Article type
Year
Abstract
Background: Qualitative research alongside trials of complex interventions can be used to explore processes, contextual factors or intervention characteristics that may have influenced trial outcomes. This research may also shed light on the results of systematic reviews of effectiveness by identifying factors that help explain heterogeneous results across trials. In a Cochrane review on the effects of lay health worker programmes, we identified 82 trials. These trials showed promising benefits but results were heterogeneous.
Objectives: To use qualitative studies conducted alongside the included trials to explore factors and processes that might have influenced intervention outcomes.
Methods: Qualitative research carried out alongside the trials was identified by contacting trial authors, checking references, searching PubMed for related studies, and through citation searches. For included qualitative studies, we extracted information regarding objectives, methods, and results.
Results: For 52 (63%) of the trials, no qualitative research had been conducted. For 16 (20%) trials, qualitative data collection had been done but was unavailable or had been done before the trial. For 14 (17%) trials, qualitative research had been done during or shortly after the trial. Most of this qualitative research aimed to elicit trial participants' perspectives and experiences of the intervention. A common theme was participants' appreciation of the lay health workers' shared circumstances, for instance, with regard to social background or experience of the health condition. In six studies, researchers explored the experiences of the lay health workers themselves. Issues included the importance of supervision and health professionals' support or lack of support. Overall, descriptions of methods and results were often sparse.
Conclusions: Qualitative studies carried out alongside trials of complex interventions could help us understand heterogeneity in systematic reviews of effectiveness. However, for interventions of lay health worker programmes at least, too few such studies exist for these opportunities to be realised.
Objectives: To use qualitative studies conducted alongside the included trials to explore factors and processes that might have influenced intervention outcomes.
Methods: Qualitative research carried out alongside the trials was identified by contacting trial authors, checking references, searching PubMed for related studies, and through citation searches. For included qualitative studies, we extracted information regarding objectives, methods, and results.
Results: For 52 (63%) of the trials, no qualitative research had been conducted. For 16 (20%) trials, qualitative data collection had been done but was unavailable or had been done before the trial. For 14 (17%) trials, qualitative research had been done during or shortly after the trial. Most of this qualitative research aimed to elicit trial participants' perspectives and experiences of the intervention. A common theme was participants' appreciation of the lay health workers' shared circumstances, for instance, with regard to social background or experience of the health condition. In six studies, researchers explored the experiences of the lay health workers themselves. Issues included the importance of supervision and health professionals' support or lack of support. Overall, descriptions of methods and results were often sparse.
Conclusions: Qualitative studies carried out alongside trials of complex interventions could help us understand heterogeneity in systematic reviews of effectiveness. However, for interventions of lay health worker programmes at least, too few such studies exist for these opportunities to be realised.