Researching Complex Interventions in Health: The State of the Art

Abstract

Since the revised MRC guidance on the development and evaluation of complex interventions was published in 2008, much progress has been made in developing and defining good practice, and there is an increasingly detailed and comprehensive set of guidance available to help researchers and funders make the right choices. But progress is patchy, and evidence continues to accumulate of waste in research. Robust approaches are needed, that combine good practice across all stages of the evaluation process, from the initial choice and framing of research questions, through to implementation and translation of evidence. The elements of a robust approach are mostly well-known, but much more rarely are they combined into a coherent package. The talk will consider why this is so, and what can be done to improve matters. This presentation will provide the history of the "Complex Interventions in Health" book. The development of the book took off in the European Academy of Nursing Science (EANS) summer school. For more than 12 years the EANS has gathered doctoral students from all over Europe in a three year programme. The content developed over time, inspired by the critique stating that nursing research was heavily dominated by descriptive, crosssectional or qualitative research not really informing practice. This lead to building a curriculum based on the MRC guidance on complex interventions and the teaching programme became truly successful among students. The road to developing the content for a book was short. Professor Richards and I played around on the black board and after that it has been a success-story. So many authors delivering on time! However, rightfully we have been told that research in health is more than researching complex interventions. I cannot agree more, it is only one step, but a very important one. Health research, as any research with aspirations for informing practice, needs to be carried out systematically and programmatically, using a variety of designs and methods. It is helpful to think of knowledge development as being a stepwise process starting off with discovery and once possible going into the phase of evaluation and once solid knowledge is obtained it is about implementation in practice. In this presentation I will explain what PPI is, what it isn't, and how it differs from engagement, as there is some misunderstanding. There is a range of both ethical and pragmatic reasons for involving members of the public and patients in research, depending on the different values and perspectives of those involved. I will provide practical examples of PPI at different stages of the research cycle: identifying and prioritising research questions; developing research proposals; doing research; analysing research data; disseminating and implementing findings; as well as PPI in systematic reviewing and operational research. Drawing on my own research, I will use the particular example of the Diabetes Intervention for Agenda Trial (DIAT) to illustrate PPI in a trial from start to finish. I will presen...

Arts, mental distress, mental health functioning & life satisfaction: fixed-effects analyses of a nationally-representative panel study

“…However, there is a large literature using experimental approaches showing that arts activities can affect mental health [10]. Arts engagement can be considered as a 'complex' or 'multimodal' health-promoting activity in that it combines multiple health-promoting or risk-reducing factors such as gentle physical activity, social interaction, relaxation, emotional expression, and cognitive stimulation [10,46]. Our analyses could shed further light onto the causal mechanisms that could link arts and mental health as we found a relationship for higher mental health functioning only with arts participation; not cultural attendance.…”

What is required to facilitate implementation of Swedish physical activity on prescription? – interview study with primary healthcare staff and management

“…the environment in which the proposed change is to be implemented, and facilitation , i.e. the manner in which the change is supported [ 18 , 21 ]. Factors of importance for successful implementation of a new method include the individual healthcare provider’s attitude to the method, and that it targets a perceived need by the users as well as general features, such as the organisational culture.…”

A controlled study of the Collaborative Care Skills Workshops versus Psycho‐educational Workshops among Spanish caregivers of relatives with an eating disorder

“…Pilot studies play a key role in health research, as they provide important information for the planning of full scale RCTs by testing whether a theoretical framework is well implemented and how changes are produced in specific contexts (Craig et al, 2016). However, most of the aforementioned studies have been carried out among British caregivers, and only five used a RCT design (Goddard et al, 2011;Grover, Naumann, et al, 2011;Hoyle, Slater, Williams, Schmidt, & Wade, 2013;Salerno et al, 2016;Whitney et al, 2012).…”