135 Realist review of Midwife-Led Continuity of Care implementation Figure 1: Development of a refined program theory on the implementation of MLCC. Patient and public involvement A client organisation was involved in this study through 2 stakeholder meetings. Their input helped shape the initial programme theory and validate the CMOCs, ensuring the findings aligned with client perspectives. RESULTS The literature search generated a total of 5,261 references: 1,288 in Ovid/Medline, 1,102 (excluding 286 conference abstracts) in Embase.com, 1,195 in Clarivate Analytics/Web of Science Core Collection, 1,471 in EBSCO/CINAHL and 203 in EBSCO/APA PsycINFO. After restricting to publication year 2013 (last 10 years), and removing duplicates of references that were selected from more than one database, 1,604 references remained for screening on title and abstract. 62 full-text articles were assessed for eligibility, of which 54 were assessed by RS and EN, and 8 by RS and AP. Consensus was reached on 3 articles only after consultation with a third 6
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