Attending to design when developing complex health interventions: a qualitative interview study with intervention developers and associated stakeholders

Nikki Rousseau, Katrina M Turner, Edward Duncan, Alicia O'Cathain, Liz Croot, Lucy Yardley, Pat Hoddinott

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
138 Downloads (Pure)

Abstract

BACKGROUND
Guidance and frameworks exist to assist those developing health interventions but may offer limited discussion of 'design', the part of development concerned with generating ideas for and making decisions about an intervention's content, format and delivery. The aim of this paper is to describe and understand the views and experiences of developers and associated stakeholders in relation to how design occurs in health intervention development.

METHODS
Semi-structured interviews were conducted with 21 people who had developed complex interventions to improve health and/or who were relevant stakeholders (e.g. funders and publishers of intervention development work), regarding their views, experiences and approaches to intervention design. Sampling was purposive in terms of maximising diversity. A thematic inductive analysis was conducted.

RESULTS
Approaches to design varied substantially between intervention developers. This contrasted with consistency in other activities undertaken during development, such as literature review. Design also posed more challenges than other parts of development. We identified six 'modes' of design: informed; negotiated; structured; delegated; 'my baby'; and creative partnership. In understanding the differences between these different modes, and the challenges posed by intervention design, we identified three key themes: enabling creativity during the design process; working with different types of knowledge; and 'stabilising' (developing clear shared understandings of) the intervention development to enable design.

CONCLUSIONS
Design has received less attention than other activities undertaken when developing interventions to improve health. Developers take a variety of approaches to design and often find it challenging. Guidance for intervention development in health has tended to see design as proceeding in a predictable and controlled manner from acquired knowledge. Our study suggests that design rarely reflects this rational ideal. Future guidance on intervention development in healthcare should support developers to work effectively with different types of knowledge, to help design progress more smoothly and to maximise creativity.
Original languageEnglish
Pages (from-to)e0223615
Number of pages20
JournalPLoS ONE
Volume14
Issue number10
DOIs
Publication statusPublished - 15 Oct 2019

Structured keywords

  • Physical and Mental Health
  • Digital Health

Keywords

  • Creativity
  • Research Design
  • Qualitative study
  • Language
  • decision making
  • allied health care professionals
  • Prototypes
  • research grants

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