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This article synthesises evidence on the experiences of immigrants in the United Kingdom who are engaged in precarious employment and explores the effects of precarious employment on their health and wellbeing. This study reveals that migrants in precarious employment often experience negative health outcomes including injury, anxiety and depression. Stress response theories and risk factors associated with occupational injury help explain how employment specific factors influence health. The study shows that immigrant-related factors like pre-migration experience and concerns around social exclusion mediate precarious employment's effect on health.

Traveller Communities constitute a complex population. A lack of reliable demographic data combined with nomadic lifestyles leads to unmet needs. Outreach has been utilized as a strategy to engage Traveller Communities in health improvement interventions. Using realist synthesis, a theory-driven approach which explores what it is about an intervention that works, for whom, in what circumstances, and why, we synthesized the available evidence on outreach interventions for Traveller Communities. We undertook comprehensive searches of electronic databases and gray literature to identify publications relevant to Traveller Communities and health. We then conducted expert hearings involving Traveller Community members and outreach workers to refine and validate our emerging findings. We found that outreach works best when community members feel they can trust the worker. Depending on this, and whether they have a say in the focus of the intervention (i.e., an intervention might aim to improve immunization rates, but if this isnt seen as a priority it is less likely to be effective), outreach interventions can lead to three types of engagement: participation, behavior change, and social capital development. Our synthesis detailed the conditions making each most likely to happen. Realist synthesis enabled us to maximize the potential of this heterogeneous literature base, and expert hearings were key in producing a unifying explanatory framework based on trust and engagement.

As the use of realist approaches gains momentum, there is a growing interest in how systems approaches can complement realist thinking. In this article, we discuss how the epistemology of Soft Systems Methodology is compatible with realist approaches. Both Soft Systems Methodology and realist approaches emphasize the necessity to engage stakeholders; through models, the description of contingencies and exploring the intricacies of how complex programmes really work. We outline the key elements of realist approaches and Soft Systems Methodology, and report on two novel case studies. Drawing on our own experiences, we make the case that, used in conjunction with a realist approach, Soft Systems Methodology can provide a useful tool to a) map programme complexity, and b) develop and refine stakeholders programme theories, thus increasing the transparency, reliability, validity and accuracy of the theory building and refining process in realist approaches. We highlight Soft Systems Methodology as a novel companion to realist approaches and detail the first case studies of its use.