Search

In rich-economy countries such as the United States, Canada, Australia and New Zealand women are increasingly experiencing first-time homelessness in older age. Focusing on the specific case of Australia, this article develops a theoretical critical realist causal account of how a gendered role in care and social reproduction has increased contemporary homelessness risk by constraining women's capacity to build financial security. We show how gender, capitalism and age have intersected as social structures to explain gendered economic outcomes for women over the life course; and how life events, individual women's experiences, agency, and decision-making interact with these structures to explain homelessness. Women's gendered financial vulnerability, accumulated whilst living conventional lives, sits at the heart of older women's susceptibility to housing loss. Limited resources reduce their capacity to respond to crises challenging their housing security within the contemporary context of Australia's unaffordable housing market. [ABSTRACT FROM AUTHOR]

Despite years of policy attention and increasing intervention, the numbers of young people experiencing homelessness in Australia continue to increase. Previous meta-theoretical approaches to understanding homelessness amongst young people are largely unable to explain the conditions which enable young people to exit homelessness and maintain stable housing. We put forward Critical Realism as a way of overcoming the limitations of the main approaches which have been used to date: Empiricism, Interpretivism, and Interactionism/Epidemiology. The meta-theoretical assumptions made by Critical Realism can allow researchers to more robustly explain what enables young people to exit homelessness and maintain stable housing by identifying what it is about the structures and mechanisms, or the absence of these structures and mechanisms, which leads to this outcome. By using a Critical Realist approach, we hope to be able to contribute to more robust explanations of how young people exit homelessness and maintain housing. [ABSTRACT FROM AUTHOR]

Families experiencing homelessness are an increasing phenomenon in Australia. However, the question of why some families living in poverty and disadvantage become homeless and others do not is not well explained in the literature. Using fuzzy-set Qualitative Comparative Analysis (fsQCA), this paper investigates how recent "shock" or crisis events, poor health and financial stress interact with social capital and emotional well-being to affect housing security for Indigenous and non-Indigenous Australian families living in poverty. The analysis draws on 307 cases (individuals with dependent and resident children) from Journeys Home, a longitudinal survey of extremely disadvantaged Australian welfare recipients. The results are explained within a critical realist understanding of depth ontology, stratification, emergence and the interaction between structure and agency. Hobfoll's conservation of resources theory provides a framework for thinking about homelessness as a severe form of poverty and resource depletion. [ABSTRACT FROM AUTHOR]

This article provides a rationale for adopting the critical realism (CR) instead of pragmatism paradigm when researching skilled migrants' (SMs) workplace integration in Australia. While the extant SM literature has provided an abundance of 'explanations' reflecting the difficulties SMs face, it appears almost impossible for SMs to overcome some challenges such as discrimination or lack of local work experience. However, there is not a sufficient explanation for why many SMs have successfully integrated within the host labour market despite facing such difficulties. This study was designed to challenge what may have been 'taken-for-granted' in the literature and explore the causal relationship behind the SMs' difficulties and success. The CR paradigm provides a new way to examine the problems SMs face and their strategies to overcome such issues. It also empowers researchers to look beyond the empirical layer of evidence and explore how and why things happen the way they do. [ABSTRACT FROM AUTHOR]

