title: Exposing the impact of Citizens Advice Bureau services on health: a realist evaluation protocol.
abstract: BACKGROUND
  Welfare advice services can be used to address health inequalities, for example, through Citizens Advice Bureau (CAB). Recent reviews highlight evidence for the impact of advice services in improving people's financial position and improving mental health and well-being, daily living and social relationships. There is also some evidence for the impact of advice services in increasing accessibility of health services, and reducing general practitioner appointments and prescriptions. However, direct evidence for the impact of advice services on lifestyle behaviour and physical health is currently much less well established. There is a need for greater empirical testing of theories around the specific mechanisms through which advice services and associated financial or non-financial benefits may generate health improvements.
  
  
  METHODS
  A realist evaluation will be conducted, operationalised in 5 phases: building the explanatory framework; refining the explanatory framework; testing the explanatory framework through empirical data (mixed methods); development of a bespoke data recording template to capture longer term impact; and verification of findings with a range of CAB services. This research will therefore aim to build, refine and test an explanatory framework about how CAB services can be optimally implemented to achieve health improvement.
  
  
  BACKGROUND
  The study was approved by the ethics committee at Northumbria University, UK. Project-related ethical issues are described and quality control aspects of the study are considered. A stakeholder mapping exercise will inform the dissemination of results in order to ensure all relevant institutions and organisations are targeted.
authors.affiliation: Department of Public Health and Wellbeing, Northumbria University, Newcastle Upon Tyne, UK Fuse (The Centre for Translational Research in Public Health), Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: N
authors.initials: N
authors.lastname: Forster
authors.affiliation: Department of Public Health and Wellbeing, Northumbria University, Newcastle Upon Tyne, UK Fuse (The Centre for Translational Research in Public Health), Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Dalkin
authors.affiliation: Department of Public Health and Wellbeing, Northumbria University, Newcastle Upon Tyne, UK Fuse (The Centre for Translational Research in Public Health), Newcastle University, Newcastle Upon Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Lhussier
authors.affiliation: Department of Public Health and Wellbeing, Northumbria University, Newcastle Upon Tyne, UK.
authors.forename: P
authors.initials: P
authors.lastname: Hodgson
authors.affiliation: Department of Public Health and Wellbeing, Northumbria University, Newcastle Upon Tyne, UK Fuse (The Centre for Translational Research in Public Health), Newcastle University, Newcastle Upon Tyne, UK Federation University, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Carr
mesh_terms: D006297:Health Services Accessibility / Q000458:organization & administration*; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D015233:Models, Statistical; D010344:Patient Advocacy; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D012946:Social Welfare; D006113:United Kingdom
keywords: PUBLIC HEALTH; citizens advice services; realist evaluation; social determinants of health; welfare benefits