A practical example of Contribution Analysis to a public health intervention

The theory of Contribution Analysis (CA) as a method of evaluating complex programs has been written about extensively and has evolved considerably since it was first introduced by John Mayne in 1999. We applied Mayne’s six steps to CA and Lemire et al.’s newly proposed framework, the Relevant Explanation Finder (REF), to a state-wide public health intervention delivered in New South Wales, Australia. We argue that CA in conjunction with the REF adds value in improving practitioners’ understanding of the assumptions and underlying mechanisms which influence program delivery and outcomes in real world practice. This participatory process increased practitioners’ ownership and accountability for the program logic and drive for improvement. Although the REF has several methodological benefits we argue that the framework needs to be sufficiently flexible to account for different levels of available evidence and stages of program delivery.