BackgroundExisting guidance for developing public health interventions does not provide information for researchers about how to work with intervention providers to co-produce and prototype the content and delivery of new interventions prior to evaluation. The ASSIST + Frank study aimed to adapt an existing effective peer-led smoking prevention intervention (ASSIST), integrating new content from the UK drug education resource Talk to Frank (www.talktofrank.com) to co-produce two new school-based peer-led drug prevention interventions. A three-stage framework was tested to adapt and develop intervention content and delivery methods in collaboration with key stakeholders to facilitate implementation.MethodsThe three stages of the framework were: 1) Evidence review and stakeholder consultation; 2) Co-production; 3) Prototyping. During stage 1, six focus groups, 12 consultations, five interviews, and nine observations of intervention delivery were conducted with key stakeholders (e.g. Public Health Wales [PHW] ASSIST delivery team, teachers, school students, health professionals). During stage 2, an intervention development group consisting of members of the research team and the PHW ASSIST delivery team was established to adapt existing, and co-produce new, intervention activities. In stage 3, intervention training and content were iteratively prototyped using process data on fidelity and acceptability to key stakeholders. Stages 2 and 3 took the form of an action-research process involving a series of face-to-face meetings, email exchanges, observations, and training sessions.ResultsUtilising the three-stage framework, we co-produced and tested intervention content and delivery methods for the two interventions over a period of 18 months involving external partners. New and adapted intervention activities, as well as refinements in content, the format of delivery, timing and sequencing of activities, and training manuals resulted from this process. The involvement of intervention delivery staff, participants and teachers shaped the content and format of the interventions, as well as supporting rapid prototyping in context at the final stage.ConclusionsThis three-stage framework extends current guidance on intervention development by providing step-by-step instructions for co-producing and prototyping an intervention’s content and delivery processes prior to piloting and formal evaluation. This framework enhances existing guidance and could be transferred to co-produce and prototype other public health interventions.Trial registration ISRCTN14415936, registered retrospectively on 05 November 2014.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4695-8) contains supplementary material, which is available to authorized users.

High-quality engineering and operations management are key to meeting all the requirements of a successful railway -quality of service, reliable and safe performance, and maximum possible use of capacity. However, the railway is a socio-technical system and therefore has human factors at its core, which requires a strong integrated ergonomics contribution. Moreover, this contribution must be at a systems level rather than providing point solutions to particular equipment, interface, workplace, or job problems. This paper draws from the first two human factors projects in the EPSRC Rail Research UK programme, interpreting them for an engineering audience. The paper first emphasizes and gives examples of the need for a systems ergonomics contribution to engineering an improved railway. Then the available literature is summarized in a structured fashion. Finally, a short summary is provided of the research which has started to develop a distributed cognition model of work on the railways, especially across functional groups of signalling, control, and train driving.

Findings from 35 qualitative interviews with drug users who were engaging in or who had engaged in sex work in Dublin, Ireland, illuminated how, because of a result of felt stigma and internalized shame, they tried to hide their drug use, thus endangering their own lives. This group carried multiple layers of stigma because of sex work, drug use (including injecting drug use), and having contracted human immunodeficiency virus (HIV) or hepatitis C virus (HCV). This stigma was powerfully reinforced by the language routinely used by health professionals. To improve the effectiveness of harm-reduction interventions, it is recommended that service providers change their language, in particular in recognition of the human dignity of these clients, but also to help attract and retain drug users in services, and to help reduce the unacceptable mortality levels among drug users.

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