Developing a Theoretical Framework for Complex Community-Based Interventions (original) (raw)
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Health promotion practice, 2008
The benefits of utilizing and measuring application of theory for behavior change programs are numerous, including the emergence of new theories and theoretically bound strategies. Despite recent attempts to make theory use more salient, there remains a dearth of practical frameworks for the development and evaluation of theory-based programs. Without literature documenting how theories have been specifically applied to interventions and their evaluation, health educators may not be well prepared to utilize theory for the design, implementation, or as a focus of the evaluation. Using a case study example of a diabetes prevention program, this article describes how theory was used for the program design and the evaluation and provides a framework for using theory in other programs. Issues discussed include: the challenges in successfully utilizing theory for intervention development and the processes of developing theoretically based instruments.
Reviews of theoretical frameworks: Challenges and judging the quality of theory application
Medical Teacher, 2015
Rigorous reviews of available information, from a range of resources, are required to support medical and health educators in their decision making. The aim of this article is to highlight the importance of a review of theoretical frameworks specifically as a supplement to reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge and some practical strategies to achieving this are presented. This article also introduces the concept of theoretical quality, arguing that a critique of how theory is applied should complement the methodological appraisal of the literature in a review. We illustrate the challenge of establishing a shared meaning of theory through reference to experiences of an on-going review of this kind conducted in the field of interprofessional education (IPE) and use a high scoring paper selected in this review to illustrate how theoretical quality can be assessed. In reaching a shared understanding of theory as a concept, practical strategies that promote experiential and practical ways of knowing are required in addition to more propositional ways of sharing knowledge. Concepts of parsimony, testability, operational adequacy and empirical adequacy are explored as concepts that establish theoretical quality. Reviews of theoretical frameworks used in medical education are required to inform educational practice. Review teams should make time and effort to reach a shared understanding of the term theory. Theory reviews, and reviews more widely, should add an assessment of theory application to the protocol of their review method.
Paradigms and the research report: making what actually happens a heuristic for theory
American journal of community psychology, 1991
Provided a perspective on the discrepancy between how community research is carried out and how it is reported in scholarly journals. Drawing on the description of an intervention by Weinstein and her colleagues, several criteria for the more complete reporting of community-based interventions are described. These criteria focus on the nature of the research relationship, adequate description of the social context hosting the intervention, and the active interest in intervention effects across multiple levels of analysis.
International Encyclopedia of the Social & Behavioral Sciences, 2015
Background: Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods: A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results: Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions: Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.
Utilisation of theoretical models and frameworks in the process of evidence synthesis
JBI Database of Systematic Reviews and Implementation Reports, 2010
Methodological quality The review was a focused scoping review to locate and describe the contribution of theoretical models or frameworks to the process of synthesis. The methodological quality of the discussion papers was therefore not assessed. Data collection Data was extracted from the discussion papers using an adaptation of the standardised data extraction tool from the Joanna Briggs Institute Data Extraction for Narrative, Expert opinion & text (JBI-NOTARI). Data synthesis Results were discussed in narrative form. The use of frameworks in each step of the synthesis process was discussed. Results Eight studies (nine papers) formed the final set included in this review. The studies targeted the following issues: Child protection; end-of-life care; predictors of adolescent sexual behaviour and intention; primary care career choice; prognosis of acute whiplash; reluctance to care; use of Information Technology; young child's post-divorce adjustment. Frameworks were used in four of the seven steps of synthesis, and integration of the data indicated that the use of frameworks in the process of evidence synthesis was valuable and had many advantages. Conclusion This review illustrates that the addition of structure and guidance provided by a framework can serve to benefit the process of integration. Studies in this review indicated that the use of frameworks helped to inform the association between variables, guide the search strategy, structure and clarify the outcomes, identify knowledge gaps and indicate areas for future research. Used in this manner, frameworks could provide a valuable foundation for the process of synthesis. Implications for practice Evidence from systematic reviews informs practice. The incorporation of a theoretical model or framework helps to guide the process of synthesis and clarify the outcomes. This added transparency will facilitate the assimilation of the evidence by the target audience. Implications for research Systematic reviews are the highest level of evidence available at this time. The use of theoretical models or frameworks in the review process strengthens the rigor and transparency of the integrative method. Further research into the contribution of theoretical models or conceptual frameworks to the process of synthesis may be valuable.
A Framework for Enhancing the Value of Research for Dissemination and Implementation
American Journal of Public Health, 2015
A comprehensive guide that identifies critical evaluation and reporting elements necessary to move research into practice is needed. We propose a framework that highlights the domains required to enhance the value of dissemination and implementation research for end users. We emphasize the importance of transparent reporting on the planning phase of research in addition to delivery, evaluation, and long-term outcomes. We highlight key topics for which well-established reporting and assessment tools are underused (e.g., cost of intervention, implementation strategy, adoption) and where such tools are inadequate or lacking (e.g., context, sustainability, evolution) within the context of existing reporting guidelines. Consistent evaluation of and reporting on these issues with standardized approaches would enhance the value of research for practitioners and decision-makers. (Am J Public Health. Published online ahead of print November 13, 2014: e1-e9.
Population health intervention research: the place of theories
Trials
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.