Studentship (Primary Care & Public Health): Exploratory trials of complex health behaviour change interventions, time for a rethink?
A review of current practice and Delphi consensus exercise.
The aim of the study is to review and develop approaches for the conduct and reporting of exploratory trials of complex interventions, via a review and Delphi consensus exercise.
The review would address the following research questions:
- What research questions are examined by exploratory trials of complex health behaviour change interventions?
- What methods are used to examine these research questions?
- On what criteria do researchers conclude that movement to a definitive RCT is/is not advisable?
The primary research phase would address the following research questions:
- According to expert funders and researchers:
- What are the most important questions to be addressed by exploratory trials?
- What are the key methodological considerations in answering these questions?
- What criteria should inform a decision on whether to progress to a definitive trial?
- How consistent are researchers’ views on best practice with those of funders?
- How consistent is current practice with expert consensus?
Where feasible, randomised controlled trials (RCTs) represent the most robust means of establishing intervention effectiveness. However, complex interventions are difficult to implement consistently across settings and target groups, whilst conducting RCTs in real word settings is challenging. Hence, the feasibility and acceptability of intervention plans and evaluation designs should be established before definitive evaluation. However, there is little consistent guidance regarding the most important questions to address in such studies, methodological considerations in addressing these questions and criteria on which decisions should be made regarding whether to progress to full-scale definitive evaluation. Hence, the conduct and reporting of ‘exploratory trials’ is inconsistent, and the basis of decisions to progress to full-scale evaluation often unclear.
The research will begin with a systematic search and review of exploratory trials of complex health behaviour change interventions, including completed studies and protocols for studies in progress. The review will focus on the aims, design and reporting of exploratory trials of complex interventions of interventions to improve health behaviours (such as diet, physical activity, and smoking), identifying consistencies and inconsistencies across studies.
Findings of the review will inform the development of a Delphi expert consensus building process (Hasson et al., 2000). Delphi methods have been widely used in the health and social sciences as a means of achieving expert consensus on issues such as future priorities in researching particular conditions (Robotin et al., 2010), definitions of medical or social scientific concepts (Jeste et al., 2010, Greene et al., 2011) and priorities for evaluating improvements in healthcare delivery (Hearnshaw et al., 2001). Two panels of up to 20 experts each will be recruited, to represent i) experienced researchers conducting exploratory trials of complex health behaviour interventions, mostly drawn from the UK but including US, European and Australian researchers and ii) UK and international funders (including US, Canada, Ireland who have already been canvassed regarding participation) of complex intervention evaluation research, including chairs and deputy chairs of scientific funding boards and at least two public representatives. A questionnaire will be developed, asking experts firstly to describe what they see as the most important aims for exploratory trials and the most important methodological and reporting issues, using an open question format. Panel members will be asked to describe what they see as the principal criteria for recommending that movement to a definitive trial is or is not appropriate following an exploratory trial. Following open questions, likert-scale type items will ask experts to rate the importance of each of a list of aims, methodological and reporting issues, and criteria for progression to a definitive trial identified by the literature review. Analysis of consensus and conflict between experts will then be fed back to members of the expert panel, who will be provided the opportunity to revise their views on the basis of this feedback. This will be repeated with a third phase of feedback and data analysis.
Although candidates will be expected to demonstrate an interest in public health improvement, the focus of the PhD is highly methodological. Hence, it is likely to be less suited to applicants whose principal interests and career aspirations lie in more applied aspects of public health improvement, Applicants will be expected to demonstrate an understanding of challenges in developing and evaluating complex public health interventions and a keen interest in advancing methodological practices directed towards addressing these challenges. Shortlisted candidates will be expected to demonstrate an understanding of MRC guidance for the development and evaluation of complex interventions (Craig et al. 2008), and the roles that the proposed project might play in advancing this guidance.
Funding: The studentship includes the payment of tuition fees at the Home/EU rate and a tax-free maintenance stipend of £14,000.00 p.a. in the first instance.
Residency criteria: Applications are welcome from UK / EU and International students. If successful, international students would have to cover the difference in the EU / International rate of fees - approximately £10,000 per year, for 3 years.
Start date: The preferred study start date is January 2013, but later start dates of April and July 2013 are also possible.
How to apply: Please send by cover letter and CV to: email@example.com
- Closing date
- 31st August 2012