Exploring peer education for migrant informal caregivers of mentally ill loved ones: a realist evaluation protocol.

Introduction: Informal caregivers with a migration background who care for someone with a mental illness often experience elevated caregiver burdens due to factors such as discrimination, language barriers, and stigma. In The Netherlands, a peer education intervention called 'They Are not Mental?!' (TANM) addresses these challenges by reducing stigma, increasing help-seeking behaviors, and improving access to healthcare. This transdisciplinary study evaluates how contextual factors and mechanisms influence its outcomes. Description: This research protocol outlines a realist evaluation of the intervention using a mixed-methods design, including interviews, post-questionnaires, and observations. The study will develop and refine the program theory to determine for whom, in what contexts, why, and how the intervention works. Discussion: This protocol shows how we plan to investigate how, why, for whom and under what circumstances TANM produces its intended outcomes, using a realist evaluation approach. This approach is well-suited for evaluating complex interventions because it accommodates for dynamic and iterative interventions. Its focus is on understanding patterns and mechanisms within specific contexts, using program theories. Conclusion: The evaluation of TANM will inform future intervention adaptations and guide future efforts to support vulnerable populations, particularly migrants navigating caregiving challenges.