Taking account of context in population health intervention research: guidance for producers, users and funders of research

  • Peter Craig, Medical Research Council (MRC)/Chief Scientist Office (CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  • Erica Di Ruggiero, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • Katherine L Frohlich, École de Santé Publique and University of Montréal Public Health Research Institute (IRSPUM), Université de Montréal, Montréal, QC, Canada
  • Eric Mykhalovskiy, Department of Sociology, York University, Toronto, ON, Canada
  • Martin White, Centre for Diet and Activity Research, Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, UK
  • Rona Campbell, Department of Population Health Sciences, University of Bristol, Bristol, UK
  • Steven Cummins, Department of Social and Environmental Health, London School of Hygiene & Tropical Medicine, London, UK
  • Nancy Edwards, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
  • Kate Hunt, Medical Research Council (MRC)/Chief Scientist Office (CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  • Frank Kee, UK Clinical Research Collaboration (UKCRC) Centre of Excellence for Public Health Research, Queen’s University Belfast, Belfast, UK
  • Charlotte Loppie, Faculty of Human and Social Development, University of Victoria, Victoria, BC, Canada
  • Laurence Moore, Medical Research Council (MRC)/Chief Scientist Office (CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  • David Ogilvie, Centre for Diet and Activity Research, Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, UK
  • Mark Petticrew, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
  • Blake Poland, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
  • Valéry Ridde, University of Montréal Public Health Research Institute (IRSPUM), Montréal, QC, Canada; School of Public Health, University of Montréal (ESPUM), Montréal, QC, Canada; IRD (French Institute for Research on Sustainable Development), CEPED (IRD-Université Paris Descartes), Universités Paris Sorbonne Cités, ERL INSERM, Paris, France
  • Jeannie Shoveller, UBC School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  • Sarah Viehbeck, School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
  • Daniel Wight, Medical Research Council (MRC)/Chief Scientist Office (CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK

Population health intervention research (PHIR) seeks to develop and evaluate policies, programmes and other types of interventions that may affect population health and health equity. Such interventions are strongly influenced by context – taken to refer to any feature of the circumstances in which an intervention is conceived, developed, implemented and evaluated. Understanding how interventions relate to context is critical to understanding how they work; why they sometimes fail; whether they can be successfully adapted, scaled up or translated from one context to another; why their impacts vary; and how far effects observed in one context can be generalised to others.

Concerns that context has been neglected in research to develop and evaluate population health interventions have been expressed for at least 20 years. Over this period, an increasingly comprehensive body of guidance has been developed to help with the design, conduct, reporting and appraisal of PHIR. References to context have become more frequent in recent years, as interest has grown in complex and upstream interventions, systems thinking and realist approaches to evaluation, but there remains a lack of systematic guidance for producers, users and funders of PHIR on how context should be taken into account.

This document draws together recent thinking and practical experience of addressing context within PHIR. It provides a broad, working definition of context and explains why and how context is important to PHIR. It identifies the dimensions of context that are likely to shape how interventions are conceptualised, the impacts that they have and how they can be implemented, translated and scaled up. It suggests how context should be taken into account throughout the PHIR process, from priority setting and intervention development to the design and conduct of evaluations and reporting, synthesis and knowledge exchange. It concludes by summarising the key messages for producers, users and funders of PHIR and suggesting priorities for future research. The document is meant to be used alongside existing guidance for the development, evaluation and reporting of population health interventions. We expect the guidance to evolve over time, as practice changes in the light of the guidance and experience accumulates on useful approaches.

The work was funded by the Canadian Institutes of Health Research – Institute of Population and Public Health (CIHR-IPPH) and the UK National Institute for Health Research (NIHR).

Please see the NIHR website for a full copy of the report [ PDF (529 KB) - external link ].

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