{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:49:08Z","timestamp":1791967748906,"version":"4.3.4"},"update-to":[{"DOI":"10.3310\/nihropenres.14151.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000}}],"reference-count":85,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/3\/"}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns3:p>Introduction People experiencing both homelessness and severe mental illness have complex needs requiring coordinated multi-sectoral and multilevel interventions. Several systematic reviews of interventions exist internationally; however, evidence on the mechanism of change and contextual factors is limited. The proposed realist review aims to synthesize evidence to understand what interventions work, how, why, for whom, and under what circumstances in low and middle-income country settings. Methods This work is nested within the National Institute for Health and Care Research (NIHR) Global Health Research Group on Homelessness and Mental Health in Africa (HOPE) project in Ethiopia, Ghana, and Kenya. In HOPE, we use participatory methods to develop and evaluate community-based interventions to address the unmet needs of people who are homeless and have severe mental illness living in the three countries. This protocol details the methodology for a realist review to inform the development, testing, and refinement of a programme theory for intervention. The review will follow five iterative steps. Step 1: Clarify the review scope and develop initial programme theories (IPTs). Step 2: Search for evidence across electronic databases and hand search for published studies to test and refine the IPTs. Step 3: Select and appraise studies. Step 4: Extract data, Step 5: Analyse and synthesize extracted data. The IPTs will be supplemented with formal theories to enhance their explanatory power. Key stakeholders will give critical inputs throughout the review process. Discussion The findings of the realist review will inform the development of contextually relevant programme theories to address the unmet needs of people who are homeless and have severe mental illness in LMICs, which will then be tested and refined within a realist evaluation. PROSPERO registration: CRD420251067136.<\/ns3:p>","DOI":"10.3310\/nihropenres.14151.2","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:59:08Z","timestamp":1780030748000},"page":"3","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Developing community-based programme theories to address unmet needs of people experiencing homelessness and severe mental illness: protocol for a realist review"],"prefix":"10.3310","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4944-0384","authenticated-orcid":false,"given":"Sisay","family":"Abayneh","sequence":"first","affiliation":[{"name":"Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa) Addis Ababa Addis Ababa Addis Ababa University College of Health Sciences"},{"name":"College of Education and Behavoural Sciences Assela Oromia Arsi University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Asher","sequence":"additional","affiliation":[{"name":"Nottingham Centre for Public Health and Epidemiology, School of Medicine, Nottingham Institute of Mental Health, University of Nottingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Smartt","sequence":"additional","affiliation":[{"name":"Division of Psychiatry, Centre for Clinical Brain Sciences Edinburgh University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Mutiso","sequence":"additional","affiliation":[{"name":"Nairobi Africa Institute of Mental and Brain Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Badimak","family":"Yaro","sequence":"additional","affiliation":[{"name":"Accra Basicneeds-Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3912-3409","authenticated-orcid":false,"given":"Eleni","family":"Misganaw","sequence":"additional","affiliation":[{"name":"Addis Ababa, Mental Health Service Users Association \u2013 Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6818-7348","authenticated-orcid":false,"given":"Kimberly","family":"Kariuki","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute Nairobi Centre for Clinical Research, Division of Mental Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faith","family":"Mukami","sequence":"additional","affiliation":[{"name":"Nairobi Mental 360 Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia Ashaley","family":"Fofo","sequence":"additional","affiliation":[{"name":"Accra Basicneeds-Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tizaa Hannan","family":"Legend","sequence":"additional","affiliation":[{"name":"Accra Basicneeds-Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasset","family":"Chenu","sequence":"additional","affiliation":[{"name":"Addis Ababa, Mental Health Service Users Association \u2013 Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Read","sequence":"additional","affiliation":[{"name":"School of Health and Social Care Colchester University of Essex"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Mayston","sequence":"additional","affiliation":[{"name":"Department of Global Health and Social Medicine London King\u2019s College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ribka","family":"Birhanu","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine, Department of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity-Building Addis Ababa Addis Ababa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atalay","family":"Alem","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine, Department of Psychiatry and WHO Collaborating Centre in Mental Health Research and Capacity-Building Addis Ababa Addis Ababa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7937-3226","authenticated-orcid":false,"given":"Charlotte","family":"Hanlon","sequence":"additional","affiliation":[{"name":"Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa) Addis Ababa Addis Ababa Addis Ababa University College of Health Sciences"},{"name":"Division of Psychiatry, Centre for Clinical Brain Sciences Edinburgh University of Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"465-486","DOI":"10.1146\/annurev-publhealth-040617-013553","article-title":"Solving homelessness from a complex systems perspective: Insights for prevention responses.","volume":"40","author":"P Fowler","year":"2019","journal-title":"Annu Rev Public Health."},{"key":"ref2","article-title":"Guidelines for the implementation of the right to adequate housing - report of the special rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context.","year":"2019"},{"key":"ref3","article-title":"Access to justice for the right to housing. Report of the Special Rapporteur on adequate housing as a component of the right to an adequate standard of living, and on the right to non-discrimination in this context.","year":"2019","journal-title":"Human Rights Council Fortieth session."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"823390","DOI":"10.3389\/fpsyg.2022.823390","article-title":"Evidence-based analysis of social impact bonds for homelessness: a scoping review.","volume":"13","author":"H Wang","year":"2022","journal-title":"Front Psychol."},{"key":"ref5","article-title":"Homelessness and street homelessness in England: trends, causes and what works.","volume":"15","author":"S Aldridge","year":"2021","journal-title":"Eur J Homelessness."},{"key":"ref6","article-title":"The ETHOS definition and classification of homelessness: an analysis.","volume":"5","author":"K Amore","year":"2011","journal-title":"Eur J Homelessness."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"241-250","DOI":"10.1016\/S0140-6736(17)31869-X","article-title":"Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis.","volume":"391","author":"R Aldridge","year":"2018","journal-title":"Lancet."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2128-2141","DOI":"10.1111\/hsc.13884","article-title":"A systematic review of the effect of stigma on the health of people experiencing homelessness.","volume":"30","author":"J Reilly","year":"2022","journal-title":"Health Soc Care Community."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e1003750","DOI":"10.1371\/journal.pmed.1003750","article-title":"The prevalence of mental disorders among homeless people in high-income countries: an updated systematic review and meta-regression analysis.","volume":"18","author":"S Gutwinski","year":"2021","journal-title":"PLoS Med."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"841-849","DOI":"10.1177\/00207640231217173","article-title":"Outcomes of psychosocial interventions for homeless individuals with mental illness: a systematic review.","volume":"70","author":"R Roy","year":"2024","journal-title":"Int J Soc Psychiatry."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"691-699","DOI":"10.1001\/jamapsychiatry.2024.0426","article-title":"Prevalence of mental health disorders among individuals experiencing homelessness: a systematic review and meta-Analysis.","volume":"81","author":"R Barry","year":"2024","journal-title":"JAMA Psychiatr."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"308-315","DOI":"10.1002\/wps.20458","article-title":"Sedentary behavior and physical activity levels in people with schizophrenia, bipolar disorder and major depressive disorder: a global systematic review and meta-analysis.","volume":"16","author":"D Vancampfort","year":"2017","journal-title":"World Psychiatry."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"11-18","DOI":"10.9734\/jammr\/2023\/v35i175099","article-title":"A review of the impact of homelessness on mental health.","volume":"35","author":"O Anombem","year":"2023","journal-title":"J Adv Med Med Res."