Intervention Component Analysis (ICA): a pragmatic approach for identifying the critical features of complex interventions

Abstract Aim: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy.Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Discussion: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care. Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

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Complex interventions and their implications for systematic reviews: A pragmatic approach

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2015.01.004 ◽

2015 ◽

Vol 52 (7) ◽

pp. 1211-1216 ◽

Cited By ~ 13

Author(s):

Mark Petticrew ◽

Laurie Anderson ◽

Randy Elder ◽

Jeremy Grimshaw ◽

David Hopkins ◽

...

Keyword(s):

Systematic Reviews ◽

Complex Interventions ◽

Pragmatic Approach

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Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the Medical Research Council framework

10.21203/rs.3.rs-39833/v5 ◽

2020 ◽

Author(s):

Kerry Evans ◽

Helen Spiby ◽

Jane C Morrell

Keyword(s):

Pregnant Women ◽

Maternity Care ◽

Public Involvement ◽

Complex Interventions ◽

Psychological Theory ◽

Intervention Component ◽

Group Discussions ◽

Mrc Framework ◽

Care Systems ◽

In Pregnancy

Abstract Background: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy.Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators.Results: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care.Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

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Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the Medical Research Council framework

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03469-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kerry Evans ◽

Helen Spiby ◽

C. Jane Morrell

Keyword(s):

Pregnant Women ◽

Maternity Care ◽

Public Involvement ◽

Complex Interventions ◽

Psychological Theory ◽

Intervention Component ◽

Group Discussions ◽

Mrc Framework ◽

Care Systems ◽

In Pregnancy

Abstract Background To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy. Methods The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Results The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care. Conclusion The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

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A Pragmatic Approach to Guide Implementation Evaluation Research: Strategy Mapping for Complex Interventions

Frontiers in Public Health ◽

10.3389/fpubh.2018.00134 ◽

2018 ◽

Vol 6 ◽

Cited By ~ 14

Author(s):

Alexis K. Huynh ◽

Alison B. Hamilton ◽

Melissa M. Farmer ◽

Bevanne Bean-Mayberry ◽

Shannon Wiltsey Stirman ◽

...

Keyword(s):

Evaluation Research ◽

Complex Interventions ◽

Research Strategy ◽

Pragmatic Approach ◽

Implementation Evaluation

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Developing a Complex Intervention to Support Pregnant Women with Mild to Moderate Anxiety: Application of the Medical Research Council Framework

10.21203/rs.3.rs-39833/v1 ◽

2020 ◽

Author(s):

Kerry Evans ◽

Helen Spiby ◽

Jane C Morrell

Keyword(s):

Pregnant Women ◽

Maternity Care ◽

Public Involvement ◽

Complex Interventions ◽

Psychological Theory ◽

Intervention Component ◽

Group Discussions ◽

Mrc Framework ◽

Care Systems ◽

In Pregnancy

Abstract Aim: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy.Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Discussion: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care.Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

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Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the Medical Research Council framework

10.21203/rs.3.rs-39833/v4 ◽

2020 ◽

Author(s):

Kerry Evans ◽

Helen Spiby ◽

Jane C Morrell

Keyword(s):

Pregnant Women ◽

Maternity Care ◽

Public Involvement ◽

Complex Interventions ◽

Psychological Theory ◽

Intervention Component ◽

Group Discussions ◽

Mrc Framework ◽

Care Systems ◽

In Pregnancy

Abstract Background: To design and develop an intervention to support women with symptoms of mild to moderate anxiety in pregnancy. Methods: The development followed the MRC framework for complex interventions, utilising psychological theory, review level evidence and professional and public involvement. Two systematic reviews were completed which helped identify potentially beneficial intervention components. The theory underpinning the components was explored to consider the potential benefit for women with mild to moderate anxiety symptoms in pregnancy. Methods of delivering the intervention within maternity services were explored. The intervention comprised: group discussions, one to one support and assisted self-help resources. Midwives were identified as ideally placed to facilitate the intervention supported by midwifery support workers. A bespoke training package was provided by subject experts to prepare the facilitators. Results: The absence of established interventions and a paucity of evidence based approaches for pregnant women with symptoms of mild to moderate anxiety indicated the need for a rigorous and systematic approach to the intervention design. This approach led to the development of an intervention feasible for implementation in maternity care systems tailored to the needs of pregnant women. The involvement of a multi-professional advisory team and active engagement of service users helped to consider the acceptability of the intervention for women and the feasibility of delivering the intervention in the context of maternity care. Conclusion: The MRC Framework provided useful overarching guidance to develop a midwife facilitated intervention for women with symptoms of anxiety in pregnancy. The framework assisted the development of a robust rationale for each intervention component and considered the processes of evaluation and implementation into maternity care systems.

