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Table 1 Initial Context-Mechanism-Outcome-Configurations (CMOC)s that were developed through the first round of interviews and focus group

From: “You can kind of just feel the power behind what someone's saying”: a participatory-realist evaluation of peer support for young people coping with complex mental health and substance use challenges

CMOC 1

C (Peer supporters share similar experiences and recovery journeys with clients) + M (Peers demonstrate positive identity and wellness while moving forward in recovery & clients develop a more positive evaluation of shared social reference group) ➔ O (Clients experience enhanced positive identity, decreased self-stigma and enhanced wellbeing)

CMOC 2

C (Peer supporters organize social events) + M (Opportunities to participate in social activities & clients build their sense of social connections) ➔ O (Reduced social isolation)

CMOC 3

C (Peers bring lived experience and practical knowledge with respect to successful coping / overcoming challenges) + M (Peers offer guidance based on their lived experience in addition to other mental health supports clients are receiving & clients recognize the value of peer advice and apply strategies) ➔ O (Clients’ experience success in applying strategies and increased self-efficacy / self-determination)

  1. CMOCs are hypotheses designed to test theoretical assumptions regarding how a program works. “Context” is used to represent the necessary conditions that are implicated in supporting the functioning of the program. “Mechanism” relates to the underlying processes that function to generate program outcomes. Often, these involve participant interpretation and response to program offerings. “Outcome” represents the program impacts that result from the proposed context-mechanism interaction
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BMC Health Services Research

ISSN: 1472-6963

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