Using Qualitative Methods to Distill the Active Ingredients of a Multifaceted Intervention

Abstract

Mental health studies frequently involve multifaceted psychosocial interventions. It may be difficult to isolate the active ingredients that make these interventions successful. This study examined the use of qualitative methods to better understand the content of one of these interventions and to help elucidate the links between the care process and health outcomes. A series of five focus groups were convened at a site remote from a model primary care clinic for veterans. Transcripts of the focus groups were analyzed to identify themes and categorize results for patients with serious mental disorders. Three themes emerged from the groups: the difficulty patients had previously faced in obtaining medical care, the flexibility and availability of resources that defined the clinic culture, and organizational restructuring that allowed enhanced communication. Qualitative methods can be a useful means of "unpacking" multifaceted mental health services interventions. These methods may make it possible to refine and disseminate these models more widely.

How is a specialist depression service effective for persistent moderate to severe depressive disorder?: a qualitative study of service user experience

“…Qualitative methods have been shown to provide a useful approach to understanding participants’ perceptions and experiences of an intervention and to identify the active ingredients of complex and multi-faceted mental health services [ 18 – 21 ]. Romakkaniemi and Kilpelainen [ 22 ] analysed the experiences of two service users with depression through their written blogs and found four themes: a confident working relationship, time and hiatus for finding one’s own authenticity, successful timing of interventions and a holistic view of life.…”

A Mixed-Methods Approach to Synthesizing Evidence on Mediators of Intervention Effects

“…Through these open queries, researchers can assess the extent to which their interventions worked as posited or through mechanisms they did not even anticipate. They also can begin to distinguish the intervention’s essential from non-essential ingredients (Miller et al, 2003). …”

“…To address these challenges, we drew findings not only from intervention studies but also from observational studies, which provide data on associations between potential mediators and outcomes (path b). We also reviewed qualitative studies of participants’ and interveners’ perceptions of why and how interventions worked to further illuminate the ways that mediators functioned to affect outcomes (Miller, Druss, & Rohrbaugh, 2003). …”

Exploring the Role of Executive Functioning Measures for Social Competence Research

“…Evaluating the active ingredients of an intervention, and perhaps which necessary ingredients are still absent, is a critical component of establishing intervention efficacy (Gersten, Baker, & Lloyd, 2000). This process, however, is often complex and costly (in terms of time and monetary resources) within applied contexts such as schools and with “challenging” populations (Hollon et al, 2002; Kasari, 2002; Lord et al, 2005; Miller, Druss, & Rohrbaugh, 2003; Smith et al, 2007). Measures of intervention efficacy that are socially valid, ecologically valid, and robust are the ideal combination.…”