Hawkins Jemma, Madden Kim, Fletcher Adam, Midgley Luke, Grant Aimee, Cox Gemma, Moore Laurence, Campbell Rona, Murphy Simon, Bonell Chris, White James
Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), Cardiff University, Cardiff, CF10 3BD, UK.
Centre for Trials Research, Cardiff University, Cardiff, CF14 4YS, UK.
BMC Public Health. 2017 Sep 4;17(1):689. doi: 10.1186/s12889-017-4695-8.
Existing guidance for developing public health interventions does not provide information for researchers about how to work with intervention providers to co-produce and prototype the content and delivery of new interventions prior to evaluation. The ASSIST + Frank study aimed to adapt an existing effective peer-led smoking prevention intervention (ASSIST), integrating new content from the UK drug education resource Talk to Frank ( www.talktofrank.com ) to co-produce two new school-based peer-led drug prevention interventions. A three-stage framework was tested to adapt and develop intervention content and delivery methods in collaboration with key stakeholders to facilitate implementation.
The three stages of the framework were: 1) Evidence review and stakeholder consultation; 2) Co-production; 3) Prototyping. During stage 1, six focus groups, 12 consultations, five interviews, and nine observations of intervention delivery were conducted with key stakeholders (e.g. Public Health Wales [PHW] ASSIST delivery team, teachers, school students, health professionals). During stage 2, an intervention development group consisting of members of the research team and the PHW ASSIST delivery team was established to adapt existing, and co-produce new, intervention activities. In stage 3, intervention training and content were iteratively prototyped using process data on fidelity and acceptability to key stakeholders. Stages 2 and 3 took the form of an action-research process involving a series of face-to-face meetings, email exchanges, observations, and training sessions.
Utilising the three-stage framework, we co-produced and tested intervention content and delivery methods for the two interventions over a period of 18 months involving external partners. New and adapted intervention activities, as well as refinements in content, the format of delivery, timing and sequencing of activities, and training manuals resulted from this process. The involvement of intervention delivery staff, participants and teachers shaped the content and format of the interventions, as well as supporting rapid prototyping in context at the final stage.
This three-stage framework extends current guidance on intervention development by providing step-by-step instructions for co-producing and prototyping an intervention's content and delivery processes prior to piloting and formal evaluation. This framework enhances existing guidance and could be transferred to co-produce and prototype other public health interventions.
ISRCTN14415936 , registered retrospectively on 05 November 2014.
现有的公共卫生干预措施制定指南未向研究人员提供有关如何在评估前与干预措施提供者合作，共同制作新干预措施的内容并进行原型设计以及交付方式的信息。ASSIST + Frank研究旨在改编现有的一项有效的同伴主导的吸烟预防干预措施（ASSIST），整合来自英国毒品教育资源Talk to Frank（www.talktofrank.com）的新内容，以共同制作两项新的基于学校的同伴主导的毒品预防干预措施。测试了一个三阶段框架，以便与关键利益相关者合作改编和开发干预措施的内容及交付方法，以促进实施。
该框架的三个阶段为：1）证据审查和利益相关者咨询；2）共同制作；3）原型设计。在第1阶段，与关键利益相关者（如威尔士公共卫生部门[PHW]的ASSIST实施团队、教师、在校学生、卫生专业人员）进行了6次焦点小组讨论、12次咨询、5次访谈以及9次干预措施实施观察。在第2阶段，成立了一个由研究团队成员和PHW的ASSIST实施团队成员组成的干预措施开发小组，以改编现有的并共同制作新的干预活动。在第3阶段，利用关于对关键利益相关者的保真度和可接受性的过程数据，对干预培训和内容进行迭代式原型设计。第2阶段和第3阶段采用行动研究过程的形式，包括一系列面对面会议、电子邮件交流、观察和培训课程。
利用这个三阶段框架，我们在18个月的时间里与外部合作伙伴共同制作并测试了这两项干预措施的干预内容和交付方法。这个过程产生了新的和改编后的干预活动，以及在内容、交付形式、活动时间安排和顺序以及培训手册方面的改进。干预措施实施人员、参与者和教师的参与塑造了干预措施的内容和形式，并在最后阶段支持了实地的快速原型设计。
这个三阶段框架通过在试点和正式评估之前为共同制作和对干预措施的内容及交付过程进行原型设计提供逐步指导，扩展了当前关于干预措施开发的指南。这个框架强化了现有指南，并且可以移植用于共同制作和为其他公共卫生干预措施制作原型。
ISRCTN14415936，于2014年11月5日追溯注册。
