Health and social care are (even) more complex than you think

By Raya Vinogradov and Domna Salonen

What are complex interventions?

Did you take a flu jab this winter? Whether you did or not, both the decision and the intervention may seem simple.  However, many “simple” interventions have hidden layers of complexity. Various people developed and tested the vaccine, planned the implementation, shaped policy and directed funds towards making the vaccine available. Recipients of the vaccine engaged in complex decision-making processes impacted by many factors such as perceived vaccine’s safety and effectiveness, transport, possible financial cost, fear of needles. People’s beliefs are affected by their previous experiences, the information available to them, the ability to compare options, and possibly other people’s attitudes. Furthermore, the intervention components might not be as static as they seem at first.

Interventions are living processes, involving interactions between clinic staff, people taking the vaccine and the local context.  New information, from opinions to scientific papers, pops up into our awareness through different medias, impacting what we know and what we believe – and each person attending a clinic brings their assumptions with them.

This seemingly simple intervention involves nuanced decision-making, requires considerable logistic efforts and interacts closely with its context. All in all, it’s very complex!

According to the Medical Research Council framework for developing and evaluating complex interventions, an intervention can be complex due to:

• the properties of the intervention itself, such as the number of components involved
• the range of behaviours targeted
• expertise and skills required by those delivering and receiving the intervention
• the number of groups, settings, or levels targeted
• flexibility of the intervention or its components

We rarely hear anyone saying “it’s simple” about health and social care related challenges.  Complex interventions research is relevant for contemporary challenges and innovations and draws from a range of methods and approaches.

Could your research be about complex interventions?

Do you think your research is about complex interventions, even if you had not framed it that way before? If you work or have worked in health and social care practice, have you considered yourself to be a part of a complex intervention?

Join the Developing and Modelling Complex Interventions (DevMod) group

If your research (aspired or already underway) relates to complex interventions and you value honest and constructive peer feedback as an integral part of robust research, you might be interested in joining the Developing and Modelling Complex Interventions (DevMod) group. Our Teams meetings take place once a month and provide an interdisciplinary forum for complex intervention researchers across career stages and organisations. Group members regularly present their work, and exchange feedback. Our focus is on facilitating respectful yet challenging conversations to help each other to develop high quality research and build our complex intervention research careers.

Raya Vinogradov and Domna Salonen co-lead the DevMod group

Raya Vinogradov is a Senior Research Radiographer Sonographer and a Doctoral Research Fellow with Newcastle University Hospitals NHSFT Researcher Development Institute.

Domna Salonen is an occupational therapist working full-time on her PhD with NIHR Newcastle Patient Safety Research Collaboration.

Raya and Domna co-lead the DevMod group. You can find out more about DevMod through the NHRP Methodology pillar.