Table 1 Four-step approach to realist evaluation of primary healthcare team learning on IPV management

Step 1. Eliciting the implicit theories

• Review of policies, programs, unpublished reports and statistical reports regarding the intervention delivered.

Qualitative-thematic analysis driven by the conceptual framework presented in Figure 1.

• Semi-structured interviews with stakeholders and providers involved in the intervention.

Step 2. Formulation of the initial middle-range theory

Contrasting and complementing implicit theories with findings from the literature review

Revise and propose initial middle-range theory configurations in the light of the information collected during Step 1.

Step 3. Testing the initial middle-range theory

• Select cases for testing of the initial MRT.

Qualitative- thematic analysis of collected data using the CMO approach

• Case studies with quantitative and qualitative data collection

Step 4. Specification

Refine the initial middle range theory in the light of the retained CMO configurations

Draft refined middle-range theory that explains how and under which contextual factors primary health care teams learn to provide adequate IPV case management