Getting better community engagement and participation of adults with learning disabilities: Realist synthesis, evaluation and co-production (CONNECT)

Research question: What are the contextual factors that impact on the implementation and delivery of social participation for people with learning disabilities?

Background: People with learning disabilities can be at risk of social isolation. Whilst interventions aimed at increasing community and social participation exist, community and social participation is often poorly defined and it is unclear what works for whom and in what contexts.

Aims and objectives: To use realist review and evaluation to develop a co-produced framework and guidance on how to implement and evaluate social and community participation interventions for people with learning disabilities.

Methods: Realist synthesis combining primary and secondary data is ideally suited to understand what is likely to be effective in different circumstances in the “real” world. In CONNECT, realist synthesis will be used to understand and explain how, why, for whom, and in what contexts community and social participation interventions can be used with people with learning disabilities.

Context, mechanism and outcome configurations will be developed to explain how the context (situations around a person) affect mechanisms that cause outcomes. Alongside a project start-up (months 1-3), we will conduct a realist review. Realist review (months 0-12):

- Clarifying scope and developing search strategy (months 1-3): An initial (candidate) programme theory, which sets out how and why outcomes occur within an intervention, will be developed. The initial theory will be refined using academic and grey literature. Stakeholder Groups (including people with learning disabilities, paid and family carers, managers and staff in local community groups, and health and social care professions) will provide feedback and advice.

Searching for relevant documents will continue until sufficient data is found to conclude that the refined programme theory is coherent and plausible. - Selection, appraisal (months 4-8): Documents will be screened against inclusion and exclusion criteria.

- Data Extraction and Analysis (months 9-13): Text extracted from these documents will be coded as contexts, mechanisms and their relationships to outcomes in NVivo. Realist Evaluation (months 10-24):

Realist interviews will take place with up to 80 stakeholders. Data analysis will use a realist logic to develop the programme theory using both the secondary and primary data. Co-production and Dissemination of Guidance (months 20-33):

The analysis will aim to identify what is needed to change contexts so that key mechanisms are triggered to produce desired outcomes. Guidance around implementation and evaluation will be co-produced. The Expert-by-Experience and Stakeholder Groups will provide feedback on the veracity of the findings and the feasibility of the strategies.

Anticipated impact and dissemination: Co-producing how to implement and evaluate social and community participation interventions for people with learning disabilities is an essential first step in development of social and community participation interventions. An integrated approach to dissemination based on NIHR Guidance will be followed. Dissemination will be integral throughout, underpinned by partnerships with key stakeholders.

Formats including academic papers, conferences, social media, newsletters and press releases will reach a diverse audience. Co-produced guidance will include animations/infographics in order to meet these diverse needs.