|Appears in Collections:||Faculty of Health Sciences and Sport Journal Articles|
|Peer Review Status:||Refereed|
|Title:||Exploring Synergistic Interactions And Catalysts In Complex Interventions: Longitudinal, Mixed Methods Case Studies Of An Optimised Multi-Level Suicide Prevention Intervention In Four European Countries (Ospi-Europe)|
|Author(s):||Harris, Fiona Margaret|
O'Connor, Rory C
Audenhove, Chantal van
programme as catalyst
|Citation:||Harris FM, Maxwell M, O'Connor RC, Coyne J, Arensman E, Coffey C, Koburger N, Gusmao R, Costa S, Szekely A, Cserháti Z, McDaid D, Audenhove Cv & Hegerl U (2016) Exploring Synergistic Interactions And Catalysts In Complex Interventions: Longitudinal, Mixed Methods Case Studies Of An Optimised Multi-Level Suicide Prevention Intervention In Four European Countries (Ospi-Europe), BMC Public Health, 16, Art. No.: 268.|
|Abstract:||Background The Medical Research Council (MRC) Framework for complex interventions highlights the need to explore interactions between components of complex interventions, but this has not yet been fully explored within complex, non-pharmacological interventions. This paper draws on the process evaluation data of a suicide prevention programme implemented in four European countries to illustrate the synergistic interactions between intervention levels in a complex programme, and to present our method for exploring these. Methods A realist evaluation approach informed the process evaluation, which drew on mixed methods, longitudinal case studies. Data collection consisted of 47 semi-structured interviews, 12 focus groups, one workshop, fieldnoted observations of six programme meetings and 20 questionnaires (delivered at six month intervals to each of the four intervention sites). Analysis drew on the framework approach, facilitated by the use of QSR NVivo (v10). Our qualitative approach to exploring synergistic interactions (QuaSIC) also developed a matrix of hypothesised synergies that were explored within one workshop and two waves of data collection. Results All four implementation countries provided examples of synergistic interactions that added value beyond the sum of individual intervention levels or components in isolation. For instance, the launch ceremony of the public health campaign (a level 3 intervention) in Ireland had an impact on the community-based professional training, increasing uptake and visibility of training for journalists in particular. In turn, this led to increased media reporting of OSPI activities (monitored as part of the public health campaign) and also led to wider dissemination of editorial guidelines for responsible reporting of suicidal acts. Analysis of the total process evaluation dataset also revealed the new phenomenon of the OSPI programme acting as a catalyst for externally generated (and funded) activity that shared the goals of suicide prevention. Conclusions The QuaSIC approach enabled us to develop and refine our definition of synergistic interactions and add the innovative concept of catalytic effects. This represents a novel approach to the evaluation of complex interventions. By exploring synergies and catalytic interactions related to a complex intervention or programme, we reveal the added value to planned activities and how they might be maximised.|
|Rights:||© Harris et al. 2016 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.|
|Harris et al_BMC Public Health_2016.pdf||458.33 kB||Adobe PDF||View/Open|
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