A protocol for a realist review of the acceptability and implementation of health checks for people with an intellectual disability and for autistic people

Background Autistic people and/or people with an intellectual disability are more likely to experience health conditions and premature mortality. Regular health checks and assessments are known to be useful for some people with an intellectual disability, but provision is not universal, uptake is lower than expected in some areas, with variable outcomes. Evidence for the effectiveness of health checks for autistic people has been gathered. It is important to understand how the NHS can increase health check provision, uptake, quality, and consistency, and how they should be implemented. Further evidence about how and in what ways health checks work for autistic people and people with an intellectual disability is needed. Health professionals and other stakeholders need to understand how to improve health check provision, uptake, and receipt by making them more accessible. This paper outlines a realist review protocol to explore the variable impacts and implementation challenges of health checks for autistic people and people with an intellectual disability. Methods This six-staged realist review will include health checks and assessments for people with an intellectual disability and/or autistic people. The review will address what works, how, why, for whom and under what circumstances. The objective is to identify context-sensitive barriers, solutions and their associated outcomes. This will inform the development of an initial programme theory explaining how and why health checks are effective for people with an intellectual disability and autistic people. Discussion The programme theories refined and developed through the review will inform subsequent stages of a broader study. A realist evaluation will follow to further develop and test these theories with stakeholder collaboration. The resulting programme theory will then be used to develop practical guidance for policymakers and healthcare staff on how to deliver more impactful health checks across diverse contexts. PROSPERO registration CRD420251041197