Table 1

Definition of Terms

Context (C)Aspects of the background of the intervention (eg, characteristics of the people involved in the intervention, the environment in which the intervention occurs, the social and political context, etc)
Mechanism (M)The generative, causal force influencing the effect of program resources on participants’ reasoning, attitudes, and behaviors (sensitive to variation in context)
Outcome (O)Effect of the intervention, dependent on the interactions between the context and mechanism
CMO configurationRelation between context, mechanisms, and outcomes that is a form of realist causal explanation
Initial program theoryA preliminary exploration of the theory on how the intervention works
DemiregularitySemipredictable patterns that could emerge from CMO configurations that appear repeatedly, or the interpretation of which is strongly supported by theory
Program theoryAn empirically testable proposition that lies in an intermediate position relative to generalizable grand theories of social systems on one end and detailed descriptions of situational microphenomena on the other
Case managerHealth care professional who provides the intervention. Can also refer to the CM team
Frequent userIndividuals/patients who frequently use health care services. Can also include their family and caregivers
Health care clinicianHealth care professionals involved in the case management intervention (eg, emergency department staff, family physician, etc)
Self-management supportActivities the purpose of which is to help patients and their families play a greater role in the management of their health
  • CM = case management; CMO = context + mechanism = outcome.