Notes on Craft: Building an Initial Programme Theory (IPT)

July 2026

By the time a realist project (review or evaluation) starts, often a lot of thinking has already gone into it. The questions are (or should be) suitably realist, a pilot or scoping review may have already taken place, and informal conversations have all likely informed the project rationale. This is all useful for building the project’s initial programme theory (IPT)* but the trouble can sometimes be that all of this thinking sits within one person’s head, often the Principal Investigator. Sharing that with a research fellow and other members of the team who (1) may be new to each other/ you; and (2) may be new to realist approaches can make the task feel challenging. Avoiding information overload at this stage is a top priority.

In one of our first methodological meetings, I shared a template with Alankrita which is one I regularly work off when building an IPT. Sometimes I publish these on open science frameworks, other times not- it depends how confident I feel in them at the time. Always though they find their way into the final supplementary material of any project, in their original form. For this current project, we are trying to map how staff can be supported to communicate and act on genomic testing information, and for whom and in what circumstances this currently works. When Alankrita joined the project in November, we needed to swiftly map out our assumptions and were able to work off our funded research protocol to help us.

Here is a list of what helped us to collaboratively develop the project's IPT:

1. Keep in mind the research questions. This sounds obvious but it is amazing how you can start developing your IPT without these in mind. You are not here to research everything on the topic- just your key questions.

2. Develop the IPT using If-Then-Because statements because it can make them more easily testable against the evidence base, down the line.

3. The intervention ideally always sits outside of your If-Then-Because statement/configuration. However, this can be challenging when the interventions are heterogenous, in which case, you might need to add some detail into the ‘context’ part of your statements.

4. Aim to reduce (and ideally avoid) the same term or construct appearing as a mechanism in one If-Then-Because statement and as a context (or indeed outcome) in another. Consider whether different terminology or tweaking of language can make the distinction explicit. This can help to minimise confusion down the line during the refinement process. It’s ok if you are proved wrong later on, that’s why you’re doing the research, but for now cut the cake and move forwards.

5. IPT outcomes should be reviewed against those specified in the original research protocol/ proposal to ensure alignment, but be open to change, as a result of the evidence.

6. When IPT statements feel unclear, prioritise what you think the outcomes are first, then revisit mechanisms. It’s ok to make incomplete statements where one of the context, mechanism or outcome may be missing or not known at this stage.

7. Fine‑grained discrimination between similar If-Then-Because statements can be deferred until engagement with the evidence clarifies which configurations are most robust.

8. Test the If-Then-Because statements with PPI and stakeholders. Then chart any refinements made.

9. The IPT should remain open and flexible at this stage, with refinement driven iteratively by evidence rather than premature conceptual fixing.

Alankrita’s reflections

While some lessons felt intuitive, such as keeping sight of the research questions and working backwards from outcomes to build an If–Then–Because explanation, others only made sense through practice. Ideas like outcomes and mechanisms (and indeed contexts!) as distinct constructs can feel less tangible in the moment, but its importance becomes clearer during coding, analysis, theory refinement and the presentation of emerging theories to stakeholders. Using the right language to articulate contexts, mechanisms and outcomes can help maintain a clearer distinction between them, reducing the risk of confusion and making realist theories more accessible to different audiences.

One useful resource: Argüelles Bullón et al (2026) Bringing Together Linked Coding and Realist Thematic Analysis: A Worked Example for Initial [Programme] Theory Development. International Journal of Qualitative Methods.

If citing this, please do so as: Abrams, R and Singh A. (2026) Notes on Craft: Building an Initial Programme Theory (IPT) July 2026. Available: https://rabrams0.wixsite.com/realistworkforce-sig/blog

*The purpose here is not to define what this is because if you are already doing realist work, hopefully you already know what this is.