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When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions

BACKGROUND: Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be ad...

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Autores principales: Movsisyan, A., Rehfuess, E., Norris, S. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532611/
https://www.ncbi.nlm.nih.gov/pubmed/33008285
http://dx.doi.org/10.1186/s12874-020-01132-6
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author Movsisyan, A.
Rehfuess, E.
Norris, S. L.
author_facet Movsisyan, A.
Rehfuess, E.
Norris, S. L.
author_sort Movsisyan, A.
collection PubMed
description BACKGROUND: Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. MAIN MESSAGE: A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. CONCLUSIONS: Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria.
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spelling pubmed-75326112020-10-05 When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions Movsisyan, A. Rehfuess, E. Norris, S. L. BMC Med Res Methodol Review BACKGROUND: Guidelines on public health and health system interventions often involve considerations beyond effectiveness and safety to account for the impact that these interventions have on the wider systems in which they are implemented. This paper describes how a complexity perspective may be adopted in guideline development to facilitate a more nuanced consideration of a range of factors pertinent to decisions regarding public health and health system interventions. These factors include acceptability and feasibility, and societal, economic, and equity and equality implications of interventions. MAIN MESSAGE: A 5-step process describes how to incorporate a complexity perspective in guideline development with examples to illustrate each step. The steps include: (i) guideline scoping, (ii) formulating questions, (iii) retrieving and synthesising evidence, (iv) assessing the evidence, and (v) developing recommendations. Guideline scoping using stakeholder consultations, complexity features, evidence mapping, logic modelling, and explicit decision criteria is emphasised as a key step that informs all subsequent steps. CONCLUSIONS: Through explicit consideration of a range of factors and enhanced understanding of the specific circumstances in which interventions work, a complexity perspective can yield guidelines with better informed recommendations and facilitate local adaptation and implementation. Further work will need to look into the methods of collecting and assessing different types of evidence beyond effectiveness and develop procedural guidance for prioritising across a range of decision criteria. BioMed Central 2020-10-02 /pmc/articles/PMC7532611/ /pubmed/33008285 http://dx.doi.org/10.1186/s12874-020-01132-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Movsisyan, A.
Rehfuess, E.
Norris, S. L.
When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title_full When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title_fullStr When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title_full_unstemmed When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title_short When complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
title_sort when complexity matters: a step-by-step guide to incorporating a complexity perspective in guideline development for public health and health system interventions
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532611/
https://www.ncbi.nlm.nih.gov/pubmed/33008285
http://dx.doi.org/10.1186/s12874-020-01132-6
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