As doctoral students from New Zealand and Australia, advised by supervision teams with a diversity of critical realist experience from limited to none, we came independently to the 2018 Critical Realism conference – primed to seek increased understanding, confidence, motivation, and reassurance. We certainly found these things from the pre-conference, presentations, and individuals within the critical realist community. We also found each other, and a virtual writing group was born. This article is a description of what we did, why, and the outcomes we experienced over the final two years completing our theses. It identifies the structures, contexts, motivations, and mechanisms from which our emotional, critical realist and writing-related outcomes emerged. We outline the roles of serendipitous timing, culture, different disciplinary approaches, administrative structures, and types of interactions on the social learning we developed. We anchor our discussion in recent theoretical literature about the role of writing groups in doctoral education. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this viewpoint article is to consider the #BlackLivesMatter movement within the Aboriginal Australian struggle for equality, sovereignty and human rights. Indigenous sovereignty has been threatened throughout Australia's history of colonization. We provide a viewpoint and recommendations for social policy education and practice. Design/methodology/approach: We provide commentary and interpretation based upon the lived experience of Black, Indigenous and Other People of Color (BIPOC) co-authors, co-authors who are Allies, extant literature and practice wisdom as social policy educators. Findings: Universities are sources of knowledge production, transmission and consumption within society. We provide critical recommendations for what social policy education within universities can address human rights and the #BlackLivesMatter movement. Originality/value: Culturally responsive inclusion for BIPOC has only just begun in Australia and globally within the context of the #BlackLivesMatter movement. This paper adds critical conversation and recommendations for what social policy programs might do better to achieve universities' teaching and learning missions. [ABSTRACT FROM AUTHOR]

This article describes and evaluates the application of an explicitly critical realist methodology to a quantitative doctoral research project on the causes of family homelessness in Australia. It is offered as an example of a critical realist approach to empirical research, in the hope that it will provide ideas and motivation to other scholars seeking a critical realist foundation to their research practice. The paper demonstrates the role of critical realism in informing and defining the analytical and theoretical approach I took. It shows how the philosophy influenced the foundations and practical development of my work. It describes the process of moving from empirical data to theoretical models by stepping through and describing each stage. Finally, I offer an assessment of how critical realism changed, enabled, improved, and liberated my project; that is, what advantage critical realism offered to explaining a complex social phenomenon and crisis in contemporary Australia. [ABSTRACT FROM AUTHOR]

This paper is intended to provide a source of critical and theoretical reflection on the current mathematics educational objectives for Indigenous students in Australia, which are premised on acceptance of underlying concepts of 'equity'. It is not the intention of this paper to identify 'how' Indigenous knowledge can be positioned within mathematics curricula, as this would entail a philosophical inquiry much deeper than has been afforded thus far. The intent here is a consideration, facilitated through the lens of key concepts of Foucault, of some of the boundaries currently shaping the ways in which this positioning is being influenced in the mathematics, albeit neoliberal education context. Acknowledging the interplay between the social, and unconsciously shaped adoptions of what can be considered truth; knowledge; and therefore power, is a first step toward developing the openness of heart and mind needed to make real and transformative changes to education for future societies. [ABSTRACT FROM AUTHOR]

Background: In Australia, ethnic Chinese people are one of the largest, youngest and fastest growing overseas-born groups. Yet, little is known about their perceptions of contraceptive methods and their experiences with choosing one. Decisions about contraceptive methods are preference sensitive. Understanding the influencing factors of Chinese migrant women's contraceptive method choice and practices will help cater to their decision-making needs in a culturally sensitive and responsive way.Methods: A qualitative study design underpinned by critical realism approach was used to explore Chinese migrant women's perceptions and experiences of choosing contraceptive methods. Semi-structured interviews were conducted with 22 women who self-identified as being ethnically Chinese and had been living in Australia for no more than 10 years. The interview guide was adapted from the Ottawa Decision Support Framework. Majority of the interviews were conducted in Mandarin Chinese. Transcribed data was analysed using thematic analysis method.Results: Four major themes were identified, including: 'every medicine is part poison: hormonal contraceptives cause harm to the body'; 'intrauterine device, a device used in the past for married women'; 'it takes two (or one) to decide, depending on the relationship dynamics and contraception preferences'; and 'it is not necessary to seek medical advice in choosing contraceptive methods'.Conclusions: Our findings suggest that Chinese migrant women's perceptions and experiences of choosing contraceptive methods are influenced by complex personal, cultural, societal and inter-relational factors. Chinese migrant women were cautious of using hormonal methods due to fears of side-effects, including reduced or absent menstrual bleeding. Women were also reluctant to consider intrauterine devices as options due to associating them with past experiences of other women and themselves and also fears of potential complications. There was a reluctant attitude towards seeking medical advice regarding contraception due to beliefs that needing to use contraception is not an illness requiring treatment. Such findings are likely to be useful in increasing healthcare professionals' and policy makers' understanding of Chinese migrant women's contraceptive method preferences, beliefs and behaviours. They also help to develop culturally and linguistically sensitive strategies, which goes beyond the provision of contraceptive counselling, in assisting Chinese migrant women's decision-making needs. [ABSTRACT FROM AUTHOR]

