A realist process evaluation of the INtegrating DEPrEssioN and Diabetes treatmENT (INDEPENDENT) randomized controlled trial in India

•This is the first published use of a realist evaluation approach to identify underlying causal mechanisms of a chronic-care treatment model implemented in a low- or middle-income country.•This paper focuses on context as an implementation leverage point that enables the transferability of integrated diabetes and depression care models to alternative care settings in India and other low-resource settings.•Findings from this evaluation highlight the resource and training gaps that hinder the implementation and sustainability of a multi-component, team-based intervention aimed at integrating depression treatment into routine diabetes care.