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1186\/s12913-024-10971-8","article-title":"A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare.","volume":"24","author":"J Miller","year":"2024","journal-title":"BMC Health Serv Res."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1-11","DOI":"10.1111\/hsc.12857","article-title":"Homeless persons' experiences of health and social care: a systematic integrative review.","volume":"28","author":"P Omerov","year":"2020","journal-title":"Health Soc Care Community."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1192\/bjo.2019.32","article-title":"Homelessness and severe mental illness in low-and middle-income countries: scoping review.","volume":"5","author":"C Smartt","year":"2019","journal-title":"BJPsych Open."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"100-113","DOI":"10.1007\/s10488-022-01224-z","article-title":"Supporting vulnerable people during challenging transitions: a systematic review of critical time intervention.","volume":"50","author":"J Manuel","year":"2023","journal-title":"Adm Policy Ment Health."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e0230896","DOI":"10.1371\/journal.pone.0230896","article-title":"The effectiveness of case management interventions for the homeless, vulnerably housed and persons with lived experience: a systematic review.","volume":"15","author":"D Ponka","year":"2020","journal-title":"PLoS One."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e1329","DOI":"10.1002\/cl2.1329","article-title":"Exploring the effect of case management in homelessness per components: a systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.","volume":"19","author":"A Weightman","year":"2023","journal-title":"Campbell Syst Rev."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"379-387","DOI":"10.1136\/jech-2018-210981","article-title":"Effects of housing first approaches on health and well-being of adults who are homeless or at risk of homelessness: systematic review and meta-analysis of randomised controlled trials.","volume":"73","author":"A Baxter","year":"2019","journal-title":"J Epidemiol Community Health."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e342-e360","DOI":"10.1016\/S2468-2667(20)30055-4","article-title":"Effectiveness of permanent supportive housing and income assistance interventions for homeless individuals in high-income countries: a systematic review.","volume":"5","author":"T Aubry","year":"2020","journal-title":"Lancet Public Health."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1339801","DOI":"10.3389\/fpsyt.2023.1339801","article-title":"A systematic review of approaches to improve medication adherence in homeless adults with psychiatric disorders.","volume":"14","author":"R Hird","year":"2024","journal-title":"Front Psychiatry."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e1154","DOI":"10.1002\/cl2.1154","article-title":"A comprehensive review of prioritised interventions to improve the health and wellbeing of persons with lived experience of homelessness.","volume":"17","author":"A Moledina","year":"2021","journal-title":"Campbell Syst Rev."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/1741-7015-11-21","article-title":"RAMESES publication standards: realist syntheses.","volume":"11","author":"G Wong","year":"2013","journal-title":"BMC Med."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1-186","DOI":"10.3310\/hsdr09170","article-title":"Improving care transfers for homeless patients after hospital discharge: a realist evaluation.","volume":"9","author":"M Cornes","year":"2021","journal-title":"Health Serv Deliv Res."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"965-989","DOI":"10.1007\/s11524-009-9392-1","article-title":"Community-based services for homeless adults experiencing concurrent mental health and substance use disorders: a realist approach to synthesizing evidence.","volume":"86","author":"P O\u2019Campo","year":"2009","journal-title":"J Urban Health."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"e043091","DOI":"10.1136\/bmjopen-2020-043091","article-title":"Contexts and mechanisms that promote access to healthcare for populations experiencing homelessness: a realist review.","volume":"11","author":"R Siersbaek","year":"2021","journal-title":"BMJ Open."},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.4135\/9781473913820","author":"R Pawson","year":"2013","journal-title":"The science of evaluation: a realist manifesto."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"21-34","DOI":"10.1258\/1355819054308530","article-title":"Realist review--a new method of systematic review designed for complex policy interventions.","volume":"10 Suppl 1","author":"R Pawson","year":"2005","journal-title":"J Health Serv Res Policy."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"10497323251316401","DOI":"10.1177\/10497323251316401","article-title":"Mechanism-based middle-range theories: using realist syntheses to reconcile specificity to context and generalizability.","author":"F Mukumbang","year":"2025","journal-title":"Qual Health Res."