Table 4 Meta-narratives on case study, context and complex intervention identified in the empirical literature
Meta-narrative #1: Case studies develop and test complex interventions [40,41,42,43,44,45,46,47,48,49] | Meta-narrative #2: Case studies analyse change in organisations [50,51,52,53,54] | Meta-narrative #3: Case studies are appropriate for conducting realist evaluation [55,56,57,58,59,60] | Meta-narrative #4: Case studies enable naturalistic study of complex change [61,62,63,64,65] | |
|---|---|---|---|---|
Epistemological assumptions | Positivist | Positivist or critical realist | Social realist (realist evaluation) | Interpretivist, critical realist |
Case study approach | Procedural – case study as enabling testing of complex interventions in ‘real life’ contexts | Recursive - in-depth study in which theory and data are mutually reinforcing | Structured - interrogating how mechanisms triggered in specific contexts lead to particular outcomes | Iterative - naturalistic, emergent, reflexive, and using theory-building to surface complexity |
Data collection methods | Main phase predominantly quantitative. Qualitative methods used to develop the intervention and provide triangulation | Purposive collection of qualitative and quantitative data to build and test theory | Semi-structured interviews to surface theories of change to guide collection and analysis of qualitative and quantitative data to explore these | Predominantly qualitative, with strong anthropological emphasis (e.g. ethnography) and high degree of researcher reflexivity |
Approach to theorisation | Seeking to identify contextual factors that affect intervention outcomes, and measure their contribution | Developing and extending middle-range or programme theory about the forces that drive change in organisations. | Developing middle-range or programme theory, perhaps expressed as context-mechanism-outcome (CMO) relationships | Rich description of the case is foregrounded with use of substantive theory to inform and extend analysis |
How complexity is articulated | Mechanistically, as multiple mediators and moderators of the effect of the intervention | Dynamically: the system is seen as evolving over time | Generatively, as an intervention triggers different mechanisms in different contexts | Narratively, as the non-linear unfolding of events and actions, including adaptation to change |
How context is conceptualised | Characteristics of the implementation setting or human factors impacting the intervention | Dynamic organisational, policy or human backdrop, changing over time as the intervention is implemented | Set of circumstances where particular mechanisms are triggered to produce particular outcomes | Emergent and co-shaped through relationships and wider social influences on implementation practices |
Analytic approach | Primarily deductive, applying frameworks to aggregate data from multiple sources | Comparative logic of analysis; sometimes informed by a priori themes from earlier phases of case study | Retroductive logic, centred around context-mechanism-outcome formations | Iterative, involving reflexivity, interpretation, multiple kinds of data synthesis and (sometimes) dialogue with theory |
Basis for transferability | Theoretical replication | Primarily interest is in the case/s, may develop middle-range theory | Identification of (generative) causal relationships: demi-regularities | Naturalistic or theoretical generalisation |
Outputs style | Typically, a structured academic paper, including a diagrammatic model of links between intervention and outcome | Varied, but often narratively as a long and discursive report. Some are more structured, offering a series of hypotheses that have been tested | Methodological narrative which sets out how different configurations of context and mechanism were systematically tested and confirmed or rejected | Rich case narrative which highlights the unique detail of the case and may use literary devices (e.g. metaphor, surprise) to create a compelling story |