Developing interventions to improve health: a systematic mapping review of international practice between 2015 and 2016

Abstract

Background: Researchers publish the processes they use to develop interventions to improve health. Reflecting on this endeavour may help future developers to improve their practice. Methods: Our aim was to collate, describe, and analyse the actions developers take when developing complex interventions to improve health. We carried out a systematic mapping review of empirical research studies that report the development of complex interventions to improve health. A search was undertaken of five databases over 2015-2016 using the term 'intervention dev*'. Eighty-seven journal articles reporting the process of intervention development were identified. A purposive subset of 30 articles, using a range of published approaches to developing interventions, was selected for in-depth analysis using principles of realist synthesis to identify the actions of intervention development and rationales underpinning those actions. Results: The 87 articles were from the USA (39/87), the UK (32/87), continental Europe (6/87), and the rest of the world (10/87). These mainly took a pragmatic self-selected approach (n = 43); a theory-and evidence-based approach, e.g. Intervention Mapping, Behaviour Change Wheel (n = 22); or a partnership approach, e.g. community-based participatory research, co-design (n = 10). Ten actions of intervention development were identified from the subset of 30 articles, including identifying a need for an intervention, selecting the intervention development approach to follow, considering the needs of the target population, reviewing published evidence, involving stakeholders, drawing or generating theory, and designing and refining the intervention. Rationales for these actions were that they would produce more engaging, acceptable, feasible, and effective interventions. Conclusions: Developers take a variety of approaches to the international endeavour of complex intervention development. We have identified and described a set of actions taken within this endeavour regardless of whether developers follow a published approach or not. Future developers can use these actions and the rationales that underpin them to help them make decisions about the process of intervention development.

Guidance for reporting intervention development studies in health research (GUIDED): an evidence-based consensus study

“…The GUIDED checklist and reporting guidance has been developed by following internationally recognised methods for developing reporting guidance,7 with items based on extensive primary4 10 and secondary3 9 research to enable greater transparency and quality of reporting development of complex interventions. The GUIDED checklist and guidance provides a clear and structured basis for the reporting of intervention development studies in a range of formats.…”

“…e-Delphi items were generated by triangulating three different data sources: a systematic methods overview of 87 articles, books and websites that identified 23 approaches to intervention development within 8 categories and with 18 actions undertaken across these approaches3; a systematic review of 87 international primary research articles reporting intervention development processes which describes 10 actions9; and an analysis of 21 indepth qualitative interviews with an international sample of intervention developers (n=15) and key stakeholders (n=6) 4 10. The research team (AOC, LY, PH, ED, LC, NR, KS) met regularly to identify the potential reporting guidance items.…”

“…Invitations were sent to 92 individuals who had undertaken intervention development and/or published a formal approach to intervention development and 80 wider stakeholders. Intervention developers, identified through parallel studies conducted by the research team,3 9 were invited to participate if they had published at least one intervention development study or written methodological books or journal articles about intervention development. Wider stakeholders were identified through a web search of journal editorial boards, funding bodies and other relevant sources.…”

“…The results of the e-Delphi studies were discussed by participants (in person or by video link) and eight team members at a 1-day consensus meeting on 13 March 2018 in London, UK. The meeting began with presentations from the team: an overview of the overall INDEX study, followed by a summary overview of both systematic reviews3 9 and qualitative study 4. The results of both e-Delphi studies were then presented, and detailed discussions were held on items that had not reached consensus, but which reflected divergence.…”

“…We identified examples of previous studies that illustrate use of the reporting items. These examples are almost completely drawn from reviews of previous intervention development literature 4 9. In one instance, where an example could not be found, an example was created and is identified as a hypothetical example.…”