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1017\/S2045796025000186","article-title":"Improving outcomes for people who are homeless and have severe mental illness in Ethiopia, Ghana and Kenya: overview of the HOPE programme.","volume":"34","author":"C Hanlon","year":"2025","journal-title":"Epidemiol Psychiatr Sci."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12961-020-00644-3","article-title":"Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews.","volume":"19","author":"J Ocloo","year":"2021","journal-title":"Health Res Policy Syst."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"173-180","DOI":"10.1136\/bmjqs-2022-015236","article-title":"Grand rounds in methodology: when are realist reviews useful, and what does a \u2018good\u2019 realist review look like?","volume":"32","author":"C Duddy","year":"2023","journal-title":"BMJ Qual Saf."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/1748-5908-7-33","article-title":"Realist synthesis: illustrating the method for implementation research.","volume":"7","author":"J Rycroft-Malone","year":"2012","journal-title":"Implement Sci."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"131-45","DOI":"10.4135\/9781526451729.n9","author":"G Wong","year":"2018","journal-title":"Doing realist research."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1186\/s12913-018-3150-6","article-title":"Unearthing how, why, for whom and under what health system conditions the antiretroviral treatment adherence club intervention in South Africa works: a realist theory refining approach.","volume":"18","author":"F Mukumbang","year":"2018","journal-title":"BMC Health Serv Res."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"1609406917741796","DOI":"10.1177\/1609406917741796","article-title":"Building realist program theory for large complex and messy interventions.","volume":"16","author":"K Shearn","year":"2017","journal-title":"Int J Qual Methods."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"361-372","DOI":"10.1146\/annurev-publhealth-031816-044451","article-title":"Realist synthesis for public health: building an ontologically deep understanding of how programs work, for whom, and in which contexts.","volume":"40","author":"J Jagosh","year":"2019","journal-title":"Annu Rev Public Health."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"546-557","DOI":"10.1080\/10999922.2017.1325999","article-title":"Thinking outside the box: using multisector approaches to address the wicked problem of homelessness among LGBTQ youth.","volume":"20","author":"K Norman-Major","year":"2018","journal-title":"Public Integrity."},{"key":"ref43","doi-asserted-by":"publisher","first-page":"143-60","DOI":"10.51952\/9781447354109.ch009","author":"L Marshall","year":"2020","journal-title":"Using evidence to end homelessness."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"347-358","DOI":"10.1007\/s10464-012-9554-2","article-title":"Planning a multi-site, complex intervention for homeless people with mental illness: the relationships between the national team and local sites in Canada\u2019s at home\/chez soi project.","volume":"51","author":"G Nelson","year":"2013","journal-title":"Am J Community Psychol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"109-110","DOI":"10.1016\/j.gaceta.2017.05.010","article-title":"Getting to grips with context and complexity \u2212 the case for realist approaches.","volume":"32","author":"G Wong","year":"2018","journal-title":"SciELO Public Health. Gac Sanit."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1-272","DOI":"10.4135\/9781526451729","author":"N Emmel","year":"2018","journal-title":"Doing realist research."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"583-595","DOI":"10.1080\/13645579.2021.1918484","article-title":"Understanding \u2018context\u2019in realist evaluation and synthesis.","volume":"25","author":"J Greenhalgh","year":"2022","journal-title":"Int J Soc Res Methodol."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"504-514","DOI":"10.1002\/jrsm.1630","article-title":"Applying and reporting relevance, richness and rigour in realist evidence appraisals: advancing key concepts in realist reviews.","volume":"14","author":"S Dada","year":"2023","journal-title":"Res Synth Methods."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"79-90","DOI":"10.4135\/9781526451729.n6","volume":"1","author":"B Marchal","year":"2018","journal-title":"Doing Realist Research."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"121-130","DOI":"10.1080\/14767430.2020.1723301","article-title":"Retroductive theorizing in Pawson and Tilley's applied scientific realism.","volume":"19","author":"J Jagosh","year":"2020","journal-title":"J Crit Realism."