Process evaluation of a complex group-based intervention for older adults living alone

Figures & data

Figure 1. Overview of the participatory group-based care management.

Table 1. Use of paradigm model components in this study (applying Creamer, 2018; Strauss & Corbin, 1998).

Terms of paradigm model	Definitions (in this study)	Practical clarifications
Phenomenon = a problem, an issue, an event, or a happening under investigation	The ability of the intervention to generate desired outcomes (effectiveness)	The core result of the study based on the analysis of the qualitative data described above
Causal conditions = sets of events or happenings that influence the phenomenon	Carrying out and the content of the intervention (what was done) Clients’ condition (wellbeing and needs)	Existing understanding based on reflective diaries and surveys related to RCT
Strategies = purposeful or deliberate acts to resolve a problem	Elements of the intervention that influence outcomes	Using qualitative data
Contextual and intervening conditions = shaping, facilitating, or constraining the strategies that take place within a specific context	Individual and environmental conditions or factors that moderate the outcomes of the intervention	Using qualitative data
Consequences = outcomes of actions or interactions, result from the strategies	Outcomes of the intervention	Focusing on qualitative data, but also reflecting the outcomes based on RCT

Table 2. The main categories and sub-categories according to the paradigm model components.

CAUSAL CONDITIONS	STRATEGIES: Important elements of the intervention	CONSEQUENCES: Proximal outcomes	CONSEQUENCES: Intermediate outcomes
(Existing understanding) − Wellbeing and needs of the participants − Aims, carrying out as well as content of the intervention	Social support exchange − Social contacts − Reciprocal peer support − Discussions Need-based counseling − Shared knowledge and information − Individual counseling Scheduled group meetings − Awaited events − Going outside the home for meetings	Strengthened social wellbeing − Continuity of social contacts − Sense of togetherness Enhanced resources and awareness − Increased awareness of services, activities etc. − Continuity of services and support − Motivation and new perspectives Experiences of meaningfulness − Variation in daily routines − Positive experiences and feelings − Sharing knowledge with those in need outside the group	Changes in routines and participation − More active to leave home and participate in events − New hobbies and activities − Some changes in health-related behavior Empowerment − Feeling invigorated and strengthened − Increased understanding of one’s own life situation − Providing for and trusting in the future
	CONTEXTUAL AND INTERVENING CONDITIONS: Moderating factors and conditions
	Intervention context	Characteristics of the participants	Competence of group tutors
	− Planning and accessibility	− Background and sociodemographic factors	− Group tutoring skills
	− Group structure and scheduling	− Functional ability and situation in life	− Situational flexibility
	− Environment, place, and atmosphere	− Individual needs and personalities

Figure 2. The possible causal pathways from preceding factors to intermediate outcomes.

Creamer, E. (2018). Enlarging the conceptualization of mixed method approaches to grounded theory with intervention research. American Behavioral Scientist, 62(7), 919–934. https://doi.org/10.1177/0002764218772642

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Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Grounded theory procedures and techniques. Sage publications.

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