories between East and West Germany? A focus on the 2008‐childcare‐reform

AbstractObjectiveAiming to generate evidence on how contextual conditions shape individuals' opportunities and constraints and, ultimately, life courses, we focus on a period of childcare expansion in reunified Germany. We investigate differences in employment trajectories around mothers' first childbirths to identify potential East–West convergence.BackgroundDuring Germany's division (1949–1990), universal public childcare and female full‐time employment were the norm in East Germany, while the male breadwinner model was dominant in the West. These differences, although declining, persisted even decades after reunification. In 2008, a reform aimed at expanding childcare availability to facilitate mothers' employment throughout the country.MethodsWe measure East–West differences in employment trajectories around childbirth pre‐ (1990–2007) and post‐reform (2008–2021) in terms of timing, order, and duration of events over time. We use data on 359 East and 986 West German first‐time‐mothers from the German Socio‐Economic Panel and sequence analysis tools.ResultsBefore the reform, employment trajectories between East and West German mothers differed both in timing and duration of employment states. After the reform, these differences decreased, showing a general convergence in the prevalence of post‐birth part‐time employment. Nonetheless, longer maternity leave is still more prevalent among West German mothers, while East German mothers are more likely to maintain full‐time jobs.ConclusionOur findings show how policy settings and reforms shape life courses in a context‐dependent fashion. They illustrate the importance of a methodological approach that focuses on process outcomes and supports a theoretical perspective that highlights how historical time and place shape life courses.

What makes communication work and for whom? Examining interprofessional collaboration among home care staff using structural equation modeling

ABSTRACT Up to 175 conditions influencing interprofessional practices have been identified. Still, little is known about to what extent these conditions interact, influence communication, and vary across professional groups and settings. We explored these knowledge gaps by examining communication among staff in home care and home nursing units in two Danish municipalities, Herning and Holstebro. Conditions were categorized into two types (programme and context) and two levels (professional and organizational). Structural Equation Modeling was used with a sample of 395 staff and 21 managers to analyze the condition categories’ interactions, influences on communication, and variations by unit type and municipality. Context conditions strongly influenced programme conditions on the professional and organizational levels. Organizational-level context conditions had no significant influence, organizational-level programme conditions had a weak influence, and professional-level programme and context conditions had moderate influences on communication. Lastly, professional-level programme conditions had the biggest influence on communication for staff in home care units and in Holstebro. In contrast, professional-level context conditions had the biggest influence on communication for staff in home nursing units and in Herning. These findings offer unique insights into conditions’ interactions, influences, and variances, contributing to our understanding of what makes communication work and for whom.

Learning from Two Early Brownfield Redevelopment Projects in Italy: Soil Desealing, Cooling Effects, and Implementation of Nature-Based Solutions Through Traditional Planning Tools

Consideration of the future fate of brownfields in urban environments has driven a complex ‘season’ of decisions, planning, and implementation that has seen the emergence of different approaches and actions for their reuse. Among the various experiences of brownfield redevelopment, some projects have also promoted the partial renaturalisation of areas through soil desealing and demolition of existing buildings. These greening initiatives have provided new public facilities, e.g., parks and green areas, helping to improve the conditions of urban environments both from ecological and social perspectives. This article adopts ex ante and ex post methods to analyse two Italian case studies of brownfield regeneration involving desealing interventions and investigates two key aspects: (i) the planning process and tools that were put in place to implement the projects and (ii) the impacts for human wellbeing that were produced in terms of cooling effects. The analyses conducted show the real effectiveness of renaturation interventions especially related to reforestation measures in terms of temperature reduction. The examination of the two case studies also revealed the importance and potential success of traditional planning and implementation tools in promoting interventions that can now be considered innovative in terms of their actual contribution to current urban challenges. The results therefore allow us to emphasize the fundamental importance of the philosophy and basic principles of a transformation process, even guided by traditional planning tools, for the improvement of the environmental conditions of an urban context and the successful implementation of nature-based solutions.

Genesis of Music Video Clip as a Popular Form of Modern Audiovisual Culture: Experiments with Music Visualisation

