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Minimal, negligible and negligent interventions

Professor Penny Hawe

By Professor Penny Hawe

The paper:

Hawe P. Minimal, negligible and negligent interventions. Social Science & Medicine Volume 138, August 2015, Pages 265–268

The project:

Theory and methods of interventions in complex systems

Why I wrote about this topic

I was irritated by the number of relatively puny interventions in public health trying to solve complex problems and, not surprisingly, coming up with lacklustre results. Researchers were blaming various guidelines that they felt were straitjacketing the style of intervention.

What’s my key point?

We can blame the conservative nature of guidelines up to a point, really, that’s a cop out. The design of an intervention has to draw on the theory and expertise of the investigators and practitioners.

It is ethically questionable to proceed to deliver an intervention when the authors feel it may be insufficient to be effective at the outset.

What now?

We rarely talk about negligence in public health or in prevention. It’s time we did. We can also revamp the way we fund and evaluate the performance of those public health interventions which necessarily work across sectors. We need to better interrogate the logic of what people want to do and their capacity to detect multiple effects and their distribution.