Moore Graham F, Evans Rhiannon E, Hawkins Jemma, Littlecott Hannah, Melendez-Torres G J, Bonell Chris, Murphy Simon
Cardiff University, UK.
London School of Hygiene & Tropical Medicine, UK.
Evaluation (Lond). 2019 Jan;25(1):23-45. doi: 10.1177/1356389018803219. Epub 2018 Oct 31.
Complex systems approaches to social intervention research are increasingly advocated. However, there have been few attempts to consider how models of intervention science, such as the UK's Medical Research Council complex interventions framework, might be reframed through a complex systems lens. This article identifies some key areas in which this framework might be reconceptualized, and a number of priority areas where further development is needed if alignment with a systems perspective is to be achieved. We argue that a complex systems perspective broadens the parameters of 'relevant' evidence and theory for intervention development, before discussing challenges in defining feasibility in dynamic terms. We argue that whole systems evaluations may be neither attainable, nor necessary; acknowledgment of complexity does not mean that evaluations must be complex, or investigate all facets of complexity. However, a systems lens may add value to evaluation design through guiding identification of key uncertainties, and informing decisions such as timings of follow-up assessments.
社会干预研究中越来越提倡采用复杂系统方法。然而,很少有人尝试思考如何通过复杂系统视角对干预科学模型(如英国医学研究理事会的复杂干预框架)进行重新构建。本文确定了该框架可能需要重新概念化的一些关键领域,以及若要与系统视角保持一致则需要进一步发展的一些优先领域。我们认为,在讨论以动态方式定义可行性所面临的挑战之前,复杂系统视角拓宽了干预发展中“相关”证据和理论的参数范围。我们认为全面系统评估可能既无法实现,也没有必要;认识到复杂性并不意味着评估必须复杂,或者要研究复杂性的所有方面。然而,系统视角可能会通过指导识别关键不确定性以及为诸如后续评估时间安排等决策提供信息,从而为评估设计增添价值。