Nursing and Health Interventions. Souraya Sidani

be examined simultaneously rather than sequentially. Newly developed interventions found acceptable to the target population are moved to the next phase for evaluating their effectiveness, whereas interventions deemed unacceptable should be reconceptualized to optimize their design (i.e. moved back to the drawing board!). Each phase is carried out using research designs and methods that are most pertinent to address the respective research questions or achieve the stated aims, and to maintain the validity of findings. The phases are briefly mentioned in Table 1.1, with an emphasis on what they aim to achieve. The book is organized into sections that detail the research methods that can be used in designing, evaluating, and implementing interventions. Different methods are discussed, consistent with the recommendation for selecting those that are most appropriate to address the research questions and are feasible within the practice context.

TABLE 1.1 Phases of the process for designing, evaluating, and implementing interventions.

Process	Phase	Aims
Designing interventions	Generating an understanding of health problem	Clarify the health problem requiring remediationconceptual and operational definitiondeterminantsconsequencesDevelop a theory of the health problemIdentify aspects of the health problem that are amenable to change or remediation
	Developing intervention	Conceptualize the intervention's active ingredientsOperationalize the intervention's active ingredients in specific and nonspecific componentsOperationalize the componentsgoals and activitiesmode of deliverydoseDelineate the intervention's mechanism of actionDevelop the theory of change
	Developing intervention theory	Integrate theory of the problem and theory of changeIdentify contextual factors affecting intervention's delivery, mechanism of action, and effectivenessOperationalize the intervention theory
Delivering interventions	Developing intervention protocol	Describe in detail the content to be covered and activities to be performed by health professionals (or interventionists) and clients during intervention delivery
	Training health professionals or interventionists	Select interventionists based on well‐defined professional qualifications and personal characteristicsProvide training and support
	Monitoring fidelity	Assess theoretical fidelityDevelop or select measures for assessing operational fidelityInvestigate operational fidelity throughout the intervention delivery period
Evaluating interventions	Examining perceptions of intervention	Assess clients' perceptions of interventions before, during, and following delivery
	Examining feasibility of intervention and research methods	Assess interventionists' perceptions of the intervention's feasibilityAssess clients' perceptions of the intervention's feasibilityDetermine the acceptability and feasibility of the research methods for intervention evaluationRevise the design of the intervention and the research methods as necessary
	Evaluating process	Monitor the delivery of the interventionExamine the intervention's mechanism of actionExplore contextual factors affecting the intervention's delivery, mechanism of action, and effectivenessRevise the conceptualization, operationalization, and delivery of the intervention, based on process evaluation results
	Evaluating outcomes	Determine the effectiveness of the intervention in producing the intended beneficial health outcomesExplore the safety (risks or discomforts associated with the intervention) and unintended outcomes
Implementing interventions	Adapting evidence‐based interventions	Examine the acceptability and feasibility of the intervention to the local contextExplore modifications required to enhance the fit of the intervention to the local contextAssess barriers and facilitators of implementation in the local contextSelect implementation techniques
	Implementing evidence‐based interventions	Support the implementation initiative

REFERENCES

      1 Aarons, G.A., Green, A.E., Palinkas, L.A., et al. (2012) Dynamic adaptation process to implement an evidence‐based child maltreatment intervention. Implementation Science, 7, 32–40.

      2 Bach‐Mortensen, A.M, Lange, B.C.L., & Montgomery, P. (2018) Barriers and facilitators to implementing evidence‐based interventions among third sector organization: A systematic review. Implementation Science, 13, 103–121.

      3 Barello S, Graffigna G, & Vegni E. (2012) Patient engagement as an emerging challenge for healthcare services: Mapping the literature. Nursing Research and Practice, 2012, 905–934.

      4 Barrera, M., Castro, F.G., Strycker, L.A., et al. (2013) Cultural adaptations of behavioral health interventions: A Progress report. Journal of Consulting and Clinical Psychology, 81(2), 196–205.

      5 Beck, C., McSweeney, J.C., Richards, K.C., et al. (2010) Challenges in tailored intervention research. Nursing Outlook, 58(2), 104–110.

      6 Benedikt, C., Kelly, S.L., Wilson, D., & Wilson, D.P., on behalf of the Optima Consortium (2016) Allocative and implementation efficiency in HIV prevention and treatment for people who inject drugs. International Journal of Drug Policy, 38, 73–80.

      7 Bleijenberg, N., de Man‐van Ginkel, J.M., Trappenburg, J.C.A., et al. (2018) Increasing value and reducing waste by optimizing the development of complex interventions: Enriching the development phase of the Medical Research Council (MRC) framework. International Journal of Nursing Studies, 79, 86–93.

      8 de Boer, D., Delnoij, D., & Rademakers, J. (2013) The importance of patient‐centered care for various groups. Patient Education and Counseling, 90, 405–410.

      9 Bonell, C., Jamal, F., Melendez‐Torres, G.J., & Cummins, S. (2015) ‘Dark logic’: Theorizing the harmful consequences of public health interventions. Journal of Epidemiology & Community Health, 69, 95–98.

      10 Bonell, C., Moore, G., Warren, E., & Moore, L. (2018) Are randomised controlled trials positivist? Reviewing the social science and philosophy literature to assess positivist tendencies of trials of social interventions in public health and health services. Trials, 19(1), 238–249.

      11 Bothwell, L.E., Greene, J.A., Podolsky, S.H., et al. (2016) Assessing the gold standard—Lessons from the history of RCTs. New England Journal of Medicine, 374, 2175–2181.

      12 Braithwaite, J, Churruca, K, Long, J.C., et al. (2018) When complexity science meets implementation science: A theoretical and empirical analysis of system change. BMC Medicine, 16, 63–76.

      13 Britten N, Moore L, Lydahl D, et al. (2017) Elaboration of the Gothenburg model of person‐centred care. Health Expectations, 20, 407–418.

      14 Cambon, L., Terral, P., & Alla, F. (2019) From intervention to interventional system: towards greater theorization in population health intervention research. BMC Public Health, 19, 389–345.

      15 Chandler,