title: Steps towards incorporating heterogeneities into program theory: A case study of a data-driven approach.
abstract: This paper describes a framework that can help refine program theory through data explorations and stakeholder dialogue. The framework incorporates the following steps: a recognition that program implementation might need to be multi-phased for a number of interventions, the need to take stock of program theory, the application of pattern recognition methods to help identify heterogeneous program mechanisms, and stakeholder dialogue to refine the program. As part of the data exploration, a method known as developmental trajectories is implemented to learn about heterogeneous trajectories of outcomes in longitudinal evaluations. This method identifies trajectory clusters and also can estimate different treatment impacts for the various groups. The framework is highlighted with data collected in an evaluation of an alcohol risk-reduction program delivered in a college fraternity setting. The framework discussed in the paper is informed by a realist focus on "what works for whom under what contexts." The utility of the framework in contributing to a dialogue on heterogeneous mechanism and subsequent implementation is described. The connection of the ideas in paper to a 'learning through principled discovery' approach is also described.
authors.affiliation: The Evaluation Centre for Complex Health Interventions, St. Michael's Hospital and University of Toronto. Electronic address: sanjeevsridharan@msn.com.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sridharan
authors.affiliation: University of Pittsburgh School of Medicine.
authors.forename: Bobby
authors.initials: B
authors.lastname: Jones
authors.affiliation: Independent Consultant.
authors.forename: Barry
authors.initials: B
authors.lastname: Caudill
authors.affiliation: The Evaluation Centre for Complex Health Interventions, St. Michael's Hospital.
authors.forename: April
authors.initials: A
authors.lastname: Nakaima
mesh_terms: D000437:Alcoholism / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D019982:Organizational Case Studies; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods; D040242:Risk Reduction Behavior; D057170:Translational Research, Biomedical; D014495:Universities; D055815:Young Adult