Definitions of context, mechanism and outcome (CMO)
| Context | Context describes the conditions and circumstances that trigger mechanisms. Context can refer to an individual’s characteristics and capacities, the properties of a programme, interpersonal relations, institutional rules and norms as well as the wider social, economic and cultural setting. In realist reviews, context cannot be understood independently of a mechanism; it is the specific condition that triggers or modifies a particular mechanism which then generates the outcome of interest. |
| Mechanism | Mechanisms are the ‘agents of action’ in a programme. They are not necessarily identical with the mechanisms hypothesised in the official programme theory. A central tenet in realism that underpins realist reviews is that it is not the programme itself or its ingredients that generate outcome but an individual’s reaction to it. A programme offers resources or other opportunities and how these are taken up depends on a stakeholder’s choices (reasoning) and their capacity to put these choices into practice. A further tenet is that mechanisms are context sensitive, which means, they only get activated in certain contexts. Based on these assumptions, mechanisms in this review are understood to describe how the resources or other opportunities provided by a workplace MBP impact an employee’s reasoning and behaviour from which various outcomes will then follow. |
| Outcome | The impact or behaviours resulting from the interaction between mechanisms and contexts. Realist review is not so much interested in the degree to which a programme achieves its effects but rather seeks to explain outcome patterns (ie, how different outcomes are produced in different contexts.) |
| Context-mechanism-outcome configuration | In realism, causation is described in form of CMO configurations where particular features of context (C) activate spcific mechanisms (M) that generate certain outcomes (O). |