Complex+Interventions

=Complex Interventions (N=10)=


 * Definition 1:** The MRC document 'A Framework for the Development and Evaluation of Randomised Controlled Trials for Complex Interventions' argues that "the greater the difficulty in defining precisely what exactly are the `active ingredients' of an intervention and how they relate to each other, the greater the likelihood that you are dealing with a complex intervention."
 * Source:** http://www.bmj.com/cgi/content/full/328/7455/1561
 * Focus:** Randomized Controlled Trials


 * Definition 2:** The review included published research articles of evaluations of complex interventions in stroke prevention and management. Because there is little clarity over the definition of a ‘complex intervention’, we defined complex interventions as educational or psychosocial interventions aimed at changing knowledge, beliefs or behaviors.
 * Source:** http://stroke.ahajournals.org/cgi/content/full/37/9/2410
 * Focus:** Health Care (Stroke)


 * Definition 3:** To clarify this, we propose three levels for defining a complex intervention: the evidence and theory which inform the intervention, the tasks and processes involved in applying the theoretical principles, and the people with whom, and context within which, the intervention is operationalised.
 * Source:** http://bmj.bmjjournals.com/cgi/content/full/318/7185/711
 * Focus:** Health Services Research


 * Definition 4:** Complex interventions in health care, whether therapeutic or preventative, comprise a number of separate elements which seem essential to the proper functioning of the interventions although the 'active ingredient' of the intervention that is effective is difficult to specify. (...) Complex interventions are built up from a number of components, which may act both independently and interdependently. The components usually include behaviors, parameters of behaviors (e.g. frequency, timing), and methods of organizing and delivering those behaviors (e.g. type(s) of practitioner, setting and location) [4].
 * Source:** http://www.biomedcentral.com/1471-2296/8/42
 * Focus:** Health Care


 * Definition 5:** Complex interventions are "built up from a number of components, which may act both independently and interdependently.
 * Source:** http://www.bmj.com/cgi/content/extract/334/7591/455
 * Focus:** Health Care


 * Definition 6 :** In this context, a complex intervention is defined as a deliberately initiated attempt to introduce new, or modify existing, patterns of collective action in health care. Deliberate initiation means that an intervention is: institutionally sanctioned; formally or informally defined; consciously planned; and intended to lead to a changed outcome.
 * Source:** http://eprints.liv.ac.uk/680/1/1472-6963-7-148.pdf
 * Focus:** Health Care


 * Definition 7:** Complex interventions – consisting of multiple behavioural, technological, and organizational components – are common and important features of health care practice and research. However, they pose special evaluation problems because their components may act independently or interdependently, and it is often difficult to tease out the relationships between them.
 * Source:** http://www.biomedcentral.com/1472-6963/7/148
 * Focus:** Health Care


 * Definition 8:** Socially complex interventions are ‘characterised by complex and diverse staffing arrangements; ambiguous protocols; hard-to-define and differently motivated populations…and permeable external boundaries in which the performance of the intervention is dependent on the social setting’ (p. 124).
 * Source:** http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1365-2648.2003.02864.x
 * Focus:** Nursing


 * Definition 9:** Interventions to address health inequalities are complex: health interventions that are non-pharmacological or clinical … and typically comprise more than one active ingredient or component (Campbell et al 2000)
 * Source:** http://www.londonshealth.gov.uk/PDF/akdraper17oct07.pdf
 * Focus:** Health Care


 * Definition 10:** Complex healthcare interventions are by definition made up of several components, which may act both independently and inter-dependently to achieve their desired outcomes. For example, the smoking cessation service provided by some community pharmacists includes a therapeutic relationship between smoker and pharmacist, a choice of smoking cessation aids, some counselling activity by the pharmacists in addition to on-going support. Whilst this service has been shown to be effective in achieving its intended goal1–3, defining the ’active ingredient’ involved within such complex interventions is problematic.
 * Source:** http://www.springerlink.com/content/v253h859qp311002/
 * Focus:** Health Care