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      Process evaluation of complex interventions: Medical Research Council guidance

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          Abstract

          Process evaluation is an essential part of designing and testing complex interventions. New MRC guidance provides a framework for conducting and reporting process evaluation studies

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          Multidisciplinary, interdisciplinary, or dysfunctional? Team working in mixed-methods research.

          Combining qualitative and quantitative methods in a single study-otherwise known as mixed-methods research-is common. In health research these projects can be delivered by research teams. A typical scenario, for example, involves medical sociologists delivering qualitative components and researchers from medicine or health economics delivering quantitative components. We undertook semistructured interviews with 20 researchers who had worked on mixed-methods studies in health services research to explore the facilitators of and barriers to exploiting the potential of this approach. Team working emerged as a key issue, with three models of team working apparent: multidisciplinary, interdisciplinary, and dysfunctional. Interdisciplinary research was associated with integration of data or findings from the qualitative and quantitative components in both the final reports and the peer-reviewed publications. Methodological respect between team members and a principal investigator who valued integration emerged as essential to achieving integrated research outcomes.
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            A new theory of health promoting schools based on human functioning, school organisation and pedagogic practice.

            This paper outlines a novel explanatory frame for understanding how schools may intervene in order to promote pupils' health. The new theory is synthesised from an Aristotelian interpretation of human functioning and a theory of cultural transmission. In keeping with recent influential theoretical developments, it is proposed that health has its roots in human functioning. It follows from this concept that the promotion of pupils' health is facilitated by the promotion of pupil functioning and the primary mechanisms through which schools promote pupil functioning and, hence, health, are through the influences of school organisation, curriculum development and pedagogic practice on pupil development. According to the new theory, good human functioning is dependent on the realisation of a number of identified essential human capacities and the meeting of identified fundamental human needs. Two essential capacities, the capacity for practical reasoning and the capacity for affiliation with other humans, plan and organise the other essential capacities. The realisation of these two capacities should, it is argued, be the primary focus of health promoting schools. Additionally, health promoting schools should ensure that fundamental human needs concerning non-useful pain and information about the body are met. A number of testable hypotheses are generated from the new theory. Comparisons with existing interpretations of health promoting schools indicate there are similarities in the actions schools should take to promote health. However, the new theory can, uniquely, be used to predict which pupils will enjoy the best health at school and in adulthood. Additionally, according to the new theory, schools do not need designated health education classes or teaching staff with specialist health education roles in order to be health promoting. It is concluded that the new theory may have a number of advantages over existing theories at both the policy and intervention levels.
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              Moving tobacco prevention outside the classroom.

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                Author and article information

                Contributors
                Role: research fellow
                Role: research fellow
                Role: associate professor of psychology
                Role: principal research officer
                Role: professor of sociology and social policy
                Role: senior research associate in behavioural science
                Role: director
                Role: professor of health services research
                Role: research fellow
                Role: children, young people, families and health programme leader
                Role: associate professor of public health
                Journal
                BMJ
                BMJ
                bmj
                BMJ : British Medical Journal
                BMJ Publishing Group Ltd.
                0959-8138
                1756-1833
                2015
                19 March 2015
                : 350
                : h1258
                Affiliations
                [1 ]DECIPHer UKCRC Public Health Research Centre of Excellence, School of Social Sciences, Cardiff University, Cardiff, UK
                [2 ]DECIPHer UKCRC Public Health Research Centre of Excellence, School of Social and Community Medicine, University of Bristol, Bristol, UK
                [3 ]MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
                [4 ]Centre of Excellence in Intervention and Prevention Science, Melbourne, VIC Australia
                [5 ]Department of Childhood, Families and Health, Institute of Education, University of London, London, UK
                [6 ]Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
                [7 ]MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
                [8 ]School of Health and Related Research, University of Sheffield, Sheffield, UK
                Author notes
                Correspondence to: G F Moore MooreG@ 123456cardiff.ac.uk
                Article
                moog021594
                10.1136/bmj.h1258
                4366184
                25791983
                f77b1b8b-660c-4d54-bfdf-702f59656374
                © Moore et al 2015

                This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/.

                History
                : 13 January 2015
                Categories
                Research Methods & Reporting

                Medicine
                Medicine

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