Theory of Change

Anticipated outcomes include prescribing volume, prescribing readiness, prescribing patterns, timeliness, and acceptability to teams and patients. The framework identifies short-term outcomes including improved learning environments, reduced trainer burden, and CTF well-being. The initial programme theory remains provisional because it is based on one Canadian context. A limitation of the initial programme theory is that policy and government interest holders were initially under-represented, potentially missing broader system-level considerations. The initial programme theory was developed through deliberative dialogues in British Columbia involving 24 representatives from settlement services, primary care clinics, counselling services, a survivor advocacy group, and a policy analyst. Candidate contexts include hospital type, ward type, service model, staffing arrangements, digital infrastructure, organisational culture, and multidisciplinary working. The final stage will compare and synthesise configurations across studies to identify how contexts trigger mechanisms that generate outcomes. Candidate mechanisms include trust, rapport, role legitimacy, self-efficacy, and perceived…