A realist review of which advocacy interventions work for which abused women under what circumstances: an exemplar

To assess advocacy interventions for intimate partner abuse in women, in terms of which interventions work for whom, why and in what circumstances. Our strategic objective reflects our higher-order (realist) question (Greenhalgh 2016), with four more specific descriptive questions as subcomponents and foci in our initial exploration of the data. We will determine all answers (as much as possible) from existing evidence.

Research questions

How do the key mechanisms associated with the delivery or use of complex interventions that include advocacy as a component interact with contextual influences, and with one another, to explain the successes, failures and partial successes of advocacy as an intervention?

  • What are the active ingredients of advocacy interventions?
  • What are the important moderators or contexts that determine whether the different mechanisms produce their intended outcomes?
  • To what extent do the views and experiences of women who have used advocacy services match the intervention's aims and outcomes?
  • How do organisational and system factors influence implementation of advocacy interventions?

These questions may change as the realist review progresses. We will consider active ingredients, impact and outcomes in relation to qualitatively and quantitatively measured effects.

Strategic objectives

Our strategic objectives are to explain successes, failures, partial successes and small effect sizes in published, empirical studies of advocacy interventions delivered in different settings, and, in particular, to explain mechanisms of effect in heterogeneous, complex, advocacy-containing interventions. This will enable us to make clear decisions on which studies should be aggregated or synthesised in future reviews, as well as how to interpret the evidence in future reviews of advocacy interventions for abused women. It will also enable researchers and developers to design more effective advocacy interventions in the future, determine which outcomes to include, and improve their reporting and evaluation. In addition, it will help policy makers and practitioners to better understand advocacy interventions, and their likely benefit in the local contexts in which they operate.

This is a protocol.