TY - JOUR
T1 - Evaluation of public health interventions from a complex systems perspective: a research methods review
AU - McGill, Elizabeth
AU - Er, Vanessa
AU - Penney, Tarra
AU - Egan, Matt
AU - White, Martin
AU - Meier, Petra
AU - Whitehead, Margaret
AU - Lock, Karen
AU - Anderson de Cuevas, Rachel
AU - Smith, Richard
AU - Savona, Natalie
AU - Rutter, Harry
AU - Marks, Dalya
AU - de Vocht, Frank
AU - Cummins, Steven
AU - Popay, Jennie
AU - Petticrew, Mark
N1 - Funding Information:
This study was funded by the National Institute for Health Research ( NIHR ) School for Public Health Research (Grant Reference Number PD-SPH-2015 ). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. PM was also funded by MRC ( MC_UU_00022/5 ).
Publisher Copyright:
© 2021 The Authors
PY - 2021/3/31
Y1 - 2021/3/31
N2 - Introduction: Applying a complex systems perspective to public health evaluation may increase the relevance and strength of evidence to improve health and reduce health inequalities. In this review of methods, we aimed to: (i) classify and describe different complex systems methods in evaluation applied to public health; and (ii) examine the kinds of evaluative evidence generated by these different methods. Methods: We adapted critical review methods to identify evaluations of public health interventions that used systems methods. We conducted expert consultation, searched electronic databases (Scopus, MEDLINE, Web of Science), and followed citations of relevant systematic reviews. Evaluations were included if they self-identified as using systems- or complexity-informed methods and if they evaluated existing or hypothetical public health interventions. Case studies were selected to illustrate different types of complex systems evaluation. Findings: Seventy-four unique studies met our inclusion criteria. A framework was developed to map the included studies onto different stages of the evaluation process, which parallels the planning, delivery, assessment, and further delivery phases of the interventions they seek to inform; these stages include: 1) theorising; 2) prediction (simulation); 3) process evaluation; 4) impact evaluation; and 5) further prediction (simulation). Within this framework, we broadly categorised methodological approaches as mapping, modelling, network analysis and ‘system framing’ (the application of a complex systems perspective to a range of study designs). Studies frequently applied more than one type of systems method. Conclusions: A range of complex systems methods can be utilised, adapted, or combined to produce different types of evaluative evidence. Further methodological innovation in systems evaluation may generate stronger evidence to improve health and reduce health inequalities in our complex world.
AB - Introduction: Applying a complex systems perspective to public health evaluation may increase the relevance and strength of evidence to improve health and reduce health inequalities. In this review of methods, we aimed to: (i) classify and describe different complex systems methods in evaluation applied to public health; and (ii) examine the kinds of evaluative evidence generated by these different methods. Methods: We adapted critical review methods to identify evaluations of public health interventions that used systems methods. We conducted expert consultation, searched electronic databases (Scopus, MEDLINE, Web of Science), and followed citations of relevant systematic reviews. Evaluations were included if they self-identified as using systems- or complexity-informed methods and if they evaluated existing or hypothetical public health interventions. Case studies were selected to illustrate different types of complex systems evaluation. Findings: Seventy-four unique studies met our inclusion criteria. A framework was developed to map the included studies onto different stages of the evaluation process, which parallels the planning, delivery, assessment, and further delivery phases of the interventions they seek to inform; these stages include: 1) theorising; 2) prediction (simulation); 3) process evaluation; 4) impact evaluation; and 5) further prediction (simulation). Within this framework, we broadly categorised methodological approaches as mapping, modelling, network analysis and ‘system framing’ (the application of a complex systems perspective to a range of study designs). Studies frequently applied more than one type of systems method. Conclusions: A range of complex systems methods can be utilised, adapted, or combined to produce different types of evaluative evidence. Further methodological innovation in systems evaluation may generate stronger evidence to improve health and reduce health inequalities in our complex world.
KW - Complexity science
KW - Evaluation methodologies
KW - Practice
KW - Public health
KW - Systems thinking
UR - http://www.scopus.com/inward/record.url?scp=85099880121&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2021.113697
DO - 10.1016/j.socscimed.2021.113697
M3 - Review article
SN - 0277-9536
VL - 272
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 113697
ER -