The primary purpose of this paper is to illustrate how a critical realist approach can add to our understanding of professional recognition of educators in a pre-school setting. Recognition is a function of personal achievement and social arrangement, and is understood through examining those subjective conditions and objective structures as observed in the field of practice or as articulated by the actors involved. Through in-depth interviews, we provoked early childhood educators to deliberate on their lived experiences of professional recognition vis-à-vis policy expectations and institutional practices. In doing so, we identified interactive forces that influence professional recognition in a pre-school context. We argue that a stratified view of reality and epistemic relativism espoused by critical realists offers valuable theoretical insights for exploring teacher professional recognition. Finally, drawing on our empirical data and latest literature, we outline four points of reflection regarding the analytical advantages of critical realism. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to advance a critical realist perspective on performativity and use it to examine how novel conceptions of corporate social responsibility (CSR) have performative effects. Design/methodology/approach: To illustrate how the authors' critical realist understanding of performativity can play out, the authors offer a field study of an Australian packaging company and engage in retroductive and retrodictive theorising. Findings: In contrast to most prior accounting research, the authors advance a structuralist understanding of performativity that pays more systematic attention to the causal relationships that underpin performative tendencies. The authors explain how such tendencies are conditioned by pre-existing, social structures, conceptualised in terms of multiple, intersecting norm circles. The authors illustrate their argument empirically by showing how specific conceptions of CSR, centred on the notion of "shared value", were cemented by the interplay between the causal powers embedded in such norm circles and how this suppressed alternative conceptions of this phenomenon. Research limitations/implications: The findings draw attention to the structural boundary conditions under which particular conceptions of CSR can be expected to become performative. Greater attention to such boundary conditions, denoting the social structures that reinforce and counteract performative tendencies, is required to further cumulative, yet context-sensitive, theory development on this topic. Originality/value: The paper is the first to adopt a critical realist perspective on performativity in the accounting literature. This perspective strikes a middle path between the highly constructivist ontology, adopted in most accounting research concerned with performativity and realist criticisms of this ontological position for de-emphasising the influence of pre-existing, objective realities on performativity. [ABSTRACT FROM AUTHOR]

Including the perspectives of scientists about the nature and process of science is important for an authentic and nuanced portrayal of science in science education. The small number of studies that have explored scientists’ worldviews about science has thus far generated contradictory findings, with recent studies claiming that scientists simultaneously hold contradictory sophisticated and naïve views. This article reports on an exploratory study that uses the framework of Bhaskar’s critical realism to elicit and separately analyse academic scientists’ ontological and epistemological views about science in semi-structured interviews. When the views of scientists are analysed through the lens of critical realism, it is clear that it is possible to hold a realist ontological commitment about what knowledge is of, simultaneously with a fallibilist epistemological commitment about knowledge itself. The apparent incongruence of scientists’ so-called naïve and sophisticated views about science is resolved when analysed using a critical realist framework. Critical realism offers a simple and coherent framework for science educators that avoids many of the problems of positivism and social constructivism by finding a middle ground between them. The three pillars of critical realism: ontological realism, epistemological fallibilism and judgmental rationality help to make sense of how socially constructed scientific knowledge can be anchored in an independent reality. [ABSTRACT FROM AUTHOR]

