We carried out a Realist Synthesis (RS), an innovative review method used in health and social policy to review heterogeneous bodies of evidence, typical of complex interventions. As part of the RS, a Realist systematic review (the protocol is registered in PROSPERO) was conducted using bibliographic databases (Medline/Pubmed, PsyInfo, Cochrane Library, Embase, Web of Science) and grey literature (web pages, reports, guides and regulations of governments, institutions, associations and organisations). In addition, working meetings were held with experts in the study phenomenon, as well as participation in meetings of the Post-Brexit working group of the Spanish Residents' Councils in the UK. In addition, two initial co-productive workshops (one focused on return to Spain and the other on return to the UK) were held with stakeholders. This process identified initial contextual differences between Spain and the UK, and contributed to the development of an initial theoretical framework to guide research and the generation of initial programme theories.
Through analysis of the selected documents, we identified 25 return migration interventions using the World Health Organization's Social Determinants of Health Framework. Information from the two initial workshops was also used in this process.
Given the incursion of the COVID-19 pandemic, it was considered highly pertinent, at the outset of the research, to conduct the analysis of the pandemic, through documentary sources, in the two study settings, the UK and Spain, and from the lenses of Complexity and Realism theory.
Continuing with the Realist systematic review, empirical evidence was identified to generate context-mechanism-outcome (CMO) configurations and to test and refine programme theories. In addition, two further co-productive stakeholder workshops were held (one aimed primarily at return to Spain and the other at return to the UK). Seven CMOs were identified: “Disaffection”, “Lost and forsaken”, “Jump into the void”, “Empowerment to act”, "The best of both worlds", “In no one's land” and “Face to face and at home".
In the last phase of the RS, a final co-productive workshop was held with stakeholders. Focusing on the key results (CMOs), we drafted four policy briefs that were presented at this final workshop to obtain stakeholder input and reach agreements from an intersectoral approach. The policy briefs finally agreed were: “How to overcome barriers to a healthy return”, “Promoting the return of human capital”, “Maintaining mobility rights to reside, work and study” and “Getting out of limbo“.
Overview of the results and their exploitation and dissemination (at the time of writing):
• News, participation in events and publications have been published in the RETORNO website, as well as on Twitter.
• Presentations at scientific conferences (International Conference on Education and Migration 2022; 2022 Realist Methodology Training Conference; British Sociological Association 2022; XL Reunión Anual de la Sociedad Española de Epidemiología and XVII Congresso da Associacao Portuguessa de Epidemiologia).
- Scientific publications:
• Serrano-Gallardo, P. & Manzano, A. (2021). A realist synthesis of interventions on social determinants of health for returned migrants: the case of the UK and Spain post-Brexit referendum. PROSPERO 2021 CRD42021254868 Available from:
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021254868(si apre in una nuova finestra) • Serrano-Gallardo P, Manzano A and Pawson R. Non-pharmaceutical interventions during COVID-19 in the UK and Spain: a rapid realist review [version 1; peer review: 1 approved with reservations]. Open Res Europe 2022, 2:52 (https://doi.org/10.12688/openreseurope.14566.1 ).
