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Background Evaluation of complex interventions (CI) is challenging for health researchers and requires innovative approaches. The objective of this work is to present the main methods used to evaluate CI. Methods A systematic review of the scientific literature was conducted to identify methods used for the evaluation of CI. We searched MEDLINE via PubMed databases for articles including an evaluation or a pilot study of a complex intervention, published in a ten-year period. Key-words of this research were (“complex intervention*” AND “evaluation”). Results Among 445 identified articles, 100 research results or protocols were included. Among them, 5 presented 2 different types of design in the same publication, thus our work included 105 designs. Individual randomized controlled trials (IRCT) represented 21.9% ( n = 23) of evaluation designs, randomized clinical trials adaptations 44.8% ( n = 47), quasi -experimental designs and cohort study 19.0% ( n = 20), realist evaluation 6.7% ( n = 7) and other cases studies and other approaches 8.6% ( n = 9). A process/mechanisms analysis was included in 80% ( n = 84) of these designs. Conclusion A range of methods can be used successively or combined at various steps of the evaluation approach. A framework is proposed to situate each of the designs with respect to evaluation questions. The growing interest of researchers in alternative methods and the development of their use must be accompanied by conceptual and methodological research in order to more clearly define their principles of use.

This paper explores the relationship between internet use and individuals' health experience. Adopting a 'mediated health' approach, it presents four cases studies of households using the internet for health information. The study shows that participants use the internet as it offers personalised information in line with individuals' and families' health needs affecting their everyday routines. The internet emerges as an everyday helper linked to the intimacy of health experiences. Agency is manifest in study participants' choice of both becoming more informed as well as having the possibility of ignoring information. Case studies also show how personal internet use is confronted by informational surroundings generating flows of information that may induce uncertainty on the information seeker's side. The paper calls for a perspective which considers together personal health experience and media use to embed online health information seeking within an everyday context of internet use.

BackgroundPublic health interventions are increasingly being recognised as complex and context dependent. Related to this is the need for a systemic and dynamic conception of interventions that raises the question of delineating the scope and contours of interventions in complex systems. This means identifying which elements belong to the intervention (and therefore participate in its effects and can be transferred), which ones belong to the context and interact with the former to influence results (and therefore must be taken into account when transferring the intervention) and which contextual elements are irrelevant to the intervention.DiscussionThis paper, from which derives criteria based on a network framework, operationalises how the context and intervention systems interact and identify what needs to be replicated as interventions are implemented in different contexts. Representing interventions as networks (composed of human and non-human entities), we introduce the idea that the density of interconnections among the various entities provides a criterion for distinguishing core intervention from intervention context without disconnecting the two systems. This differentiates endogenous and exogenous intervention contexts and the mediators that connect them, which form the fuzzy and constantly changing intervention/context interface.ConclusionWe propose that a network framework representing intervention/context systems constitutes a promising approach for deriving empirical criteria to delineate the scope and contour of what is replicable in an intervention. This approach should allow better identification and description of the entities that have to be transferred to ensure the potential effectiveness of an intervention in a specific context.