Jack, Joseph, and Morton Mandel School of Applied Social Sciences Case Western Reserve University, United States; Center on Trauma and Adversity, United States.
Jack, Joseph, and Morton Mandel School of Applied Social Sciences Case Western Reserve University, United States.
Eval Program Plann. 2023 Aug;99:102303. doi: 10.1016/j.evalprogplan.2023.102303. Epub 2023 May 1.
Hospital-based violence intervention programs (HVIP) are critical to interrupting the cycle of violence. These interventions are considered "complex" in that they have many mechanisms of change and related outcomes. Few HVIPs clearly identify the underlying mechanisms of intervention and explicitly link those with key outcomes however, limiting the field's ability to know what works best and for whom. To develop a program theory of change for these "complex interventions," a non-linear, robust methodology that is grounded in the lived experience of those delivering and receiving services is needed. To aid researchers, evaluators, students, and program developers, we describe the use of Grounded Theory as a methodology to enhance the development of complex interventions, illuminating a non-linear approach that engages key stakeholders. To illustrate application, we describe a case example of The Antifragility Initiative, a HVIP in Cleveland, Ohio. The development of the program theory of change was conducted in four phases: (1) review of existing program documents, (2) semi-structured interviews with program developers (n = 6), (3) a focus group with program stakeholders (n = 8), and (4) interviews with caregivers and youth (n = 8). Each phase informed the next and culminated in a theoretical narrative and visual model of the Antifragility Initiative. Together, the theoretical narrative and visual model identify the underlying mechanisms that can promote change by the program.
医院暴力干预项目（HVIP）对于打断暴力循环至关重要。这些干预措施被认为是“复杂的”，因为它们有许多变化机制和相关结果。然而，很少有 HVIP 明确确定干预的潜在机制，并明确将这些机制与关键结果联系起来，这限制了该领域了解哪些措施最有效以及对哪些人有效。为了为这些“复杂干预措施”制定一个计划理论的变化，需要一种非直线的、稳健的方法，这种方法基于提供和接收服务的人的实际经验。为了帮助研究人员、评估人员、学生和项目开发者，我们描述了使用扎根理论作为一种方法来增强复杂干预措施的发展，阐明了一种与关键利益相关者接触的非线性方法。为了说明应用，我们描述了俄亥俄州克利夫兰市的 HVIP——抗脆弱倡议的案例。该计划理论变化的发展分为四个阶段：（1）审查现有计划文件，（2）与计划开发者进行半结构化访谈（n=6），（3）与计划利益相关者进行焦点小组讨论（n=8），以及（4）与护理人员和青年进行访谈（n=8）。每个阶段都为下一个阶段提供信息，并最终形成抗脆弱倡议的理论叙述和视觉模型。理论叙述和视觉模型共同确定了计划可以通过哪些潜在机制来促进变革。
