Realistic Evaluation

1. Programs Are Theories

Programs are theories incarnate. They begin in the heads of policy architects, pass into the hands of practitioners and, sometimes, into the hearts and minds of program subjects. They originate with an understanding of what gives rise to deficiencies in behavior or to discriminatory events or to inequalities of social condition and are expected to lead to changes in those patterns. They are inserted into existing social systems that are thought to underpin and account for present problems. Changes in patterns of behavior, events, or conditions are then generated through disturbances and reconstitutions of those systems. For instance, some health education theories explain the unhealthy lifestyles of adolescents by noting the undue influence of popular culture and the poor examples created by film, soap, and rock stars. This has led to the program theory of trying to insinuate equally attractive but decidedly healthy role models (e.g., sport stars) into the pages and onto the airwaves of the teen media. Programs are thus conjectures and, as in the case of this example, carry the risk of oversimplification in diagnosis and remedy.

2. Programs Are Embedded

As they are delivered, therefore, programs are embedded in social systems. It is through the workings of entire systems of social relationships that any changes in behaviors, events, and social conditions are effected. A key requirement of realist evaluation is thus to take heed of the different layers of social reality that make up and surround programs. For instance, a program of prisoner education and training may offer inmates the immediate resources to start on the road to reform. Whether the ideas will cement depends on (a) the individual capacities of trainees and teachers, (b) the interpersonal relationships created between them, (c) the institutional balance within the prison toward rehabilitation or containment, and (d) the wider infrastructural and welfare systems that support or undermines the return to society.

3. Programs Are Active

The triggers of change in most interventions are ultimately located in the reasoning and resources of those touched by the program. Effects are thus generally produced by and require the active engagement of individuals. Take two dental health programs: the fluoridation of water and publicity on brushing twice a day. The former is a rare example of a passive program. It works whenever tapwater is swallowed and thus affects whole populations. They are not required to engage with it actively. In the health education intervention, however, the message is in the medium, and that message may be heeded and acted on, or it may be missed, ignored, forgotten, disputed, found boring, or simply overridden by the lure of sugar. So it is with the vast majority of program incentives.

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