Abstract: Despite the significant amount of change experienced by the public sector, there has been relatively limited empirical examination of how change agendas affect public sector employees in Australia. This article presents a comparative analysis of two Australian public sector organisations that implemented the same positive work change agenda, but experienced very different outcomes. Using a critical realist approach, we draw on a mix of qualitative techniques to suggest that textbook notions of ‘successful change’, which are often derived from large private sector expectations, may fail to capture the complex nature of how public sector change initiatives may unfold. In particular, we demonstrate how political, temporal, contextual, and process factors interact to shift change momentum. Illustrative examples are provided throughout and the findings are discussed in terms of their implications for theory building, for change facilitation, and for future research. [ABSTRACT FROM AUTHOR]

Australia is restricted by the academic, social and administrative mechanisms of financialization. Exaggerated critiques about the adequacy of learner-centered approaches to education have been used to support a retrogressive shift from curriculum informed by contemporary educational theories, towards curriculum informed by management theories based on the dehumanizing educational theory of behaviourism. I therefore suggest a return to pre-1987 learning-centered educational theories, which include face-to-face relations, compassion and civility. This call is not new, but it has been largely ignored by powerful agents in society: politicians, and regulatory-body representatives. It is therefore necessary to embark on an alternative approach to agential change. In this case, I appeal not to the powerful agents, but to all of us involved in VET. Since VET subsists on our activities, that is, since we daily reproduce it with our activities, it should be possible for us to withdraw those activities that reproduce the marketized approach to VET. [ABSTRACT FROM AUTHOR]

Findings from recent deaf education intervention programmes with health care professionals emphasise the importance of sociocultural dimensions of medicine, pointing to the need to further investigate health professionals’ current understandings of deafness. Situated within a social constructionist and critical realist framework, we investigated health professionals’ understandings of deafness and experiences of providing health services in Australia to d/Deaf people. Through an inductive thematic analysis of 18 individual interviews with medical or allied health professionals, we identified an overarching theme we labelled hearingness as privileged, whereby professionals accounted for the quality of the health services available to d/Deaf people in Australia. The professionals recognised the services as not good enough and, through relating their efforts to do the best they can, and describing how the situation could always be better, it was evident that the professionals were negotiating a larger health system that disadvantages the needs of d/Deaf people for the needs of people with hearingness. We discuss the implications of working within a system that privileges hearingness. [ABSTRACT FROM PUBLISHER]

Quantitative methods and secondary data informed by critical realism and a feminist standpoint provide a contemporary snapshot of academic gender ratios in Australian universities, along with historical data, for the entire population of interest. The study is set in the context of the well-researched, worldwide gendered nature of higher education and focuses on female academics in teaching due to the teaching-research status divide and systemic changes such as managerialism that bring teaching into the limelight. Findings reveal that women's overall status continues to improve, albeit slowly. For example, parity in the teaching professoriate may not be achieved until 2033. Apparent gains are patchy in that women tend to be confined to 'bad' jobs as casual teachers and males still constitute a large majority of the academic professoriate. Overall, the increasing numbers of women mask segmentation and marginalisation. The pipeline and critical mass theories are useful explanations for this gender imbalance. The main policy recommendation is to create and privilege ongoing, teaching specialist roles. [ABSTRACT FROM AUTHOR]

The authors introduce the special section on the topic of the application of critical realism theory to information systems (IS) research. An overview is presented of the basic concepts of critical realism, such as retroduction, agency, and reflexivity. They explore several articles within the issue, including "Technological Objects, Social Positions, and the Transformational Model of Social Activity," by P. Faulkner and J. Runde, "Methodological Implications of Critical Realism for Mixed-Methods Research," by M. Zachariadis, S. Scott, and M. Barrett, and "Explaining Broadband Adoption in Rural Australia: Modes of Reflexivity and the Morphogenetic Approach," by P. Dobson, P. Jackson, and D. Gengatharen.

