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Using documents to investigate links between implementation and sustainability in a complex community intervention: The PRISM study


  • Willis, Karen
  • Small, Rhonda
  • Brown, Stephanie


The increasing imperative to find what works in health services has meant a rise in research trialing interventions deemed ‘complex’. While the strength of these interventions comes from taking a ‘whole of problem’ approach using multiple and inter-linking strategies, ways of examining implementation are under-explored. Building sustainability is an important part of implementing complex intervention research, but this too has received little exploration in the implementation literature. This paper explores issues of implementation and sustainability by examining the case of PRISM (Program of Resources, Information and Support for Mothers), a community randomised trial in Victoria, Australia aimed at improving maternal health and wellbeing. It examines documents placed on the project website. Three groups of documents relating to implementation of the intervention were examined – implementation reports, media reports and community newsletters. Analysing these documents allowed a focus on the ‘work’ of the intervention – who does the work and what activities comprise the work – in order to examine implementation as it relates to sustainability. Document analysis provides a useful way of considering implementation and sustainability of complex intervention research. It can ‘value add’ to findings from process evaluation and extend our understanding of an intervention beyond outcome measures. Analysis of the documents in this case provides insights into why sustainability of an intervention may be difficult to achieve during implementation.

Suggested Citation

  • Willis, Karen & Small, Rhonda & Brown, Stephanie, 2012. "Using documents to investigate links between implementation and sustainability in a complex community intervention: The PRISM study," Social Science & Medicine, Elsevier, vol. 75(7), pages 1222-1229.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:7:p:1222-1229
    DOI: 10.1016/j.socscimed.2012.05.025

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    References listed on IDEAS

    1. Roen, Katrina & Arai, Lisa & Roberts, Helen & Popay, Jennie, 2006. "Extending systematic reviews to include evidence on implementation: Methodological work on a review of community-based initiatives to prevent injuries," Social Science & Medicine, Elsevier, vol. 63(4), pages 1060-1071, August.
    2. Bonetti, Debbie & Eccles, Martin & Johnston, Marie & Steen, Nick & Grimshaw, Jeremy & Baker, Rachel & Walker, Anne & Pitts, Nigel, 2005. "Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial," Social Science & Medicine, Elsevier, vol. 60(9), pages 2135-2147, May.
    3. Hoddinott, Pat & Britten, Jane & Pill, Roisin, 2010. "Why do interventions work in some places and not others: A breastfeeding support group trial," Social Science & Medicine, Elsevier, vol. 70(5), pages 769-778, March.
    4. Hawe, Penelope & Noort, Michelle & King, Lesley & Jordens, Christopher, 1997. "Multiplying Health Gains: the critical role of capacity-building within health promotion programs," Health Policy, Elsevier, vol. 39(1), pages 29-42, January.
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