Methodological innovations across realist methods and behavioural science.

Realist methods generate context-sensitive programme theories that explain how, why and for whom complex health interventions work — but these theories often lack structured operationalisation to inform comparison or intervention design. Behavioural science systematically identifies and modifies behaviour change mechanisms using theory-driven frameworks, but has been criticised for insufficiently considering context. My work brings the two together: using behaviour change techniques and mechanisms of action to clarify mechanisms, and behavioural settings to explicate context, I have proposed a five-step framework for integration that gives programme theories a common language — making them more structured, testable and transferable, and better able to support intervention design and policy translation.

I have also applied this behavioural lens empirically, systematically coding 44 interventions to reduce unprofessional behaviour between healthcare staff against the 284-technique Behaviour Change Technique Ontology — demonstrating that the ontology is broadly applicable to organisational behaviour change in healthcare, and showing that complex interventions rely on consequence-based and goal-oriented techniques.

A second strand tackles speed. Policymakers and regulators often need rigorous evidence within timeframes academics consider unworkable. The Accelerated Parallelised Realist-Informed Literature review (APRIL) is a nine-step method I developed for delivering a realist review in under one month, originally for the Care Quality Commission. It achieves its rapidity through parallelised review processes, highly purposive but still systematic searching, and theory-informed data extraction. Its first application — a four-week review of adult community mental health services in England spanning 81 sources — produced an initial programme theory of how a system under stress can generate conditions that undermine good practice, increasing risk and ultimately harm.

This methodological work is gaining recognition: I have been invited to guest-edit a special collection, "Advances in Qualitative and Mixed Methods Methodology for Realist Evaluation and Synthesis", at the International Journal of Qualitative Methods, and to record a podcast for 'Realist Lens' coming later in 2026.