Learning from complexity: when theory follows practice
Project title: Theory and methods of interventions in complex systems
Start date: January 2015
End date: June 2018
This project is finished
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.
- Professor Penny Hawe, University of Sydney
- Dr Therese Riley, Prevention Centre
- Professor Alan Shiell, La Trobe University
This project was funded by the NHMRC, Australian Government Department of Health, NSW Ministry of Health, ACT Health and the HCF Research Foundation.
Professor Hawe and colleagues published a number of papers aimed at developing stronger insights and theory from case studies of complex interventions. A review of complex interventions in the Annual Review of Public Health, for example, shows that interventions that harness complexity have stronger health impacts than those that impose rigid rules.
See the list of presentations in the ‘Publications and presentations’ tab.
- Rutter H, Savona N, Glonti K, Bibby J, Cummins S, Finegood DT, Greaves F, Harper L, Hawe P, Moore L, Petticrew M, Rehfuess E, Shiell A, Thomas J, White M. The need for a complex systems model of evidence for public health. Lancet. 2017; doi: 10.1016/S0140-6736(17)31267-9
- Greenwood-Lee J, Hawe P, Nettel-Aguirre A, Shiell A, Marshall DA. Complex intervention modelling should capture the dynamics of adaptation. BMC Medical Research Methodology 2016 16:51 DOI 10.1186/s12874-016-0149-8
- Hawe P, Bond L, Ghali LM, Perry R, Blackstaffe A, Davison CM, Casey DM, Butler H, Webster CM, Scholz B. Replication of a whole school ethos changing intervention: different context, similar effects, additional insights. BMC Public Health 2015;15:265 Full text
- Hawe P. Lessons from complex interventions to promote health. Annual Review of Public Health 2015;36:307-323 Full text
- Hawe P. Minimal, negligible and negligent interventions. Social Science & Medicine Volume 138, August 2015, Pages 265–268
- Hawe P, Riley T, Gartrell A, Turner K, Canales, Omstead D. Comparison communities in a cluster randomised trial innovate in response to ‘being controlled’. Social Science and Medicine 2015;133:102-110 Abstract
- Hawe P. The contribution of social ecological thinking to community psychology: origins, practice and research. In Bond MA, Keys CB, Serrano-Garcia I, Shinn M (Eds) (2017). APA Handbook of Community Psychology: Theoretical foundations, Core Concepts, and Emerging Challenges, Vol. 1, (pp. 87-105). Washington, DC, US: American Psychological Association, xxxi, 521 pp. http://dx.doi.org/10.1037/14953-004
- Hawe P. The social ecological paradigm. In Bond MA, Keys CB, Serrano-Garcia I, Shinn M (Eds) Handbook of Community Psychology
- Shiell A, Riley T. Methods and methodology of systems analysis. In Bond MA, Keys CB, Serrano-Garcia I, Shinn M (Eds) Handbook of Community Psychology