Using grounded theory to develop a theory of change for a violence intervention program

Area of Science:

• Public Health
• Sociology
• Program Evaluation

Background:

• Hospital-based violence intervention programs (HVIPs) are vital for interrupting violence cycles.
• HVIPs are complex interventions with multiple change mechanisms and outcomes.
• Lack of clear program theories hinders understanding of HVIP effectiveness.

Purpose of the Study:

• To describe Grounded Theory as a methodology for developing program theories of change for complex interventions.
• To illustrate the application of Grounded Theory using a case example of a HVIP.

Main Methods:

• A four-phase approach was used: document review, interviews with developers, stakeholder focus group, and interviews with caregivers/youth.
• Grounded Theory methodology was employed to ensure a non-linear approach grounded in lived experiences.
• The Antifragility Initiative, a Cleveland-based HVIP, served as the case example.

Main Results:

• A program theory of change, including a theoretical narrative and visual model, was developed for the Antifragility Initiative.
• The developed theory identifies underlying mechanisms driving change within the HVIP.
• The methodology engaged key stakeholders, including program developers, participants, and caregivers.

Conclusions:

• Grounded Theory provides a robust, non-linear methodology for developing program theories of change for complex interventions like HVIPs.
• Clearly defined program theories enhance the understanding of what works, for whom, and why in violence intervention.
• This approach supports researchers, evaluators, and program developers in optimizing intervention strategies.