A tool for exploring the dynamics of innovative interventions for public health: the critical event card

• Published in: International journal of public health Vol. 62; no. 2; pp. 177 - 186
• Main Authors: Figueiro, Ana Claudia, de Araújo Oliveira, Sydia Rosana, Hartz, Zulmira, Couturier, Yves, Bernier, Jocelyne, do Socorro Machado Freire, Maria, Samico, Isabella, Medina, Maria Guadalupe, de Sa, Ronice Franco, Potvin, Louise
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-03-2017; Springer Nature B.V
• Subjects: Actor-network theory; Brazil; Diffusion of Innovation; Environmental Health; Focus Groups; Health Promotion - methods; Humans; Intervention; Medicine; Medicine & Public Health; Occupational Medicine/Industrial Medicine; Original Article; Public Health; Social Theory; Studies; Brazil; Critical event; Health promotion; Innovative interventions; Actor network theory
• ISSN: 1661-8556; 1661-8564
• DOI: 10.1007/s00038-016-0861-5

Objectives
Public health interventions are increasingly represented as complex systems. Research tools for capturing the dynamic of interventions processes, however, are practically non-existent. This paper describes the development and proof of concept process of an analytical tool, the critical event card (CEC), which supports the representation and analysis of complex interventions’ evolution, based on critical events.
Methods
Drawing on the actor-network theory (ANT), we developed and field-tested the tool using three innovative health interventions in northeastern Brazil. Interventions were aimed to promote health equity through intersectoral approaches; were engaged in participatory evaluation and linked to professional training programs. The CEC developing involve practitioners and researchers from projects. Proof of concept was based on document analysis, face-to-face interviews and focus groups.
Results
Analytical categories from CEC allow identifying and describing critical events as milestones in the evolution of complex interventions. Categories are (1) event description; (2) actants (human and non-human) involved; (3) interactions between actants; (4) mediations performed; (5) actions performed; (6) inscriptions produced; and (7) consequences for interventions.
Conclusions
The CEC provides a tool to analyze and represent intersectoral internvetions’ complex and dynamic evolution.