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Table 1 Outcome, context and mechanism components obtained from the thematic analysis of the document review and in-depth interviews with programme managers and designers. Source: Mukumbang et al. [44]

From: A realist approach to eliciting the initial programme theory of the antiretroviral treatment adherence club intervention in the Western Cape Province, South Africa

Context Mechanisms Outcomes
Distal (Macro) Context Provider/Management Level Long-term Outcomes
- Monitoring and evaluation - Buy-in - Programme standardisation
- Higher level support - Interaction (perceived social support) - Retention in care and adherence to medication
- Stakeholder collaboration - Motivation - Healthier communities
Organisational (Meso) Context Social mechanisms Intermediate Outcomes
- Sustained hierarchical pressure - Group dynamics - Social/Peer support - Decongestion of clinic
- Human resources (staffing dynamics) - Mutual learning (empowerment) - Improved patient self-management
- Implementation methodology - Bonding (sense of belonging)  
Local (Micro) Context Patient (individual)-Level Immediate Outcomes
- Availability of conducive space - Encouragement - Decreased workload for operational staff
- Programme champions - Trust - Decreased patient opportunity cost
- Oppressive surveillance - Nudging  
  - Fear  
  - Motivation