Universal fast broadband is currently being implemented by the Australian government. It is the largest single project in Australia's history. Represented as a nation-building exercise by the government and many public and private promoters, it is vilified by others as a massive waste of taxpayers' money. Ultimately the target of successful universal availability will require that metropolitan installations subsidize rural adoption. The take-up of these facilities, particularly in regional and remote areas, constitutes a complex, multi-factorial scenario in which political, personal, and organizational decisions are shaped by physical, cultural, economic, and ideological elements. Critical realism is proposed here as an aid for examining the complex reality of rural adoption for communities and small businesses in the regions. This article highlights the importance of considering individual reflexivity in explaining the adoption decision and potential adoption barriers. [ABSTRACT FROM AUTHOR]

This paper argues that competency-based training in vocational education and training in Australia is one mechanism through which the working class is denied access to powerful knowledge represented by the academic disciplines. The paper presents a modified Bernsteinian analysis to argue that vocational education and training students need access to disciplinary knowledge using Bernstein's argument that abstract, conceptual knowledge is the means societies use to think 'the unthinkable' and 'the not-yet-thought'. I supplement Bernstein's social argument for democratic access to the disciplines with an epistemic argument that draws on the philosophy of critical realism. [ABSTRACT FROM AUTHOR]

To illustrate the potential use of plural research methods, two studies of Australian women's retirement incomes are examined. The first study employed quantitative microsimulation techniques. Its outcomes emphasised low lifetime earnings as a cause of women's lower retirement incomes. The second study used an inductive approach known as grounded theory, and its conclusions emphasised household decision-making processes as a cause of both women's low lifetime earnings and lower retirement incomes. Using Runde's criteria for assessing causal explanations, a comparison is made of the outcomes of the two studies. The conclusion is that, rather than being seen as competing accounts, the outcomes of the two varying research methods can be viewed as complementary. By demonstrating the different insights afforded by contrasting research methods, this paper provides some support for pluralism of research methods within the discipline of economics. [ABSTRACT FROM AUTHOR]

This paper investigates the use and provision of biomedicine among Korean-Australian men on the basis of interview data from all of the eight Korean-speaking doctors practising in the Korean community in Sydney in 1995. From the viewpoint of these general practitioners, an analysis is made of the processes Korean men go through in adjusting to a new country, being involved in constant hard manual work and long working hours, and explores how they make use of all available resources to stay healthy. The Korean men have fully utilized the 'freely' available medical services under government-subsidized Medicare, bearing in mind that health is a capacity to work under the current environment, although illegal migrants restrained themselves from using it until they obtained legal status. Korean-speaking medical practitioners have been able to provide their fellow Koreans with 'culturally appropriate' health care, with the key factor being the absence of a language barrier. The level of patient satisfaction is high, possibly due to the excellent understanding the doctors have of the social aspects of illnesses, although the doctors do not go beyond curative medicine in their practice. However, the increasing number of Korean-speaking doctors in the small Korean community means that there is competition for patients. Consequently, the medical care is highly entrepreneurial. Referral by Korean doctors to practitioners of Korean herbal medicine is also a notable feature of the health care sector of the Korean community, especially as this offers Korean patients 'satisfactory' health relief for problems that are not easily relieved by doctors in the biomedical system. [ABSTRACT FROM AUTHOR]

Many rural communities throughout Australia depend on international medical graduates (IMGs) for the provision of primary health care. To date, however, it is not clear how well they integrate into rural communities or how long they intend to stay in practice there. This study reports the results of in-depth interviews undertaken in 2003 with 57 lMGs practising in rural Victoria with the aim of identifying which factors facilitate or inhibit their integration into rural communities and consequently affect their intention to stay in rural practice. Based on the interview results, four different types of IMGs were identified according to their level of integration into rural communities. They are ‘satellite operators’ (city-oriented), ‘fence-sitters’ (affiliated with city fringe areas), the ‘ambivalent’ (unsure about their future settlement place) and those ‘integrated’ into rural communities. Recognition of such a typology is useful in assisting to better target support and incentives designed to increase IMG rural retention rates towards those doctors most likely to remain in rural practice on completion of their mandatory period. [ABSTRACT FROM AUTHOR]

