The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems.
Cupples, Margaret E
Smith, Susan M
Leathem, Claire S
Murphy, Andrew W
AffiliationDivision of Medical Education, Queen's University Belfast, Northern Ireland, UK. email@example.com
Aged, 80 and over
Attitude of Health Personnel
Attitude to Health
Delivery of Health Care
Primary Health Care
Randomized Controlled Trials as Topic
MetadataShow full item record
CitationThe contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems. 2006, 6:90 BMC Health Serv Res
JournalBMC health services research
AbstractBACKGROUND: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems. METHODS: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis. RESULTS: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change. CONCLUSION: Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.
CollectionsJournal articles & published research
- Do practitioners and friends support patients with coronary heart disease in lifestyle change? a qualitative study.
- Authors: Cole JA, Smith SM, Hart N, Cupples ME
- Issue date: 2013 Aug 28
- Development of a complex intervention for secondary prevention of coronary heart disease in primary care using the UK Medical Research Council framework.
- Authors: Byrne M, Cupples ME, Smith SM, Leathem C, Corrigan M, Byrne MC, Murphy AW
- Issue date: 2006 May
- Structured, intensive education maximising engagement, motivation and long-term change for children and young people with diabetes: a cluster randomised controlled trial with integral process and economic evaluation - the CASCADE study.
- Authors: Christie D, Thompson R, Sawtell M, Allen E, Cairns J, Smith F, Jamieson E, Hargreaves K, Ingold A, Brooks L, Wiggins M, Oliver S, Jones R, Elbourne D, Santos A, Wong IC, O'Neill S, Strange V, Hindmarsh P, Annan F, Viner R
- Issue date: 2014 Mar
- Effect of tailored practice and patient care plans on secondary prevention of heart disease in general practice: cluster randomised controlled trial.
- Authors: Murphy AW, Cupples ME, Smith SM, Byrne M, Byrne MC, Newell J, SPHERE study team.
- Issue date: 2009 Oct 29
- The SPHERE Study. Secondary prevention of heart disease in general practice: protocol of a randomised controlled trial of tailored practice and patient care plans with parallel qualitative, economic and policy analyses. [ISRCTN24081411].
- Authors: Murphy AW, Cupples ME, Smith SM, Byrne M, Leathem C, Byrne MC
- Issue date: 2005 Jul 29