Table 2.
Key questions for THRIVE’s realist process evaluation and how these will be examined
| Key questions | Data source |
|---|---|
| How faithfully are MB and ETPB implemented? | |
| How well do facilitators feel they understand programme content and theory? | Observation of facilitator training and implementation, facilitator interviews, and facilitator self-reports on fidelity |
| How consistent are programme materials/protocols in directing facilitators what to deliver? | Observation of training and review of materials |
| What directions are facilitators given about adhering/adapting/personalizing the programme? | Observation of training and review of materials |
| How confident are facilitators about delivering ETPB or MB? | Observation of facilitator training and implementation, facilitator interviews, and facilitator self-reports on fidelity |
| What programme content is consistently covered? What content, if any, is missed out and why? | Facilitator self-reports on fidelity, supervisor interviews, and observation of selected groups during implementation |
| What work do facilitators have to undertake in order to deliver the intervention? | Interview at Time 2 (after facilitators gain experience of delivering groups) |
| How consistent are facilitators at delivering groups to completion? | Facilitator self-reports on fidelity, supervisor interviews, and observation of selected groups during implementation |
| What role does peer-assisted support (ETPB) and supervision (MB) have in fidelity? | Facilitator and supervisor interviews |
| To what extent do facilitator pairings (two deliver each group) affect delivery? | Facilitator self-reports on fidelity, supervisor interviews, and observation of selected groups during implementation |
| What are the mechanisms by which MB and ETPB work, if they do, and who do they work for and how? | |
| How does the programme’s theory of change explain the functioning of MB/ETPB? | Meetings with intervention developers and the research team to agree theory of change models |
| What information are facilitators given about programme theory and key mechanisms during training? | Observation of training, review of materials, facilitator interviews, and facilitator questionnaires |
| How do the programme materials/protocols explain programme theory and mechanisms? | Review of materials and observation of training |
| How well are key mechanisms understood by facilitators (at the point of training and later during implementation)? | Observation of facilitator training and selected groups during implementation, facilitator interviews, and facilitator self-reports on fidelity |
| What do facilitators think of the intervention and its key mechanisms? | Facilitator interviews, questionnaires, and facilitator post-session evaluation |
| How well do participants like the interventions? | Observation of selected groups, participant interviews, and questionnaires (facilitator’s perspectives will also be considered) |
| How do participants respond to knowledge on infant and child development in ETPB and MB? | Participant interviews and questionnaires, and observation of selected groups (facilitator’s perspectives will also be considered) |
| How do participants respond to parenting skills, partner skills content, and home-based practice in ETPB? | Participant interviews and questionnaires, and observation of selected groups (facilitator’s perspectives will also be considered) |
| How do participants respond to the nurturing aspects of MB, along with self-care, relaxation, and planned social activities in MB? | Participant interviews and questionnaires, and observation of selected groups (facilitator’s perspectives will also be considered) |
| How do participants respond to exploration of their past and present difficulties in MB? | Participant interviews and questionnaires, and observation of selected groups (facilitator’s perspectives will also be considered) |
| How does the experience of group sessions contribute to, or inhibit, the change mechanisms? | Participant interviews at Time 2 (3–12 months following birth) |
| What contextual factors are necessary for the programmes to function, or might prevent them functioning? | |
| What factors affect identification of suitable mothers-to-be and the referral process? | Interviews with referring practitioners, fieldworker observations, and interviews with managers |
| What are facilitator’s professional backgrounds? | Questionnaire and interviews with facilitators |
| What is the facilitators’ knowledge of, views on, and interest in MB/ETPB? Any experience of delivering parenting interventions? | Questionnaire and interviews with facilitators |
| What is the facilitators’ interest in, empathy and respect for, individual biographies and circumstances of mothers? | Interviews with facilitators and observation of training and selected groups during implementation |
| What are facilitators’ views on parenting interventions and what are their own experiences of parenting and of being parented? | Questionnaire and interviews with facilitators |
| How do facilitators manage MB/ETPB with other commitments? | Interviews with facilitators |
| How do facilitator managers view involvement with THRIVE? | Interviews with managers and facilitators |
| To what extent do facilitator pairings affect facilitators’ experiences of delivering ETPB and MB? | Interviews with facilitators and intervention developers/supervisors, post-session evaluation reports |
| How do facilitators feel about their engagement with, and response from, participants? | Interviews with facilitators and observation of selected groups during implementation |
| What is the suitability of venues for programme? | Observation of selected groups during implementation and post-session evaluation (facilitator and participant); interviews with participants and facilitators |
| What are mothers’ backgrounds (key relationships; social context; nature of social and health care needs)? | Mother-to-be questionnaires and interviews; observation of selected groups during implementation |
| How does mother engage with group? | Observation of selected groups during implementation and post-session evaluation (facilitator and participant); interviews with participants |
| What benefits does social interaction within the group offer participants? Are there any unintended consequences? | Observation of selected groups during implementation and post-session evaluation (facilitator and participant); interviews with participants |
| How do intervention group dynamics affect the experience of participation/retention? | Observation of selected groups during implementation and post-session evaluation (facilitator and participant); interviews with participants; interviews with non-attenders to explore reasons |
| How do vulnerabilities (e.g. mental health, drug use or stress) affect engagement? | Interviews with mothers-to-be and observation of groups; participant and facilitator post-session evaluation |
| How do material circumstances affect retention/adherence, e.g. poverty? | Interviews with mothers-to-be (attenders and non-attenders) and facilitator interviews Time 2 |
| How do families affect adherence? | Interviews with mothers-to-be and observation of selected groups during implementation |
ETPB Enhanced Triple B for Baby, MB Mellow Bumps