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

Autoři: Nikki Rousseau aff001;  Katrina M. Turner aff003;  Edward Duncan aff001;  Alicia O’Cathain aff004;  Liz Croot aff004;  Lucy Yardley aff005;  Pat Hoddinott aff001
Působiště autorů: Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP-RU), University of Stirling, Stirling, United Kingdom aff001;  Institute of Health and Society, Newcastle University, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom aff002;  Population Health Sciences, University of Bristol, Bristol, United Kingdom aff003;  School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom aff004;  Department of Psychology, University of Southampton, Southampton, United Kingdom aff005;  School of Psychological Science, University of Bristol, Bristol, United Kingdom aff006
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223615



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.


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.


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.


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.

Klíčová slova:

Allied health care professionals – Creativity – Decision making – Language – Prototypes – Qualitative studies – Research design – Research grants


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Článek vyšel v časopise


2019 Číslo 10