Learning from complexity: when theory follows practice

What is the issue?

Chronic disease prevention has had some enormous gains over the past 30 years, with the combined effect of multiple actions producing significant impacts such as the reduction in smoking. But the effect of any one individual action has been small. There are also numerous examples of ‘state of the art’ interventions that have not worked.

This project sought to learn from failures, successes and the transfer of interventions from one site to another.

How did the project address the issue?

This program of work gained insights into the dynamics of complex interventions in public health. The work involved interrogations of real-world existing projects and the methods used to capture effects.

Relevance for practice

The program of work provided guidance about how to manage and fund ‘bundled’ interventions – that is, those that move away from the familiar silos (smoking, alcohol, drug use) to achieve multiple impact in the prevention of chronic disease. It aimed to increase understanding of how to design and evaluate interventions in complex systems.

What were the outcomes?

The program gained insights about mechanisms of action of complex interventions. In particular how do we make effects stronger, understand multiple and multiplied effects, and how does context help to drive the outcome? The goal was to develop stronger theory from case studies of complex interventions. We anticipate the results will help to rewrite the textbooks on how to design and evaluate interventions in complex systems.