This paper aims to illustrate the benefits that accrue from critical realism's sustained, explicit reflection about ontological issues. The paper pursues this aim by examining the work of radical subjectivist Austrian economists as it has developed since the post-1974 revival in the fortunes of the Austrian school, focusing in particular on their account of the generation of socio-economic order in decentralized market economies. Ambiguities and tensions can be discerned in the radical subjectivist account of the causal forces at work in the market process. It is argued that the conceptual resources required for resolving those tensions and ambiguities are to be found in critical realism. The final section of the paper draws out some of the broader implications of the suggested resolution for radical subjectivist Austrian economics. [ABSTRACT FROM AUTHOR]

Climatic events express the dynamics of the Earth's oceans and atmosphere, but are profoundly personal and social in their impacts, representation and comprehension. This paper explores how knowledge of the climate has multiple scales and dimensions that intersect in our experience of the climate. The climate is objective and subjective, scientific and cultural, local and global, and personal and political. These divergent dimensions of the climate frame the philosophical and cultural challenges of a dynamic climate. Drawing on research into the adaptation in Australia's Murray Darling Basin, this paper outlines the significance of understanding the cultural dimensions of the changing climate. This paper argues for greater recognition of the ways in which cultures co-create the climate and, therefore, that the climate needs to be recognised as a socio-natural hybrid. Given the climate's hybrid nature, research should aim to integrate our understanding of the social and the natural dimensions of our relationships to a changing climate. [ABSTRACT FROM AUTHOR]

Introduction: We take as our starting point the proposition that antenatal and postnatal maternal stress and depression adversely impact on the developmental origins of health and disease. We cannot yet be certain of the biological level mechanisms that alter the genotypic and phenotypic response to perinatal adversity but the triggering of genetic, neuroendocrine and physiological mechanisms but psychological and nutritional stress are regarded as strong contenders. Little is known, however, of the role played by ecological constructs such as social capital. Theory/Methods: In the study reported here we use multilevel Bayesian hierarchical spatial logistic regression to examine relationships between those ecological latent constructs and depressive symptoms among migrant mothers, while controlling for individual level covariants. Migrant mothers (n=7256) delivering in 2002 and 2003 were assessed at 2-3 weeks after delivery for risk factors for depressive symptoms. The individual-level binary outcome variables were Edinburgh Depression Scale (EDS) >9 and >12. The association between social, demographic and ecological factors and aggregated outcome variables were investigated using exploratory factor analysis and Bayesian methods. Results: Migrant mothers had higher rates of depressive symptoms in communities with higher concentration of mothers born in Australia. The reverse was also true. The exploratory factor analysis identified six latent constructs: neighbourhood adversity, social cohesion, health behaviours, housing quality, social services, and social capital. Migrant mothers were at higher risk of depressive symptoms if they were living in communities with strong group-level social capital. Conclusions: These findings suggest that bonding capital may be a health liability rather than [the] force for health promotion that it is often assumed to be. The finding have implications for the distribution of health services including early nurse home visiting, which has recently been confirmed to be effective in preventing postnatal depression. Lessons Learned: The study reported here was used to design and integrated care initiative in South Western Sydney The paradoxical findings with respect to minority groups and social capital were used to inform intervention design. The methods used here can readily inform critical realist informed intervention designs. Limitations: There were methodological limitations in that the latent variables were developed using frequentist rather than Bayesian methods. Suggestions for future research: Analysis using multilevel spatial latent class analysis will add to our understanding of our population groups are influenced by population level social capital. [ABSTRACT FROM AUTHOR]