The purpose of the article is to reveal the peculiarities of the development of the music video clip in the context of the historical interaction of musical and audiovisual culture. Research methodology. General scientific methods of cognition were applied, in particular analysis and synthesis, systematisation of theoretical data, the method of structural-functional analysis, which made it possible to reveal specific aspects of the interaction of music and various forms of artistic practices in the space of audiovisual culture; a typological method, with the help of which various features of the music video clip in the structure of modern audiovisual culture are revealed. Scientific novelty. The genesis of the music video clip as a popular form of modern audiovisual culture is studied; the problem of integration of visual images and music as part of artistic practices in historical retrospect is considered. Little-known works of foreign scientists, the problems of which are correlated with the subject area of research were introduced into scientific circulation. Conclusions. The genesis of the music video clip testifies to the significant role of artistic practices in the process of image and music interaction at the early stages, which contributed to the invention of new creative ways of representing the imaginary – animation and montage proposed by avant-garde artists; videos and video installations created by mastering the television image; music videos that opened a new dimension for experimentation, becoming an influential form of modern culture. Artistic history of analogue interactions between cinema and music during the 20th century demonstrates the antecedent conditions of production, perception, and socio-political context that were necessary for the mass popularization of the music video as an established form. Thanks to the early experiments in the formation of visualised music, the music video as a new form of audiovisual art gained cultural value, which allowed it to play a significant role at the modern stage. The music video played and continues to play a key role in the socio-cultural space. The technological evolution from analogue to digital means of production and display has accelerated the development of both the form and the aesthetics of the music video, which emphasises one of the most important roles of art in society – to provoke thought and encourage a rethinking of social, political and cultural conditions and surroundings, using this is the main means of communication, including popular music.

Parental education and neighbourhood socioeconomic status in the prediction of childhood overweight: A multilevel analysis.

This study examined cross-level interaction between parental education and neighbourhood SES in predicting overweight including obesity among school-aged children. This analysis used data from 19 984 children aged 5-6 years participating in the school-entry examination of the years 2015 to 2019 in the Aachen city region in Germany. We employed multilevel logistic regression models to predict overweight based on parental education and neighbourhood SES, along with their cross-level interaction, while controlling for several characteristics of the child. Children from families with intermediate (OR: 1.99; 95% CI, 1.65-2.40) and low parental education (OR: 2.55; 95% CI, 1.92-3.39) and from neighbourhoods with intermediate (OR: 1.25; 95% CI, 1.02-1.53) and low SES (OR: 1.61; 95% CI, 1.29-2.02) were at significantly higher odds for overweight. There was an indication of a cross-level interaction effect (p-value <0.10) to the disadvantage of children with higher parental education, suggesting that inequalities in overweight decrease in more deprived neighbourhoods. The predicted probability of overweight for children with high parental education increased from 6.4% in high SES neighbourhoods to 7.8% in intermediate and 9.9% in low SES neighbourhoods. Sensitivity analyses for obesity and a higher context level of spatial SES confirmed the results. The results highlight the crucial role of both individual and contextual socioeconomic conditions in predicting childhood overweight. They also suggest that the impact of neighbourhood socioeconomic status on childhood overweight varies by parental education, particularly disadvantaging children with higher parental education, indicating a social contagion of overweight through spatial disadvantage.

Influences Personalisation and Student Engagement in the AI Era: Exploring Effects and Influences

The study is based on a conceptual model to examine the integration of artificial intelligence (AI) technologies in education and their impact on student engagement. This model structures the analysis around several axes: AI technologies, including intelligent tutoring systems (ITS), adaptive learning platforms, and educational chatbots, play a key role in personalizing learning paths, making pedagogical support more accessible, and adapting content to students' specific needs. Student engagement is thus assessed through the personalization of pathways and the accessibility of support, while taking into account individual moderating factors such as learning styles, self-motivation, and prior experience with AI technologies, which influence the effectiveness of these tools. In addition, the study examines contextual conditions, including the importance of adequate technological infrastructure and teacher training, which are essential for the successful integration of AI technologies into pedagogical practices. This conceptual model guides the study in evaluating the assumptions made, providing an in-depth understanding of the interactions between these variables and making recommendations to optimize the use of AI technologies in education.

About Pavlov

The article gives a brief general characteristic of the architect Vladimir Pavlov’s work in Irkutsk. It considers regional roots, international context and Russian conditions of the emergence of his unique architectural projects. Pavlov’s architecture is seen as a phenomenon of world culture.

Orexin mechanisms in the prelimbic cortex modulate the expression of contextual conditioned fear.

Despite the existing anatomical and physiological evidence pointing to the involvement of orexinergic projections from the lateral hypothalamus (LH) in regulating fear-related responses, little is known regarding the contribution of the orexin system in the prelimbic cortex (PL) on contextual fear. We investigated the role of orexin-A (OrxA) and orexin type 1 receptors (Orx1R) in the PL during the expression of contextual conditioned fear in mice. Neural tract tracing of the LH-PL pathway and Orx1R immunoreactivity in the PL of C57BL/6 male mice were performed. In a pharmacological approach, the animals were treated with either the Orx1R selective antagonist SB 334,867 (3, 30, and 300 nM/0.1 µL) or OrxA (28, 70, and 140 pmol/0.1 µL) in the PL before the test session of contextual fear conditioning. Neural tract tracing deposits in the LH showed some perikarya, mainly axons and terminal buttons in the PL, suggesting LH-PL reciprocate pathways. Furthermore, we showed a profuse network comprised of Orx1R-labeled thin varicose fibers widely distributed in the same field of LH-PL pathways projection. The selective blockade of Orx1R with SB 334,867 at 30 and 300 nM in the PL caused a decrease in freezing response, whereas the treatment with OrxA at 140 pmol promoted an increase in freezing response. In summary, these data confirmed an anatomical link between LH and PL, established the presence of Orx1R in the PL, and a modulatory role of the orexin system in such structure, possibly mainly via Orx1R, during contextual fear conditioning.

