Designing and evaluating complex interventions to improve health care

Campbell, Neil; Murray, Elizabeth; Darbyshire, Janet; Emery, Jon; Farmer, Andrew; Griffiths, Frances; Guthrie, Bruce; Lester, Helen; Wilson, Philip; Kinmonth, Ann Louise

doi:10.1136/bmj.39108.379965.be

Cited by 1,109 publications

(1,115 citation statements)

References 23 publications

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“…As stated in the recommendations of MRC, it is important to report contextual factors because these shape and co-construct the interpretation of the intervention experience (Campbell et al, 2007; Craig et al, 2008a, 2008b). Rigorous development both validated the intervention and secured its clinical relevance in the viewpoints of the health professionals handling the intervention.…”

Section: Comprehensive Understanding and Discussionmentioning

confidence: 99%

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Beck

Martinsen

Birkelund

et al. 2017

International Journal of Qualitative Studies on Health and Well

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The British concept named Protected Mealtimes is known for stopping all non-acute activities and giving health professionals an opportunity to focus on providing patients their meals without being interrupted or disturbed. PM involves a cultural and behavioural change in the clinical setting, since health professionals are asked to adjust their daily routines. This study investigate how health professionals experience participating in a mealtime intervention inspired by the concept of Protected Mealtimes and intend to change mealtime practices. Three focus group interviews was conducted and included a total of 15 interdisciplinary staff members. After transcribing the interviews, the text material was analysed and interpreted in a three-methodological-step process inspired by the French philosopher Paul Ricoeur.In the analysis and interpretation three themes was identified. The themes were: (1) a chance towards a new and better scene; (2) a step towards a more neurologically friendly environment; and (3) a renewed view of the neurological patients. This study concludes that to the health professionals, the intervention was meaningful in several ways because it created structure during mealtimes and emphasized the importance of creating a calm environment for both patients and health professionals. The intervention was described as an eye-opening and well-regarded event in the field of neurological care that facilitated community, and reflections on nursing care and professional identity were expressed.

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Section: Comprehensive Understanding and Discussionmentioning

confidence: 99%

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Beck

Martinsen

Birkelund

et al. 2017

International Journal of Qualitative Studies on Health and Well

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“…Reviews of theory provide a useful starting point for problem framing, as they can be used to map the various explanations of relationships between individual circumstances, wellbeing and health [11]. Logic models can be used to articulate relationships between cause and effect using root cause analysis [12][13][14][15][16].…”

Section: Problem Framingmentioning

confidence: 99%

Cochrane Qualitative and Implementation Methods Group guidance series—paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis

Harris

Booth

Cargo

et al. 2018

Journal of Clinical Epidemiology

138

104

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This paper updates previous Cochrane guidance on question formulation,searching and protocol development, reflecting recent developments in methods for conducting qualitative evidence syntheses to inform Cochrane intervention reviews. Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry, and mapping the information available to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility and implementation. Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Further, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route-map, particularly in qualitative reviews that ask more exploratory and open ended questions.Keywords: Systematic reviews, question formulation, Cochrane Collaboration, methods, qualitative evidence synthesis. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Word count: 4014 words excluding tables and references Key findings:Tools and methods are recommended to assist reviewers in developing protocols, which accommodate alternative approaches to question formulation and searching and protocol development for qualitative evidence synthesis. What this adds to what was known?Questions within qualitative and implementation systematic review protocols may be indicative, allowing more detailed questions to be formulated when more information is needed on specific aspects of the review. A broader range of question formats is presented, to reflect the need for reviews that explore and generate theory. What is the implication and what should change now?This guidance provides examples of protocols for qualitative evidence synthesis that are flexible, to allow the incorporation of open-ended and exploratory review questions and iterative searching methods. 'recontextualise' effectiveness. Recontextualising requires considering effectiveness research in relation to issues in society [4] to enable a decision-maker to make an informed decision about whether an intervention is likely to be useful and whether that intervention is applicable to their local population. Qualitative research produces contingent and experiential knowledge on why interventions work the way that they do (or fail to work) [5]. Further, implementation questions provide information on how the implementation process produces...

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“…Early recognition of the "black box" problem focused on encouraging the specification of the underlying theoretical basis for the intervention [17,[23][24][25][26] and the constructs targeted by an intervention. Following methods to systematically plan and develop interventions with links between theory and intervention components were introduced [e.g., 4,27,28].…”

Section: Deconstructing Interventions or Unpacking The "Black Box"mentioning

confidence: 99%

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

Tate

Lytle

Sherwood

et al. 2016

Behav. Med. Pract. Policy Res.

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Deconstructing interventions into the specific techniques that are used to change behavior represents a new frontier in behavioral intervention research. This paper considers opportunities and challenges in employing the Behavior Change Techniques Taxonomy (BCTTv1) developed by Michie and colleagues, to code the behavior change techniques (BCTs) across multiple interventions addressing obesity and capture dose received at the technique level. Numerous advantages were recognized for using a shared framework for intervention description. Coding interventions at levels of the social ecological framework beyond the individual level, separate coding for behavior change initiation vs. maintenance, fidelity of BCT delivery, accounting for BCTs mode of delivery, and tailoring BCTs, present both challenges and opportunities. Deconstructing interventions and identifying the dose required to positively impact health-related outcomes could enable important gains in intervention science.

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Designing and evaluating complex interventions to improve health care

Cited by 1,109 publications

References 23 publications

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Cochrane Qualitative and Implementation Methods Group guidance series—paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis

Deconstructing interventions: approaches to studying behavior change techniques across obesity interventions

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