Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches
Abstract Background There is a growing need for methods that acknowledge and successfully capture the dynamic interaction between context and implementation of complex interventions. Case study research has the potential to provide such understanding, enabling in-depth investigation of the particula...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Medical Research Methodology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12874-021-01418-3 |
| _version_ | 1819044900482580480 |
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| author | Sara Paparini Chrysanthi Papoutsi Jamie Murdoch Judith Green Mark Petticrew Trisha Greenhalgh Sara E. Shaw |
| author_facet | Sara Paparini Chrysanthi Papoutsi Jamie Murdoch Judith Green Mark Petticrew Trisha Greenhalgh Sara E. Shaw |
| author_sort | Sara Paparini |
| collection | DOAJ |
| description | Abstract Background There is a growing need for methods that acknowledge and successfully capture the dynamic interaction between context and implementation of complex interventions. Case study research has the potential to provide such understanding, enabling in-depth investigation of the particularities of phenomena. However, there is limited guidance on how and when to best use different case study research approaches when evaluating complex interventions. This study aimed to review and synthesise the literature on case study research across relevant disciplines, and determine relevance to the study of contextual influences on complex interventions in health systems and public health research. Methods Systematic meta-narrative review of the literature comprising (i) a scoping review of seminal texts (n = 60) on case study methodology and on context, complexity and interventions, (ii) detailed review of empirical literature on case study, context and complex interventions (n = 71), and (iii) identifying and reviewing ‘hybrid papers’ (n = 8) focused on the merits and challenges of case study in the evaluation of complex interventions. Results We identified four broad (and to some extent overlapping) research traditions, all using case study in a slightly different way and with different goals: 1) developing and testing complex interventions in healthcare; 2) analysing change in organisations; 3) undertaking realist evaluations; 4) studying complex change naturalistically. Each tradition conceptualised context differently—respectively as the backdrop to, or factors impacting on, the intervention; sets of interacting conditions and relationships; circumstances triggering intervention mechanisms; and socially structured practices. Overall, these traditions drew on a small number of case study methodologists and disciplines. Few studies problematised the nature and boundaries of ‘the case’ and ‘context’ or considered the implications of such conceptualisations for methods and knowledge production. Conclusions Case study research on complex interventions in healthcare draws on a number of different research traditions, each with different epistemological and methodological preferences. The approach used and consequences for knowledge produced often remains implicit. This has implications for how researchers, practitioners and decision makers understand, implement and evaluate complex interventions in different settings. Deeper engagement with case study research as a methodology is strongly recommended. |
| first_indexed | 2024-12-21T10:20:01Z |
| format | Article |
| id | doaj.art-20e89c98ecfe478bb371d69d8328bd97 |
| institution | Directory Open Access Journal |
| issn | 1471-2288 |
| language | English |
| last_indexed | 2024-12-21T10:20:01Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Research Methodology |
| spelling | doaj.art-20e89c98ecfe478bb371d69d8328bd972022-12-21T19:07:28ZengBMCBMC Medical Research Methodology1471-22882021-10-0121112210.1186/s12874-021-01418-3Evaluating complex interventions in context: systematic, meta-narrative review of case study approachesSara Paparini0Chrysanthi Papoutsi1Jamie Murdoch2Judith Green3Mark Petticrew4Trisha Greenhalgh5Sara E. Shaw6Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory QuarterNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory QuarterSchool of Population Health & Environmental Sciences, King’s College LondonWellcome Centre for Cultures & Environments of Health, University of ExeterPublic Health, Environments & Society, London School of Hygiene & Tropical MedicineNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory QuarterNuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory QuarterAbstract Background There is a growing need for methods that acknowledge and successfully capture the dynamic interaction between context and implementation of complex interventions. Case study research has the potential to provide such understanding, enabling in-depth investigation of the particularities of phenomena. However, there is limited guidance on how and when to best use different case study research approaches when evaluating complex interventions. This study aimed to review and synthesise the literature on case study research across relevant disciplines, and determine relevance to the study of contextual influences on complex interventions in health systems and public health research. Methods Systematic meta-narrative review of the literature comprising (i) a scoping review of seminal texts (n = 60) on case study methodology and on context, complexity and interventions, (ii) detailed review of empirical literature on case study, context and complex interventions (n = 71), and (iii) identifying and reviewing ‘hybrid papers’ (n = 8) focused on the merits and challenges of case study in the evaluation of complex interventions. Results We identified four broad (and to some extent overlapping) research traditions, all using case study in a slightly different way and with different goals: 1) developing and testing complex interventions in healthcare; 2) analysing change in organisations; 3) undertaking realist evaluations; 4) studying complex change naturalistically. Each tradition conceptualised context differently—respectively as the backdrop to, or factors impacting on, the intervention; sets of interacting conditions and relationships; circumstances triggering intervention mechanisms; and socially structured practices. Overall, these traditions drew on a small number of case study methodologists and disciplines. Few studies problematised the nature and boundaries of ‘the case’ and ‘context’ or considered the implications of such conceptualisations for methods and knowledge production. Conclusions Case study research on complex interventions in healthcare draws on a number of different research traditions, each with different epistemological and methodological preferences. The approach used and consequences for knowledge produced often remains implicit. This has implications for how researchers, practitioners and decision makers understand, implement and evaluate complex interventions in different settings. Deeper engagement with case study research as a methodology is strongly recommended.https://doi.org/10.1186/s12874-021-01418-3Complex interventionsEvaluationCase study methodsContextQualitative researchMixed methods research |
| spellingShingle | Sara Paparini Chrysanthi Papoutsi Jamie Murdoch Judith Green Mark Petticrew Trisha Greenhalgh Sara E. Shaw Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches BMC Medical Research Methodology Complex interventions Evaluation Case study methods Context Qualitative research Mixed methods research |
| title | Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches |
| title_full | Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches |
| title_fullStr | Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches |
| title_full_unstemmed | Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches |
| title_short | Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches |
| title_sort | evaluating complex interventions in context systematic meta narrative review of case study approaches |
| topic | Complex interventions Evaluation Case study methods Context Qualitative research Mixed methods research |
| url | https://doi.org/10.1186/s12874-021-01418-3 |
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