Positioning Strategies in B2B Marketing: The Regulatory Focus Orientation

ABSTRACT Purpose Relying on regulatory focus theory (RFT), this study examines the mechanisms that guide managers’ positioning-related decisions in business-to-business contexts. Specifically, this research answers two main questions: what motivates managers to recommend specific positioning strategies and what motivates related decisions regarding contextual and market conditions? Design/methodology/approach Two studies are undertaken in this research. Using the Delphi method, Study 1 adopted an online scenario-based experimental design related to the positioning decisions of three companies. A panel of expert informants assisted in the design process. Study 2 tested the stability of the results from Study 1 and then extended the analysis through the introduction of an additional dependent variable and market feedback. The results of the scenario-based online surveys are subjected to partial least squares structural equation analyses. Findings The findings are in line with regulatory focus theory and show that RFT can provide motivationally derived answers to questions regarding inter-manager differences in positioning decision-making under similar market and company conditions. The results further show that decisions made by marketing managers in B2B contexts are guided by a desire to achieve congruity (fit) between their regulatory focus and their positioning strategy. Moreover, there is a differential impact of the regulatory foci on the likelihood of changing a recommended strategy. Originality/value This paper investigates the moderating effects of involvement, valence framing, and market feedback. The study finds that the valence of the recommendation of a positioning strategy moderates the relationship between regulatory focus and the type of positioning strategy.

High mobility lifestyles: Unpacking travel behavior in Accra's rapidly expanding periphery

This paper explores everyday travel behavior among urbanites in Accra's periphery and unpacks how travel choices and preferences are conditioned and constrained in a context of rapid urban expansion, unregulated residential sprawl, infrastructural deficits, congestion and changing socio-economic conditions. The paper draws on qualitative interviews (n = 48) and a travel survey (n = 2107) targeting economically active adults residing in peripheral neighborhoods. Their travel behavior is characterized by a high proportion of adults who regularly travel outside their neighborhoods, over relatively long distances (10+ km) and mainly using motorized transport. The paper proposes “high mobility lifestyles” as a metaphor to capture key aspects of travel behavior in the peripheries and explores how travelers navigate the opportunities and constraints associated with living in the peripheries. As a unique feature, spatially explicit destination data are used to map the predominant destinations and long distances travelled from Accra's peripheral neighborhoods. The research illuminates how infrastructural deficits, long distances, severe congestion and rising transport costs combine to make high mobility lifestyles exceedingly strenuous, costly, and time-consuming. Ultimately, in-depth understanding of travel behavior, embedded in contextual conditions, can provide insights on how travel choices may be changed and how transport, systems may be made more sustainable and inclusive.

A semantically enabled architecture for interoperable edge‐cloud continuum applied to the e‐health scenario

AbstractThe progress made in the field of medicine and the consequent increase in the prospect of life have contributed to rise people's interest towards a healthier lifestyle. Fitness activity is becoming a must for those who aspire to live more and better. However, this should be accompanied by additional good practices to safeguard individuals' life from risks that could undermine their health. Most of these risks are linked to personal, surrounding, and contextual conditions that technology can detect and monitor. Recommender systems can adequately support fitness activity by performing data analyzes aimed at identifying possible risk factors for users, starting from their physiological data and those related to the closest context where they are. This article introduces the architecture of a recommender system called App4Health in the context related to both mobile crowd sensing and wellness. The App4Health architecture consists of a smart application platform, capable of interfacing and managing data from heterogeneous edge sources, such as mobile phones, IoT, and sensors. The analysis result consists of the semantic generation of healthy behavioral conducts to the user as Telegram BOT messages. For evaluating the proposed solution, the article also provides a case study and a testbed. The testbed consists of a comparative stress test of two edge software components of the App4Health's architecture in order to identify the performance degradation threshold of these components, assuming that they can be deployed on edge‐level hardware devices with different technical specifications and configurations.

