Understanding and Adapting to Complexity in Real-World Contexts

Complex systems approaches to intervention science are increasingly advocated. However, despite a growing abundance of conceptual publications, there have to date been few attempts to consider in practical terms what a complex systems lens means for intervention researchers. This talk discusses the influence of complex systems thinking within historical and ongoing guidance development for intervention researchers. It will argue that whole systems evaluations may be neither attainable, nor necessary and that acknowledgment of complexity does not mean that real-world evaluations must investigate all facets of complexity. However, a systems lens may add value to intervention science through framing issues such as how fidelity is conceived, aspects of context which matter for intervention effects to transfer across contexts, and how intervention effects may build or diminish over time in real world settings. The talk will introduce new MRC-NIHR funded ADAPT guidance, which draws upon complex systems perspectives to provide guidance in thinking through and undertaking the adaptation of interventions for new contexts.

LEARNING OBJECTIVES

1. Definitions of a complex systems perspective, including i) what is meant by the terms ‘complex intervention’, ii) a ‘complex system” iii) intervention as an ‘event within a complex system’
2. The influence of complex systems perspectives in guidance development for health intervention research;
3. Practical implications of complexity for development, evaluation and implementation of interventions, with an emphasis on adaptation of interventions across contexts