Background Personal and community networks are recognized as influencing and shaping self‐management activities and practices. An acceptable intervention which facilitates self‐management by mobilizing network support and improves network engagement has a positive impact on health and quality of life. This study aims to identify the processes through which such changes and engagement take place. Methods The study was conducted in the south of England in 2016‐2017 and adopted a longitudinal case study of networks design. Purposive sample of respondents with long‐term conditions (n = 15) was recruited from local groups. Barriers and facilitators to implementation were explored in interviews with key stakeholders (5). Results Intervention engagement leads to a deepening of relationships within networks, adding new links and achieving personal objectives relevant for improving the health and well‐being of users and network members. Such changes are supported through two pathways: the mobilization of network capabilities and by acting as a nudge. The first is a gradual process where potentially relevant changes are further contemplated by forefronting immediate concerns and negotiating acceptable means for achieving change, prioritizing objective over subjective valuations of support provided by network members and rehearsing justifications for keeping the status quo or adopting change. The second pathway changes are enacted through the availability of a potential fit between individual, network and environmental conditions of readiness. Conclusions The two pathways of network mobilization identified in this study illuminate the individual, network and environmental level processes involved in moving from cognitive engagement with the intervention to adopting changes in existing practice.

The challenge to produce 'evidence' which is tailored to, and captures, the complexity of reality when implementing and integrating a sport-for-development programme (SfD) within a given set of circumstances tends to follow technocratic 'evaluation' approaches as a means of 'controlling' the evidence sought (Chouinard, 2013;Harris, 2018). This approach predominately focuses on monitoring and/or tracking changes within a SfD programme, at the expense of fostering evaluative thinking and learning about the programme's impacts (Levemore and Beacom, 2009; Harris and Adams, 2016). The impact of technocratic approaches focusing on what can be measured in evaluation has constrained current monitoring and evaluation (M&E) practice. This limits the ability to introduce and examine the utility of alternative approaches to evaluation and data collection methods for understanding the impact of SfD programmes (Harris, 2018) whilst recognising the role and contribution of stakeholders (funders, practitioners and participants) within evaluation processes.

The increasing adoption of Local Area Coordination across the United Kingdom as a strengths-based approach to acting on inequalities which impact on individual health and well-being, and reducing reliance and avoidable use of health and social care services, has catalysed increasing calls for evidence to justify economic commitment. In a time of austerity where extreme pressure is on resources to prove short-term outputs, Pawson and Tilley’s realist evaluation methodology holds significant promise in asking critical questions of how and why programmes work. Ultimately, such philosophical standpoints facilitate opportunities to examine whether the sustainability of programmes are cost-effective for the system in the longer term. This article draws upon the findings of a realist evaluation of Local Area Coordination on the Isle of Wight and establishes how and why the programme works for people and local communities. A blend of realist approaches, Q-method and realist interviews were adopted within this study. The study’s sample was a cross section of 18 people who engaged with the Local Area Coordination programme across the Isle of Wight. The findings of the evaluation established that the Local Area Coordinators’ ability to facilitate a ‘golden triangle’ of listening, trust and time were factors which made Local Area Coordination work. It was also clear that Local Area Coordination worked for different people in different ways, demonstrated through the contextual differences between three subgroups who were categorised based on shared viewpoints, and presented through the holistic narratives and corroborating interview data.

This method note presents Q methodology as a useful tool for evaluators to add to their practice toolbox. Q methodology, which involves both quantitative and qualitative techniques, can help researchers and evaluators systematically understand subjectivity and the communicability of opinions and perspectives. We first provide an overview of Q methodology, followed by a brief summary of how evaluators are using Q, and an explanation of the steps for implementing Q methodology. Either by itself or with other methods, the potential uses of Q methodology in evaluation are diverse. For practical demonstration, we describe how Q methodology was used in a recent evaluation in the UK to understand stakeholder subjectivity within the program. We then reflect upon the pros and cons of using Q in program evaluation, concluding that it constitutes a worthwhile tool for evaluating complex programs.

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