Question	Rationale
Can you tell me what your involvement in this specialist model of care is?	Realist evaluation assumes that people know different things according to their role. These answers will be used to tailor future questions according to the specific insight of the stakeholder.
What is the purpose of the service? /what do you think are the desired outcomes for women? Do you think the service makes a difference to these outcomes? Can you give examples?	Assuming that programmes have different outcomes for different groups, stakeholders, women and family members will be asked this question until the range of outcomes has been identified. Interviewer will prompt for evidence of the nature and extent of the outcome. If expected outcomes are not identified (improved access and engagement), Interviewer will prompt for those outcomes. If unexpected outcomes are identified, interviewer will prompt for greater description. These outcomes will be verified using the quantitative data analysis.
We are interested in how specialist models of care have an effect on women's outcomes. How do you think the service has caused, or helped to cause [outcomes identified earlier in interview]?	Initial question leading into exploration of mechanisms. When participants identify programme activities (for example flexible appointments, 24hr access to a known mw, safeguarding training) Interviewer will probe further – e.g. – So, what is it about being able to contact a known midwife 24/7? How did that help cause (the later outcome)?
Are the outcomes previously mentioning the same for all women? For example, women with different social risk factors? [using the specific sub-groups identified in the programme theories – specific disadvantaged groups/social risk factors and different cultures]. In what ways have they been different?	This question is seeking more specific information about “for whom” the programme has and has not been effective (in what respects, to what extent). Interviewer will specifically probe in relation to sub- groups that are identified in the realist synthesis’ programme theories.
Do you think women with social risk factors want/are open to this model of care prior to accessing it? How might this differ for different groups of women (specific risk factors?) Do you think this specialist model of care changes the way women feel about maternity services? In what ways? Can you provide examples?	This theory-based question sets out to explore candidacy theory. Examples might be given of how women with particular social risk factors have reported their experience of maternity care (for example those who are unfamiliar with the UK system, or those who have social care involvement), to explore if and how the programme addresses these issues and what the outcomes of this might be.
There are lots of ideas about how specialist models of care actually work, and we think they probably work differently in different places or for different people. One of those ideas is (an example: that if women trust their midwife then they will engage with the services and be more open to disclosing concerns.) Does it work at all like that here? Can you give an example? Does this apply to all women? What about: (brief description of other mechanisms not previously identified)    - Engagement with the multi-disciplinary team    - Engagement with local community    - What other resources the service offers (practical support, interpretation services, access)	The subject of a realist interview is the programme theory. The aim is to get the respondent to refine the programme theory for the particular context about which they know. This question revisits the mechanisms (particularly those not identified before) but in a more specific way to test the programme theories and whether the programme works differently for different people. This (in conjunction with the women and family members responses) will help confirm or refute the initial programme theories.
We've seen that specialist models of care work differently in different places. What is it about this service that makes it work so well/less well? Do you think culture, the local community or other resources has an effect on women's outcomes? Can you give examples?	Realist evaluation assumes context does affect outcomes (by affecting which mechanisms fire). Interviewer will probe for aspects of culture, local resources/lack of them, local and family relationships/support, relationship between organisation and participants and so on.
If you could change something about this service to make it work more effectively here, what would you change and why?	This question aims to elicit understanding of why the programme has not worked as effectively as it might (i.e. mechanisms not firing, aspects of context) as well as strategies for improvement.
What else do you think we need to know, to really understand how the service works here?	This open probe that enables participants to comment on anything not covered by the interview. The structure of the question keeps the focus on ‘how the programme works’ and ‘in this context’.