Mechanisms Activated in the Interaction between Peer Supporters and Peers: How do the Peer Supporters Perceive and Perform Their Role in an Intervention Targeted Socially Vulnerable People with Type 2 Diabetes: A Realist-Informed Evaluation

Table 1

Definition of relevant ICAMO terms in realist methodology.

Category		Definition	Applied in the study
Intervention		“A combination of program elements or strategies designed to produce behaviour changes or improve health status among individuals or a group” [17]	In this study, the intervention was the biweekly peer-to-peer meetings
Context		“An irreducible set of factors influencing when and how an intervention is delivered and how mechanisms are triggered” [22]	We investigated how individual contextual factors influenced peer supporters’ perception of and performance in the intervention
	Individual contextual factors	Pawson categorises context into four layers (individual, interpersonal, institutional and infrastructure). The individual layer includes the actors of the programme’s sociodemographic characteristics, capacities, and life circumstances [24]
Actors		“Individuals, groups, and institutions who play a role in the implementation and outcomes of an intervention” [17]	In this study, the actors were peer supporters and peers
Mechanism		A mechanism is defined as “a combination of resources offered by the social programme under study and stakeholders”	We investigated how peer supporters perceived and performed in the intervention (resource) and how this resulted in changes (reasonings) in the encounter with peers
		“Reasoning in response” [22]. Thus, resources and reasoning are mutually constitutive of a mechanism, but to help operationalise the difference between a mechanism and a context Dalkin et al., recommend disaggregating them as separate concepts [25]
	Resources	The resource that an intervention provides
	Reasoning	The actors’ reasoning and response to the resources [25]
Outcomes		Outcomes of a programme can take many forms, be intended and unintended, as well as they can be multiple and vary across the target group(s) depending on the mechanisms and context [16]	Inspired by Mukumbang et al.[23], we used the terms “immediate outcome” and “intermediate outcome” to disaggregate between changes in awareness and behavioural changes among peers
	Immediate outcomes:	Refers to changes in awareness, skills, or understanding. These types of changes usually come before behavioural changes [17]
	Intermediate outcomes:	Refers to behavioural changes that follow the immediate outcomes [17]