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Complex interventions and their implications for systematic reviews: a pragmatic approach

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2013.06.004 ◽

2013 ◽

Vol 66 (11) ◽

pp. 1209-1214 ◽

Cited By ~ 97

Author(s):

Mark Petticrew ◽

Laurie Anderson ◽

Randy Elder ◽

Jeremy Grimshaw ◽

David Hopkins ◽

...

Keyword(s):

Systematic Reviews ◽

Complex Interventions ◽

Pragmatic Approach

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Emotional disclosure in palliative care: A scoping review of intervention characteristics and implementation factors

Palliative Medicine ◽

10.1177/02692163211013248 ◽

2021 ◽

pp. 026921632110132

Author(s):

Daisy McInnerney ◽

Nuriye Kupeli ◽

Paddy Stone ◽

Kanthee Anantapong ◽

Justin Chan ◽

...

Keyword(s):

Palliative Care ◽

Scoping Review ◽

Advanced Disease ◽

Component Analysis ◽

Included Study ◽

Emotional Disclosure ◽

Population Characteristics ◽

Intervention Component ◽

Underlying Mechanisms ◽

Implementation Factors

Background: Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics. Aim: To derive a greater understanding of the characteristics of potentially effective emotional disclosure-based interventions in palliative care by: (1) Developing a taxonomy of emotional disclosure-based interventions tested in people with advanced disease and (2) Mapping and linking objectives, outcomes, underlying mechanisms, and implementation factors. Design: A scoping review drawing on Intervention Component Analysis to combine evidence from studies’ methods, results, and discussion sections. Data sources: Six databases were searched to May 2020 including CINAHL, PsycINFO, and MEDLINE. Studies of emotional disclosure in adults with advanced disease were included. Study quality was appraised using an established tool. Results: Seven thousand seven hundred ninety-two unique records were screened, of which 25 primary studies were included. Intervention characteristics were grouped into classes within three domains: topic of disclosure, format, and dose. Evidence was not available to determine which, if any, of the characteristics is most effective. Thematic synthesis of evidence from methods and discussion sections identified factors to consider in tailoring an emotional disclosure-based intervention to this setting, including: population characteristics (e.g. time since diagnosis), providing a safe environment, and flexibility in format. Conclusions: This review approach facilitated a clearer understanding of factors that may be key in developing emotional disclosure-based interventions for palliative populations. Intervention Component Analysis has potential for application elsewhere to help develop evidence-based interventions.

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‘Leading from the front’ implementation strategies increase the success of influenza vaccination drives among healthcare workers: A reanalysis of Systematic Review evidence using Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA)

10.1101/2021.02.10.21251475 ◽

2021 ◽

Author(s):

Katy Sutcliffe ◽

Dylan Kneale ◽

James Thomas

Keyword(s):

Systematic Review ◽

Comparative Analysis ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Qualitative Comparative Analysis ◽

Implementation Strategies ◽

Component Analysis ◽

Health Campaigns ◽

Intervention Component ◽

Leadership Support

AbstractBackgroundSeasonal influenza vaccination of healthcare workers (HCW) is widely recommended to protect staff and patients. A previous systematic review examined interventions to encourage uptake finding that hard mandates, such as loss of employment for non-vaccination, were more effective than soft mandates, such as signing a declination form, or other interventions such as incentives. Despite these overarching patterns the authors of the review concluded that ‘substantial heterogeneity’ remained requiring further analysis. This paper reanalyses the evidence using Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) to examine whether the strategies used to implement interventions explain the residual heterogeneity.MethodsWe used ICA to extract implementation features and trialist’s reflections on what underpinned the success of the intervention they evaluated. The ICA findings then informed and structured two QCA analyses to systematically analyse associations between implementation features and intervention outcomes. Analysis 1 examined hard mandate studies. Analysis 2 examined soft mandates and other interventions.ResultsIn Analysis 1 ICA revealed the significance of ‘leading from the front’ rather than ‘top-down’ implementation of hard mandates. Four key features underpinned this: providing education prior to implementation; two-way engagement so HCW can voice concerns prior to implementation; previous use of other strategies so that institutions ‘don’t-go-in-cold’ with hard-mandates; and support from institutional leadership. QCA revealed that either of two configurations were associated with greater success of hard mandates. The first involves two-way engagement, leadership support and a ‘don’t-go-in-cold’ approach. The second involves leadership support, education and a ‘don’t-go-in-cold’ approach. Reapplying the ‘leading from the front’ theory in Analysis 2 revealed similar patterns.ConclusionsRegardless of intervention type a ‘leading from the front’ approach to implementation will likely enhance intervention success. While the results pertain to flu vaccination among HCWs, the components identified here may be relevant to public health campaigns regarding COVID-19 vaccination.

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