Once there is a basic understanding interventions may be developed and trialed for effectiveness.
Placing the known implementation problem (in this case, missed appointments) as a starting point to enquiry has been cited as a useful way to understanding interventions [ 28].
15 16 Many studies using an experimental design did not find any significant effect of lean and other quality-improvement interventions. 1 2 6 9 10 17 Experimental methods are not very helpful in understanding interventions' effectiveness because they rule out context, content and application variables.
An analysis of the barriers is crucial for understanding intervention effectiveness and improving the way in which design, implementation and evaluation of interventions are carried out.
The results demonstrate that a theory-based approach to evidence synthesis is feasible, and can prove beneficial in understanding intervention design, even where there is insufficient empirical evidence to reliably synthesise effects of specific intervention components.
A key approach to understanding intervention effectiveness is to identify the psychological variables that mediate the effects of interventions on behavioral outcomes [ 37, 38].
This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.
Mangham and Hanson argue that "understanding intervention complexity," for example by using Gericke et al's framework, can help to overcome barriers to scaling up complex interventions, including the important barrier of resource constraints [ 15].
The mixed methods approach to understanding intervention impacts may be important, particularly for quality of life, as previous studies have documented null associations between quality of life and IPV screening [ 51].
With this understanding, future prevention and intervention methods may pair existing tobacco and marijuana strategies when targeting college hookah smokers.
