Population health intervention research: the place of theories

Abstract

Background An international workshop on population health intervention research (PHIR) was organized to foster exchanges between experts from different disciplines and different fields. This paper aims to summarize the discussions around some of the issues addressed: (1) the place of theories in PHIR, (2) why theories can be useful, and (3) how to choose and use the most relevant of them in evaluating PHIR. Methods The workshop included formal presentations by participants and moderated discussions. An oral synthesis was produced by a rapporteur to validate, through an expert consensus, the key points of the discussion and the recommendations. All discussions were recorded and have been fully transcribed. Results The following recommendations were generated through a consensus in the workshop discussions: (i) The evaluation of interventions, like their development, could be improved through better use of theory. (ii) The referenced theory and framework must be clarified. (iii) An intervention theory should be developed by a partnership of researchers and practitioners. (iv) More use of social theory is recommended. (v) Frameworks and a common language are helpful in selecting and communicating a theory. (vi) Better reporting of interventions and theories is needed. Conclusion Theory-driven interventions and evaluations are key in PHIR as they facilitate the understanding of mechanisms of change. There are many challenges in developing the most appropriate theories for interventions and evaluations. With the wealth of information now being generated, this subject is of increasing importance at many levels, including for public health policy. It is, therefore, timely to consider how to build on the experiences of many different disciplines to enable the development of better theories and facilitate evidence-based decisions.

WITHDRAWN: Understanding the complexity of population health interventions: assessing intervention system theory (ISyT)

“…These points remind us of the necessity to pay careful attention to evidence-based arguments when choosing a theory (16). Similar to other authors (7), they specify that the issue of integrating TDE more fully into evaluation design involves clarifying what we actually mean by theory because "people are talking at cross purposes in relation to the various kinds of theory" (7). We hypothesize that if TDE is underused in PHIR (15), it is because of the failure to de ne the so-called theory and the lack of clear and practical guidelines for designing and validating this theory.…”

“…One way to do this would be to theorize interventions by using the theory-driven evaluation paradigm (6,7). Indeed, a theory-driven evaluation (TDE) (8-10) is based on a contribution analysis (11), which assesses questions inferring causality in real-life program evaluations (12).…”

“…The aim is to reduce uncertainty about the contribution of all inputs that could contribute to the outcome. A TDE could be an evaluation design by itself as an alternative to an experimental trial (e.g., a realist evaluation), or it could be combined with/integrated into a classic experimental design (7,13,14). The core principle is to base the evaluation on an explicit conceptualization of the theory used to de ne the data collection such that the theory conceptualizes the features of the intervention that should be made explicit and validated by the evaluation process.…”

“…But what theory are we talking about in TDE? Indeed, while various methodological works have acknowledged that this theory-based approach is crucial (7,16), they have noted the tendency to pick a theory 'off the shelf' rather than using task-speci c theories of change, even as many dominant theories "have done little to make interventions more effective" (16). These points remind us of the necessity to pay careful attention to evidence-based arguments when choosing a theory (16).…”

Models and theoretical frameworks for osteopathic care – A critical view and call for updates and research

“…There is an overall scientific consensus on the importance of having a robust theoretical framework for complex health interventions such as osteopathic care [22]. Traditional or innovative theoretical models are more likely to be accepted and implemented if they provide guidance on the process of care, clearly frame their intent and level of application, are logically plausible and consistent, are backed up by a rational documented understanding of the change process including causal relationships among the constructs, are testable, are supported by empirical observations, show good explanatory power, and are generalisable to different settings and subpopulations [23].…”