"Did the trial kill the intervention?" experiences from the development, implementation and evaluation of a complex intervention
نویسندگان
چکیده
BACKGROUND The development, implementation and evaluation of any new health intervention is complex. This paper uses experiences from the design, implementation and evaluation of a rehabilitation programme to shed light on, and prompt discussion around, some of the complexities involved in such an undertaking. METHODS Semi-structured interviews were conducted with 15 trial participants and five members of staff at the conclusion of a trial evaluating a rehabilitation programme aimed at promoting recovery after stem cell transplantation. RESULTS This study identified a number of challenges relating to the development and evaluation of complex interventions. The difficulty of providing a standardised intervention that was acceptable to patients was highlighted in the participant interviews. Trial participants and some members of staff found the concept of equipoise and randomisation challenging and there was discord between the psychosocial nature of the intervention and the predominant bio-medical culture in which the research took place. CONCLUSIONS A lack of scientific evidence as to the efficacy of an intervention does not preclude staff and patients holding strong views about the benefits of an intervention. The evaluation of complex interventions should, where possible, facilitate not restrict that complexity. Within the local environment where the trial is conducted, acquiescence from those in positions of authority is insufficient; commitment to the trial is required.
منابع مشابه
Many Moving Parts: Evaluating the Implementation of the Kin KeeperSM Cancer Prevention Intervention
Introduction: This paper details an evaluation of the implementation and feasibility of a multilevel project entitled Kin KeeperSM Cancer Prevention Intervention that utilizes community health workers (CHWs) to deliver breast and cervical cancer education. The evaluation includes intervention fidelity, participant satisfaction, participant retention, and the cost of program implementa...
متن کاملRural Women’s Experiences with Money and Developmental Intervention: A Case Study in Semnan Province
This article tries to analyze the interaction between the implementation of a microfinance project in a rural area and the social and cultural infrastructure prevailing in the project site. In 2000, 53 women in a small village in central Iran formed an association of beekeepers with the support of a developmental intervention promoting microfinance as a strategy for poverty alleviation. Because...
متن کاملThe effect of a designed Care Plan on the incidence of aspiration in intubated patients: A randomized clinical trial
Background : Patients hospitalized in intensive care unit are at risk of aspiration and subsequent complications due to factors such as endotracheal tube, mechanical ventilation, and decreased level of consciousness. Aspiration of gastric residuals to the lung is one of the preventable lesions in patients who are feeding by tube and under mechanical ventilation.This study was conducted to deter...
متن کاملThe Role of Government and Local Actors in the Tourism Industry Development in Iran: An Unsuccessful Intervention Model
This study designed to give us a better understanding of the experiences and mechanism of the Government intervention in tourism industry development in Iran. This study is mainly focused on the government relations With local community According to their acceptance or disagreement with tourism development project in their region. Having used Phenomenology Strategy in order to understand the ex...
متن کاملApplication of Collaborative Care Model on Components of Caregiver Burden in Families of Patients with Mental Disorders
Background: Collaborative care can be used as a component of self-care in reducing the complications of care in family caregivers of mental patients. Therefore, the present study aims to "determine the impact of the use of collaborative care model on the care burden parameters of the family of patients with mental disorders". Methods: In this clinical trial, 66 households from family...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 11 شماره
صفحات -
تاریخ انتشار 2011