},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1609406920938577","DOI":"10.1177\/1609406920938577","article-title":"What\u2019s in a realist configuration? Deciding which causal configurations to use, how, and why.","volume":"19","author":"E De Weger","year":"2020","journal-title":"Int J Qual Methods."},{"key":"ref52","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s13012-017-0638-0","article-title":"An exploration of group-based HIV\/AIDS treatment and care models in Sub-Saharan Africa using a realist evaluation (Intervention-Context-Actor-Mechanism-Outcome) heuristic tool: a systematic review.","volume":"12","author":"F Mukumbang","year":"2017","journal-title":"Implement Sci."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"922","DOI":"10.4102\/sajhivmed.v20i1.922","article-title":"\u2018At this [adherence] club, we are a family now\u2019: a realist theory-testing case study of the antiretroviral treatment adherence club, South Africa.","volume":"20","author":"F Mukumbang","year":"2019","journal-title":"South Afr J HIV Med."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"e0210565","DOI":"10.1371\/journal.pone.0210565","article-title":"Unravelling how and why the antiretroviral adherence club intervention works (or not) in a public health facility: a realist explanatory theory-building case study.","volume":"14","author":"F Mukumbang","year":"2019","journal-title":"PLoS One."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"14-35","DOI":"10.1002\/jrsm.1386","article-title":"The \u201crealist search\u201d: a systematic scoping review of current practice and reporting.","volume":"11","author":"A Booth","year":"2020","journal-title":"Res Synth Methods."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"26320843231224807","DOI":"10.1177\/26320843231224807","article-title":"An exploration of analytical tools to conduct a realist synthesis and demonstrate programme theory development: an example from a realist review.","volume":"6","author":"L Peters","year":"2024","journal-title":"Res Methods Med Health Sci."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"242-265","DOI":"10.1080\/1750984X.2021.1969674","article-title":"Realist review.","volume":"15","author":"R Hunter","year":"2022","journal-title":"Int Rev Sport Exerc Psychol."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"25642521","DOI":"10.3310\/hsdr02300","article-title":"Development of methodological guidance, publication standards and training materials for realist and meta-narrative reviews: the RAMESES (Realist And Meta-narrative Evidence Syntheses\u2013Evolving Standards) project.","volume":"2","author":"G Wong","year":"2014","journal-title":"Health Serv Deliv Res."},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/2046-4053-4-1","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.","volume":"4","author":"D Moher","year":"2015","journal-title":"Syst Rev."},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.17605\/OSF.IO\/G432U","article-title":"Developing programme theories to address unmet needs of people experiencing homelessness and severe mental illness: protocol for a realist review.","author":"S Abayneh","year":"2025"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1609406920916299","DOI":"10.1177\/1609406920916299","article-title":"Developing an initial program theory to explain how patient-reported outcomes are used in health care settings: methodological process and lessons learned.","volume":"19","author":"R Flynn","year":"2020","journal-title":"Int J Qual Methods."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"62-76","DOI":"10.1016\/S2215-0366(25)00206-8","article-title":"Programmes for people who are homeless and have severe mental illness in low-income and middle-income countries: a systematic review.","volume":"13","author":"L McPhail","year":"2026","journal-title":"Lancet Psychiatry."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"e074336","DOI":"10.1136\/bmjopen-2023-074336","article-title":"Implementing a package of essential non-communicable diseases interventions in low- and middle-income countries: a realist review protocol.","volume":"13","author":"A Vaidya","year":"2023","journal-title":"BMJ Open."},{"key":"ref88","doi-asserted-by":"publisher","first-page":"1-272","DOI":"10.4135\/9781526451729","author":"N Emmel","year":"2018","journal-title":"Doing Realist Research."},{"key":"ref92","doi-asserted-by":"publisher","first-page":"41-58","DOI":"10.4135\/9781526451729.n4","article-title":"Understanding mechanisms in realist evaluation and research.","author":"G Westhorp","year":"2018","journal-title":"Doing realist research."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"e009059","DOI":"10.1136\/bmjopen-2015-009059","article-title":"Interventions to improve antimicrobial prescribing of doctors in training: the IMPACT (IMProving Antimicrobial presCribing of doctors in Training) realist review.","volume":"5","author":"G Wong","year":"2015","journal-title":"BMJ Open."