Urban planning for the futures; urban foresight

Urban planning for the coming decades must accommodate rapidly changing global conditions and communities that accept the plausibility of multiple futures and more innovative approaches to reach them. The article explores the attributes of the changing contextual conditions and new urban planning requirements, global uncertainty, chaos, urban syntax and complexity of the urban systems. Urban foresight is also discussed within the arguments of Childs, Dixon and Tewdwr-Jones, UNDP foresight manual, and other sources, for a better understanding of its theoretical core. The article ends with a comparative discussion of the urban foresight tools that can deal with “known unknowns” about the future (Childs 2023), so that “not-knowing” the future (Miller 2011) becomes an anticipated normal that requires dealing with cities as open networked systems (Batty 2018). Being interactive, creative, experience-based or evidence based as mentioned by Popper 2008 is briefly discussed for better understanding of the planners’ choice of tools.

Heterogeneous effects of information and communication technology development on digital financial consumer protection: Evidence from the global sample

ABSTRACT This study primarily examines the influence of Information and Communication Technology (ICT) on Digital Financial Consumer Protection (DFCP), utilizing a dataset spanning 88 countries globally from 2014 to 2018, within the context of consumer welfare under diverse socioeconomic conditions. The research confirms a positive relationship between information and communication technology (ICT) evolution and digital finance consumer protection (DFCP) in OECD countries with inclusive institutions, competitive markets, and solid educational foundations. Conversely, a negative correlation is observed between ICT growth and DFCP in countries with moderate gender inequality. The study further confirms that ICT development positively influences DFCP due to contextual conditions (i.e. cybersecurity index, political stability, higher educational level, and market quality). Policy implications emphasize the need to address information inequality and protect consumer rights in the digital era. Measures to curb market monopolies of major tech companies and combat unauthorized data usage are recommended. Additionally, enhancing digital literacy is crucial for harnessing the benefits of ICT and promoting financial consumer welfare. Establishing a practical code of conduct aligned with market needs is also essential for ensuring consumer protection.

Designing the Model of Human Resources Analytics in Health System with Grounded Theory

Background: Given the necessity of attracting, retaining, and developing human capital within the health system, the process of human resources analytics in this context is of paramount importance, and it plays a significant role in evidence-based decision-making and policy formulation. Therefore, the aim of the present study was to design a model for human resources analytics in the health system. Methods: This research is practical in nature and utilized a qualitative approach based on grounded theory. In 2023, semi-structured interviews were conducted with 14 experts and managers from Kerman University of Medical Sciences, using purposive sampling until theoretical saturation was achieved. Throughout the process, interviews were continuously compared, and notes were taken during and after the interviews. The collected data from each interview were then analyzed using open, axial, and selective coding with the assistance of MaxQDA20 software. Through categorizing the open codes, axial categories were identified and in the final step, relationships among core categories were established through selective coding. Additionally, the validity and reliability of the findings were assessed and confirmed based on the four criteria of credibility, dependability, confirmability and transferability. Results: In identifying the codes and categories related to human resources analytics, a total of 370 open codes, 61 subcategories, and 24 main categories were generated. These were ultimately examined across 6 main axes, including the central phenomenon, causal conditions, contextual conditions, intervening conditions, strategies and consequences. Conclusion: It is recommended that in order to enhance and develop the human resources analytics process within the health system, attention be paid to the extracted model and its dimensions and components, particularly the identified causal conditions, contextual conditions, and strategies

How does Kailo work to improve adolescent mental health? A developmental realist evaluation protocol

Background Kailo is a community-centred research and design initiative that aims to improve adolescent mental health by addressing its wider social determinants. Unlike conventional interventions that often neglect systemic factors, Kailo employs a complex systems approach to identify and address the social causes of poor adolescent mental health in two pilot sites. This protocol outlines a developmental realist-informed evaluation that will develop, test, and refine the programme theory underpinning the Kailo framework. This evaluation will generate recommendations for the enhancement of Kailo before it is implemented in additional sites. Methods A developmental realist-informed evaluation will be conducted to investigate how and why Kailo works, for whom, and under what circumstances. This mixed-methods evaluation will engage key members of the Kailo consortium, local stakeholders, and young people who have interacted with Kailo. The initial phase incorporates a rapid realist synthesis, interviews with key informants, observations, and document analyses to formulate the initial programme theory. The second phase will employ semi-structured interviews, focus group discussions, observations, and analyses of routinely collected data to test the initial programme theory. The final phase will use focus group discussions to refine and consolidate the initial programme theory. Given the developmental nature of this evaluation, this programme theory will refine the implementation of the intervention in the pilot sites and generate recommendations to improve future versions of the Kailo framework. Discussion This study will explore the mechanisms by which the implementation of Kailo improves adolescent mental health by facilitating place-based systems change in the two pilot locations. This theory-based evaluation will illuminate the primary contextual conditions and mechanisms which produce intended (and unintended) outcomes to inform the future development of the Kailo framework. Moreover, the methodological approach used may contribute to broader understanding of how to implement and evaluate complex interventions designed to improve public health.