Background: Healthy Homes and Neighbourhoods (HHAN) Integrated Care Initiative was established to improve the care of families with complex health and social needs who reside in Sydney Local Health District. HHAN seeks to provide long-term multi-disciplinary care coordination as well as enhance capacity building and promote integrated care. The critical realist study reported here is part of the longitudinal development and evaluation of complex integrated health and social care interventions in Sydney, Australia., Methods: We describe the qualitative component of a critical realist pilot case study aimed at exploring, explaining and refining emerging HHAN programme theories in relation to care coordination. Qualitative interviews were undertaken with HHAN clients (n = 12), staff and other stakeholders (n = 21). Interviews and coding used a context (C), mechanism (M) and outcome (O) framework. Inductive, deductive, retroductive and abductive modes of reasoning were used with the CMO heuristic tool to inform the developing programme theory., Results: The mechanisms underpinning effective engagement of clients by care coordinators included: building trust, leveraging other family, social and organisational relationships, meeting clients on their own terms, demonstrating staff effectiveness as quickly as possible, and client empowerment. Mechanisms for enhancing care integration included knowledge transfer activities and shared learning among collaborators, structural and cultural changes, enhancing mutual respect, co-location of multidisciplinary and/or interagency staff and cultivating faith in positive change among staff., Conclusions: Use of a critical realism case study approach served to elucidate the varied influences of contexts and mechanisms on programme outcomes, to highlight what works for whom and in what context. Findings supported the initial programme theory that engagement and trust building with clients, alongside enhanced collaboration and integration of services, improved outcomes for vulnerable families with complex needs. Further research is needed to explore the cost-effectiveness of integrated care initiatives, in view of the long term nature of service provision and the risk of staff burnout.

Introduction: Inequities in the health and wellbeing of Australian children and families who live in disadvantaged communities are growing despite a range of government initiatives designed to alleviate the impact of disadvantage and social exclusion (1). Increased understanding of the complex and inter-related issues that contribute to poor outcomes for vulnerable disadvantaged families have prompted concern from researchers and service providers about the often fragmented and inefficient service response. This has prompted an increased national policy commitment to community-led, multi-disciplinary, cross-sector integrated service delivery (1). The aim of the study was to use previously described realist causal and program theory to inform collaborative design of initiatives for vulnerable families Theory/Methods: Previously developed realist causal and program theory were used to inform the collaborative design of initiatives for vulnerable families (2). The collaborative design included: identification of outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal. Results: The Design proposed initiatives and service activities that: Are sustainable with an exit strategy or have the scope to be absorbed into the current service budget Build partnerships with the Medicare Local (primary health networks), Local Government, Government and non-Government agencies Provide for capacity building within SLHD services, families and communities, and partner agencies Establish organisational structures and processes that provide options for future growth and organisational change. The Design Elements included: Perinatal coordination, Sustained home visiting, Integrated service model development, two place-based hubs, Health Promotion and strengthened research and analysis capability. Discussion: We have used critical realist meta-theory to assist in the translation of previously reported empirical explanatory theory building to theory driven interventions. Local quantitative and qualitative studies were used together with consultation forums and collaborative design approaches. In applying the realist programme theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners. Conclusions: We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. [ABSTRACT FROM AUTHOR]

Purpose and Setting: The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate 'What is the fit between HIA and public policy?', Methods: Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory 'Policy Cycles and Subsystems' (Howlett et al., 2009) was used to re-analyse the empirical data., Findings: HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy formulation instrument. HIA provides, tactically and technically, a space for practical reasoning to navigate facts, values and processes underlying the substantive and procedural dimensions of policy., Conclusions: Re-analysing empirical experiential data using existing public policy theory provided valuable explanations for future research, policy and practice concerning why and how HIA fits tactically and technically with the world of public policy development. The use of theory and empiricism opens up important possibilities for future research in the search for better explanations of complex practical problems., (Copyright © 2014 Elsevier Ltd. All rights reserved.)