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. 2018 Nov 21;8(6):968-978.
doi: 10.1093/tbm/iby102.

The ecology of multilevel intervention research

Kara L Hall  1 , April Oh  1 , Lilian G Perez  1 , Elise L Rice  1 , Minal Patel  1 , Susan Czajkowski  1 , Lisa Klesges  2
Affiliations

The ecology of multilevel intervention research

Kara L Hall et al. Transl Behav Med. .

Abstract

Behavior change research to promote health and prevent disease increasingly relies on a complex set of interacting characteristics across levels of influence such as biological, psychological, behavioral, interpersonal, and environmental. How to best develop health-related interventions that incorporate the individual, the macro-environment, and their interactions remains a challenge. This article considers a set of key dimensions that constitute what we refer to as the ecology of research across a broad context of multilevel research (MLR), spanning fundamental multilevel research (FMLR), multilevel intervention research (MLIR), and multilevel implementation science (MIS). With the goal of promoting improvements in MLIR, we describe the inherent interdependencies among aspects of research and consider how the growth and development of evidence and resources influence the cross-talk among researchers from different perspectives (e.g., disciplines and domains). We propose a framework that highlights opportunities to reduce barriers and address gaps in areas critical to generating an evidence base through MLR, MLIR, and MIS. Overall, we aim to support strategic decisions that can accelerate our understanding of ML health outcomes and interactions among factors within and across levels, with the goal of strengthening the effectiveness of ML interventions across health-related outcomes.

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Figures

Fig 1
Fig 1
| Reciprocal, cyclical, and iterative relationships between multilevel research, theory, intervention, and implementation.
Fig 2
Fig 2
| Exemplar features across the continuum of fundamental multilevel research to multilevel intervention research.
See this image and copyright information in PMC

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