Grant: Catalyst Grant: Patient-Oriented Research

The proposed research is an evaluation of a program, Sanctum 1.5, that offers residential and specialized health care services to pregnant women living with HIV in Saskatoon, SK. For this research, clients of Sanctum 1.5 will be full partners throughout the research process. Other team members include university-based multidisciplinary researchers, Sanctum's executive director and staff, and Sanctum board members. During initial meetings for this project, research questions that clients generated led to the adoption of our methodology: a Realist Evaluation. This approach to evaluation establishes what works (and does not work) in a program, for whom, in what contexts, through identification of the how (mechanisms), and why. The goal of a Realist Evaluation is to develop and refine a program theory that identifies how program activities cause or contribute to outcomes and impacts. Our research aims to determine how and why Sanctum works (or does not work), for which clients, and under what circumstances. Both quantitative data (e.g. hospital admission records) and qualitative data (e.g. interviews with various stakeholders) will be collected to inform outcomes and outline context and mechanisms for theory development. Our analysis will consider the pattern of context, mechanisms, and outcomes that make Sanctum work (or not work); clients will play a central role in this process and validating these results. The development and refinement of a program theory will help us understand how Sanctum 1.5 enhances health outcomes for both mother and child, which will inform how to facilitate improvements and replication of the program.