},{"key":"ref67","doi-asserted-by":"publisher","first-page":"364-382","DOI":"10.1177\/1356389013505042","article-title":"Developing complexity-consistent theory in a realist investigation.","volume":"19","author":"G Westhorp","year":"2013","journal-title":"Evaluation."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"220-235","DOI":"10.1111\/hir.12108","article-title":"Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable?","volume":"32","author":"A Booth","year":"2015","journal-title":"Health Info Libr J."},{"key":"ref69","article-title":"Interventions for people who are homeless and have severe mental illness in low- and middle-income countries: a systematic review.","author":"L Caroline Smartt","year":"2024","journal-title":"PROSPERO 2024."},{"key":"ref70","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1186\/1471-2288-13-118","article-title":"Towards a methodology for cluster searching to provide conceptual and contextual \u201crichness\u201d for systematic reviews of complex interventions: case study (CLUSTER).","volume":"13","author":"A Booth","year":"2013","journal-title":"BMC Med Res Methodol."},{"key":"ref71","doi-asserted-by":"publisher","first-page":"576-589","DOI":"10.1002\/jrsm.1502","article-title":"CLUSTER searching approach to inform evidence syntheses: a methodological review.","volume":"12","author":"A Tsang","year":"2021","journal-title":"Res Synth Methods."},{"key":"ref96","doi-asserted-by":"publisher","first-page":"e38239","DOI":"10.2196\/38239","article-title":"Synthesis of the evidence on what works for whom in telemental health: rapid realist review.","volume":"11","author":"M Schlief","year":"2022","journal-title":"Interact J Med Res."},{"key":"ref101","doi-asserted-by":"publisher","first-page":"190-203","DOI":"10.1002\/jrsm.1523","article-title":"Identifying evidence for five realist reviews in primary health care: A comparison of search methods.","volume":"13","author":"C Duddy","year":"2022","journal-title":"Res Synth Methods."},{"key":"ref102","doi-asserted-by":"publisher","first-page":"16094069241309277","DOI":"10.1177\/16094069241309277","article-title":"Eliciting the Initial Programme Theory in a Realist Evaluation of Facility-Based Maternal Death Reviews in Benin: Methodological Process, Challenges and Lessons Learned.","volume":"24","author":"C Hounsou","year":"2025","journal-title":"Int J Qual Methods."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"127-142","DOI":"10.1080\/13645570600595314","article-title":"Digging for nuggets: how \u2018bad\u2019 research can yield \u2018good\u2019 evidence.","volume":"9","author":"R Pawson","year":"2006","journal-title":"Int J Soc Res Methodol."},{"key":"ref74","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12911-021-01659-8","article-title":"Personal Electronic Records of Medications (PERMs) for medication reconciliation at care transitions: a rapid realist review.","volume":"21","author":"C Waldron","year":"2021","journal-title":"BMC Med Inform Decis Mak."},{"key":"ref75","doi-asserted-by":"publisher","first-page":"e079153","DOI":"10.1136\/bmjopen-2023-079153","article-title":"Optimising digital clinical consultations in maternity care: a realist review and implementation principles.","volume":"14","author":"C Evans","year":"2024","journal-title":"BMJ Open."},{"key":"ref76","doi-asserted-by":"publisher","first-page":"1609406919859754","DOI":"10.1177\/1609406919859754","article-title":"Data analysis and synthesis within a realist evaluation: toward more transparent methodological approaches.","volume":"18","author":"B Gilmore","year":"2019","journal-title":"Int J Qual Methods."},{"key":"ref77","doi-asserted-by":"publisher","first-page":"16094069211053516","DOI":"10.1177\/16094069211053516","article-title":"Examining the application of retroductive theorizing in realist-informed studies.","volume":"20","author":"F Mukumbang","year":"2021","journal-title":"Int J Qual Methods."},{"key":"ref78","doi-asserted-by":"publisher","first-page":"93-114","DOI":"10.1177\/15586898211049847","article-title":"Retroductive theorizing: a contribution of critical realism to mixed methods research.","volume":"17","author":"F Mukumbang","year":"2023","journal-title":"J Mixed Methods Res."},{"key":"ref79","doi-asserted-by":"publisher","first-page":"e2751","DOI":"10.1002\/casp.2751","article-title":"Community arts, identity and recovery: a realist review of how community-based arts activities enables the identity change recovery process from serious mental illness.","volume":"34","author":"L Peters","year":"2024","journal-title":"J Community Appl Soc Psychol."},{"key":"ref80","doi-asserted-by":"publisher","first-page":"481-488","DOI":"10.1097\/NNR.0000000000000686","article-title":"Realist approach to qualitative data analysis.","volume":"72","author":"A Putri","year":"2023","journal-title":"Nurs Res."