Exploring the experiences of people living with dementia in Dementia Friendly Communities in Northern Ireland: a realist evaluation

Background:<br/><br/>The main elements of a DFC are related to people; communities; organisations and partnerships. There are over 200 organisations recognised as dementia-friendly in Northern Ireland (NI). This realist evaluation was to understand how geographical DFCs work for people living with dementia, how positive outcomes are achieved, for whom and in what contexts do DFCs work best.<br/><br/>Methods:<br/><br/>The underpinning theoretical lens that was used in this study is realist evaluation. This theory-driven methodology supports researchers in evaluating social programmes, such as DFCs. Realist evaluation, as opposed to a traditional cause-effect, non-contextual style of research, suits the complex social intervention of DFCs as an alternate lens to traditional empirical evaluation techniques, as this perspective seeks to determine what works, for whom, in what circumstances and to what degree. A qualitative approach following 4 stages involving a realist review, non-participant observation, semi-structured interviews and focus groups was utilised.<br/><br/>Results:<br/><br/>The programme theory comprised interconnected context-mechanism-outcome configurations: 1) organisational commitment from existing businesses and organisations, 2) access to educational resources, which have been co-designed with people living with dementia and 3) the geographical/ environmental requirements required to support people living with dementia.<br/><br/>Conclusion:<br/><br/>Mechanisms perceived by participants in this study support an existing theory as proposed in the framework developed in stage 1 of this study. This research provides important pieces of the explanatory jigsaw that will help us understand how geographical DFCs work for people living with dementia, for whom and in what contexts do geographical DFCs work best.