Evaluating Complex Interventions

Theme Lead: Steve Cummins (LSHTM)
Generating robust evidence on the impacts and cost-effectiveness of public health programmes, polices and interventions and translating this evidence into practice is central to health improvement in low, middle and high income settings. With decreasing returns from downstream behaviour change interventions, many of the major challenges for public health lie in the generation of high quality causal evidence for upstream social and environmental interventions that have an impact on health and health inequalities where the ‘gold-standard’ randomised controlled trial may not be practical or possible. Rigorous development and evaluation of contemporary programmes, policy innovations and of health system change, now often thought of as complex interventions, require highly-trained interdisciplinary researchers to evaluate and understand how these interventions work, for whom, and in what circumstances.

LSHTM is at the forefront of research and training in this area with a unique breadth and depth of expertise in trial methodology (including pragmatic trials), the utility and use of non-randomised evaluation designs (such as quasi-experimental designs, natural experiments, interrupted controlled time-series and ‘big’ data), process and implementation evaluation (tackling issues of context and complexity in implementation) and health economic evaluation. SGUL has ongoing projects (supported by NIHR, the National Prevention Research Initiative and MIND) which would lend themselves to application of these techniques, including trials to promote physical activity and evaluations of urban rehousing and of peer support in mental health care.

This work aligns with MRC’s strategic research and skills priorities (especially the Environment & Health priority). Our staff have contributed to the development of MRC’s guidance on evaluation of complex interventions (2008), use of natural experiments (2012) and process evaluation in complex interventions (2014) to support work in this area. This theme is also is a strategic research and training initiative for both institutions with the LSHTM Centre for Evaluation established to coordinate and develop research, training and professional development in this area.

Training in this theme will equip researchers with the ability to integrate quantitative and qualitative skills in evaluation, and provide an interdisciplinary theoretical foundation in the evaluation of complex public health interventions. Training will be delivered through existing accredited modules and short-courses including Evaluation of Public Health Interventions, Health Care Evaluation, Economic Evaluation, Design & Evaluation of Mental Health Programmes alongside generic teaching in epidemiological methods and study design, and qualitative approaches.