},{"key":"ref81","doi-asserted-by":"publisher","first-page":"503-518","DOI":"10.1111\/medu.15482","article-title":"Realist analysis of qualitative data in Health Professions Education Research.","volume":"59","author":"C Rees","year":"2025","journal-title":"Med Educ."},{"key":"ref83","article-title":"What is a mechanism? What is a programme mechanism.","author":"T Greenhalgh","year":"2017","journal-title":"The Rameses II Project."},{"key":"ref103","doi-asserted-by":"publisher","first-page":"361-379","DOI":"10.1177\/13563890231223182","article-title":"Developing middle-range theories within a realist evaluation of how health committees support community capacity for health.","volume":"30","author":"B Gilmore","year":"2024","journal-title":"Evaluation."},{"key":"ref84","doi-asserted-by":"publisher","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance.","volume":"374","author":"K Skivington","year":"2021","journal-title":"BMJ."},{"key":"ref86","doi-asserted-by":"publisher","first-page":"e037636","DOI":"10.1136\/bmjopen-2020-037636","article-title":"Realist review protocol for understanding the real-world barriers and enablers to practitioners implementing self-management support to people living with and beyond cancer.","volume":"10","author":"K Kantilal","year":"2020","journal-title":"BMJ Open."},{"key":"ref87","doi-asserted-by":"publisher","first-page":"29072890","DOI":"10.3310\/hsdr05280","article-title":"Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project.","volume":"5","author":"G Wong","year":"2017","journal-title":"Health Serv Deliv Res."}],"container-title":["NIHR Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T08:09:35Z","timestamp":1791965375000},"score":1,"resource":{"primary":{"URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":85,"URL":"https:\/\/doi.org\/10.3310\/nihropenres.14151.2","relation":{"has-version":[{"id-type":"doi","id":"10.3310\/nihropenres.14151.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40603","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40602","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40633","asserted-by":"subject"},{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40603","asserted-by":"object"},{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40602","asserted-by":"object"},{"id-type":"doi","id":"10.3310\/nihropenres.15631.r40633","asserted-by":"object"}]},"ISSN":["2633-4402"],"issn-type":[{"value":"2633-4402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"assertion":[{"value":"Indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.15631.r40603, Rasmus Handest, Copenhagen University Hospital, Copenhagen, 10 Jun 2026, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#referee-response-40603","order":0,"name":"referee-response-40603","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sisay Abayneh<\/b>; \n<i>Posted: 10 Jun 2026<\/i>; We sincerely thank the reviewer for his insightful and constructive feedback, which has substantially improved the quality and clarity of our manuscript. We also deeply appreciate the reviewer's endorsement of our protocol and his kind wishes for the successful conduct of the realist review.","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#referee-comment-3597","order":1,"name":"referee-comment-3597","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15631.r40602, Geoff Wong, University of Oxford, Oxford, England, 02 Jun 2026, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#referee-response-40602","order":2,"name":"referee-response-40602","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sisay Abayneh<\/b>; \n<i>Posted: 10 Jun 2026<\/i>; We would like to express our sincere gratitude to the reviewer for his insightful and constructive comments, which have significantly strengthened and improved our manuscript. We also greatly appreciate the reviewer's approval of our protocol and his kind wishes for the successful conduct of the realist review","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#referee-comment-3598","order":3,"name":"referee-comment-3598","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.15631.r40633, Martha Paisi, University of Plymouth, Plymouth, England, 17 Jun 2026, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/6-3\/v2#referee-response-40633","order":4,"name":"referee-response-40633","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute for Health and Social Care Research (NIHR) through the Global Health Research Group on Homelessness and Mental Health in Africa (Grant Reference Number NIHR134325). The views expressed in this publication are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care or Public Health England. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This open access work is licensed under the Open Government Licence v3.0.","order":0,"name":"copyright-info","label":"Copyright"}]}}