Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;22(3):286-303.
doi: 10.1177/1356389016652743. Epub 2016 Jun 2.

Realist complex intervention science: Applying realist principles across all phases of the Medical Research Council framework for developing and evaluating complex interventions

Adam Fletcher  1 , Farah Jamal  2 , Graham Moore  1 , Rhiannon E Evans  1 , Simon Murphy  1 , Chris Bonell  3
Affiliations

Realist complex intervention science: Applying realist principles across all phases of the Medical Research Council framework for developing and evaluating complex interventions

Adam Fletcher et al. Evaluation (Lond). 2016 Jul.

Abstract

The integration of realist evaluation principles within randomised controlled trials ('realist RCTs') enables evaluations of complex interventions to answer questions about what works, for whom and under what circumstances. This allows evaluators to better develop and refine mid-level programme theories. However, this is only one phase in the process of developing and evaluating complex interventions. We describe and exemplify how social scientists can integrate realist principles across all phases of the Medical Research Council framework. Intervention development, modelling, and feasibility and pilot studies need to theorise the contextual conditions necessary for intervention mechanisms to be activated. Where interventions are scaled up and translated into routine practice, realist principles also have much to offer in facilitating knowledge about longer-term sustainability, benefits and harms. Integrating a realist approach across all phases of complex intervention science is vital for considering the feasibility and likely effects of interventions for different localities and population subgroups.

Keywords: Complex interventions; complex systems; evaluation; pilot trials; public health; randomised controlled trials; realism.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Anderson R. (2008) New MRC guidance on evaluating complex interventions. BMJ 337(7676): 944–945. - PubMed
    1. Arain M, Campbell MJ, Cooper CL, et al. (2010) What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Medical Research Methodology 10: 67. - PMC - PubMed
    1. Aventin A, Lohan M, O’Halloran P, et al. (2015) Design and development of a film-based intervention about teenage men and unintended pregnancy: Applying the Medical Research Council framework in practice. Evaluation and Program Planning 49: 19–30. - PubMed
    1. Bartholomew LK, Parcel GS, Kok G, et al. (2011) Planning Health Promotion Programs: An Intervention Mapping Approach. 3rd ed. San Francisco, CA: Jossey-Bass.
    1. Bhaskar RA. (2008) A Realist Theory of Science. London: Verso.

LinkOut - more resources