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Understanding successful development of complex health and health care interventions and its drivers from the perspective of developer and wider stakeholder an international qualitative interview study

Understanding successful development of complex health and health care interventions and its drivers from the perspective of developer and wider stakeholder an international qualitative interview study
Understanding successful development of complex health and health care interventions and its drivers from the perspective of developer and wider stakeholder an international qualitative interview study
Objective: Identify how individuals involved in developing complex health and health care interventions (developers), and wider stakeholders in the endeavour, such as funders, define successful intervention development and what factors influence how interventions are developed.

Design: In-depth interviews with developers and wider stakeholders to explore their views and experiences of developing complex health and health care interventions.

Setting: Interviews conducted with individuals in the UK, Europe and North America.

Participants: Twenty-one individuals were interviewed: 15 developers and 6 wider stakeholders. Seventeen participants were UK based.

Results: Most participants defined successful intervention development as a process that resulted in effective interventions that were relevant, acceptable and could be implemented in real world contexts. Accounts also indicated that participants aimed to develop interventions that end users wanted, and to undertake a development process that was methodologically rigorous and provided research evidence for journal publications and future grant applications. Participants’ ambitions to develop interventions that had real world impact drove them to consider the intervention’s feasibility and long-term sustainability early in the development process. However, this process was also driven by other factors: the realities of resource-limited health contexts; pre-specified research funder priorities; a reluctance to deviate from grant application protocols to incorporate evidence and knowledge acquired during the development process; limited funding to develop interventions; and the need for future randomised controlled trials (RCTs) to prove effectiveness. Participants expressed concern that these drivers discouraged long-term thinking and the development of innovative interventions, and prioritised evaluation over development and future implementation.

Conclusions: Tensions exist between developers’ goal of developing interventions that improve health in the real world, current funding structures, the limited resources within health care contexts, and the dominance of the RCT for evaluation of these interventions. There is a need to review funding processes and expectations of gold standard evaluation.
intervention development, health, qualitative research, drivers
2044-6055
Turner, Katrina
c76bab80-e780-4c3e-ab29-88fbfd914bad
Rousseau, Nikki
4ca285a5-911a-4f74-908f-a5f82bf45c18
Croot, Liz
6a7122e5-5491-4c4a-94f7-6be24d84f3a9
Duncan, Edward A.S.
fb1ca430-1a49-4822-9315-b3bef4f78d01
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
O'Cathain, Alicia
2fa113fb-2028-4cfb-84e2-2c2fdacce907
Hoddinott, Pat
d0ad946c-3bc1-4a35-b8fc-4fe7efc3d834
Turner, Katrina
c76bab80-e780-4c3e-ab29-88fbfd914bad
Rousseau, Nikki
4ca285a5-911a-4f74-908f-a5f82bf45c18
Croot, Liz
6a7122e5-5491-4c4a-94f7-6be24d84f3a9
Duncan, Edward A.S.
fb1ca430-1a49-4822-9315-b3bef4f78d01
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
O'Cathain, Alicia
2fa113fb-2028-4cfb-84e2-2c2fdacce907
Hoddinott, Pat
d0ad946c-3bc1-4a35-b8fc-4fe7efc3d834

Turner, Katrina, Rousseau, Nikki, Croot, Liz, Duncan, Edward A.S., Yardley, Lucy, O'Cathain, Alicia and Hoddinott, Pat (2019) Understanding successful development of complex health and health care interventions and its drivers from the perspective of developer and wider stakeholder an international qualitative interview study. BMJ Open, 9. (doi:10.1136/bmjopen-2018-028756).

Record type: Article

Abstract

Objective: Identify how individuals involved in developing complex health and health care interventions (developers), and wider stakeholders in the endeavour, such as funders, define successful intervention development and what factors influence how interventions are developed.

Design: In-depth interviews with developers and wider stakeholders to explore their views and experiences of developing complex health and health care interventions.

Setting: Interviews conducted with individuals in the UK, Europe and North America.

Participants: Twenty-one individuals were interviewed: 15 developers and 6 wider stakeholders. Seventeen participants were UK based.

Results: Most participants defined successful intervention development as a process that resulted in effective interventions that were relevant, acceptable and could be implemented in real world contexts. Accounts also indicated that participants aimed to develop interventions that end users wanted, and to undertake a development process that was methodologically rigorous and provided research evidence for journal publications and future grant applications. Participants’ ambitions to develop interventions that had real world impact drove them to consider the intervention’s feasibility and long-term sustainability early in the development process. However, this process was also driven by other factors: the realities of resource-limited health contexts; pre-specified research funder priorities; a reluctance to deviate from grant application protocols to incorporate evidence and knowledge acquired during the development process; limited funding to develop interventions; and the need for future randomised controlled trials (RCTs) to prove effectiveness. Participants expressed concern that these drivers discouraged long-term thinking and the development of innovative interventions, and prioritised evaluation over development and future implementation.

Conclusions: Tensions exist between developers’ goal of developing interventions that improve health in the real world, current funding structures, the limited resources within health care contexts, and the dominance of the RCT for evaluation of these interventions. There is a need to review funding processes and expectations of gold standard evaluation.

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Accepted/In Press date: 8 May 2019
e-pub ahead of print date: 30 May 2019
Keywords: intervention development, health, qualitative research, drivers

Identifiers

Local EPrints ID: 431626
URI: https://eprints.soton.ac.uk/id/eprint/431626
ISSN: 2044-6055
PURE UUID: b86a3b46-c308-4f22-9039-74d8a1eb631e
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 11 Jun 2019 16:30
Last modified: 20 Jul 2019 01:11

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Contributors

Author: Katrina Turner
Author: Nikki Rousseau
Author: Liz Croot
Author: Edward A.S. Duncan
Author: Lucy Yardley ORCID iD
Author: Alicia O'Cathain
Author: Pat Hoddinott

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