Exploring synergistic interactions and catalysts in complex interventions: Longitudinal, mixed methods case studies of an optimised multi-level suicide prevention intervention in four european countries (Ospi-Europe)

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dc.contributor.authorHarris, Fiona M.
dc.contributor.authorMaxwell, Margaret
dc.contributor.authorO'Connor, Rory
dc.contributor.authorArensman, Ella
dc.contributor.authorCoffey, Claire
dc.contributor.authorKoburger, Nicole
dc.contributor.authorGusmão, Ricardo
dc.contributor.authorCosta, Susana
dc.contributor.authorSzékely, András
dc.contributor.authorCserhati, Zoltan
dc.contributor.authorMcDaid, David
dc.contributor.authorVan Audenhove, Chantal
dc.contributor.authorHegerl, Ulrich
dc.contributor.authorCoyne, James C.
dc.contributor.authorCoyne, James C.
dc.contributor.funderSeventh Framework Programme
dc.date.accessioned2017-06-21T11:01:25Z
dc.date.available2017-06-21T11:01:25Z
dc.date.issued2016-03-15
dc.description.abstractBackground: The Medical Research Council (MRC) Framework for complex interventions highlights the need to explore interactions between components of complex interventions, but this has not yet been fully explored within complex, non-pharmacological interventions. This paper draws on the process evaluation data of a suicide prevention programme implemented in four European countries to illustrate the synergistic interactions between intervention levels in a complex programme, and to present our method for exploring these. Methods: A realist evaluation approach informed the process evaluation, which drew on mixed methods, longitudinal case studies. Data collection consisted of 47 semi-structured interviews, 12 focus groups, one workshop, fieldnoted observations of six programme meetings and 20 questionnaires (delivered at six month intervals to each of the four intervention sites). Analysis drew on the framework approach, facilitated by the use of QSR NVivo (v10). Our qualitative approach to exploring synergistic interactions (QuaSIC) also developed a matrix of hypothesised synergies that were explored within one workshop and two waves of data collection. Results: All four implementation countries provided examples of synergistic interactions that added value beyond the sum of individual intervention levels or components in isolation. For instance, the launch ceremony of the public health campaign (a level 3 intervention) in Ireland had an impact on the community-based professional training, increasing uptake and visibility of training for journalists in particular. In turn, this led to increased media reporting of OSPI activities (monitored as part of the public health campaign) and also led to wider dissemination of editorial guidelines for responsible reporting of suicidal acts. Analysis of the total process evaluation dataset also revealed the new phenomenon of the OSPI programme acting as a catalyst for externally generated (and funded) activity that shared the goals of suicide prevention. Conclusions: The QuaSIC approach enabled us to develop and refine our definition of synergistic interactions and add the innovative concept of catalytic effects. This represents a novel approach to the evaluation of complex interventions. By exploring synergies and catalytic interactions related to a complex intervention or programme, we reveal the added value to planned activities and how they might be maximised.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid268
dc.identifier.citationHarris, F. M., Maxwell, M., O’Connor, R., Coyne, J. C., Arensman, E., Coffey, C., Koburger, N., Gusmão, R., Costa, S., Székely, A., Cserhati, Z., McDaid, D., Van Audenhove, C. and Hegerl, U. (2016) ‘Exploring synergistic interactions and catalysts in complex interventions: longitudinal, mixed methods case studies of an optimised multi-level suicide prevention intervention in four european countries (Ospi-Europe)’, BMC Public Health, 16, 268 (9pp). doi: 10.1186/s12889-016-2942-zen
dc.identifier.doi10.1186/s12889-016-2942-z
dc.identifier.endpage9
dc.identifier.issn1471-2458
dc.identifier.journaltitleBMC Public Healthen
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/4129
dc.identifier.volume16
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/223138/EU/Optimizing suicide prevention programs and their implementation in Europe/OSPI-EUROPE
dc.relation.urihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-2942-z
dc.rights© 2016, Harris et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectComplex interventionsen
dc.subjectLongitudinal studyen
dc.subjectProcess evaluationen
dc.subjectSuicide preventionen
dc.subjectSynergistic interactionsen
dc.subjectProgramme as catalysten
dc.titleExploring synergistic interactions and catalysts in complex interventions: Longitudinal, mixed methods case studies of an optimised multi-level suicide prevention intervention in four european countries (Ospi-Europe)en
dc.typeArticle (peer-reviewed)en
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