Table 2. Main overarching Context Mechanism Outcome Configurations in REAL analysis.

Analysis areas	Main Context Mechanism outcome configurations (CMOCs)
Working relationships established
	CMOC1: When researchers develop working relationships with local research stakeholders (C) and provide tangible benefits (C) local research stakeholders may show increased acceptance of research (O) because they are re-assured by the sense of relationship and reciprocity with researchers (M)
1. Exchange and negotiation of benefits	CMOC2: When researchers in resource poor settings provide free health care and other personal and community benefits, compensation and incentives (C) this may increase participation in research (O) when the benefits provided are seen by people as an acceptable exchange for their time, inconvenience, risk, blood,samples (M) or when research related benefits are seen as irresistible (M)
	CMOC3: Involving leaders and organisations based in study settings in research (C) and recruiting and training people from those communities as research staff (C) may reduce costs (O) and support research implementation (O) because it leverages local personnel, infrastructure and practical support for research (M)
2. Researcher contiguity and familiarity	CMOC4: The everyday presence of community-based research staff (C) and repeated respectful interactions, both formal and informal, between community members and research staff (C) can lead to working relationships between researchers and community members (O) because people feel a sense of familiarity and rapport (M) and degree of reciprocity (mutual respect and understanding) (M)
	CMOC5: When participants are approached by research staff who they have a good previous experience of (C) or who have a good reputation and perceived competence (C), they are more likely to participate (O), because of increased confidence in those doing the research (M)
3. Sense of influence or control over research	CMOC6: When research is endorsed by people, networks and/or organisations that community members have confidence in (C) they are more likely to accept or participate in the research (O) because they are re-assured by the endorsement (M) they feel leaders have some influence on researchers (M) or feel socially pressured (M)
	CMOC7: Where community members have early involvement (C) and share decision making in the design or conduct of research (C) they may contribute time and resources (O) and research may address locally relevant issues (O2) because they have a sense of influence over the process (M) and are motivated to identify challenges and solutions (M)
	CMOC8: Researchers working with a wide range of people in a community (C) and using multiple and complementary forms of representation (C) can lead to stakeholders being more likely to accept research (O) and share their views with researchers (O) since all groups feel they have been considered (M)
4. Researcher responsiveness	CMOC9: Where local research stakeholders have regular opportunities to raise concerns and have them acknowledged and responded to (C) they better accept/tolerate research (O) because they feel re-assured by having their concerns taken seriously (M) and feel respect has been demonstrated (M)
	CMOC 10: When researchers identify community members’ concerns, beliefs and practices (e.g. using formative research, knowledge of locally embedded staff and ongoing CE) (C), research implementation is likely to be improved (O), because researchers can adapt the research to address local practical and social issues (M)
5. Culture of engagement in research institutions
	CMOC11: Where senior researchers see engagement as important (C) and/or there is a culture of and infrastructure for engagement (C) researchers will more likely dedicate time and resources to engagement (O) because engagement is an expectation for those conducting research (M)
6. Dominant health paradigm context
	CMOC12: Where there are differences of wealth, power and culture between research centres and local research stakeholders (C) and previous negative experiences of colonialism or outside agencies (C) people may be suspicious of research (O) because they perceive research as having an exploitative or hidden agenda (M)