Leeds Unit for Complex Intervention Development (LUCID)

Complex interventions healthcare research - LUCID group


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Our team

Areas of expertise

Academic capacity development

Publications


Our mission

We provide an interdisciplinary centre of excellence for developing and optimising complex health care interventions. Using mixed-methods research, our aim is to develop evidence-based interventions designed to be implemented and tested in ‘real world’ applied health care settings, and to push forward the methodological approaches to intervention development and process evaluation. Our interventions will be designed to improve the outcomes for both service users and providers.

Rationale 

In 2008 the Medical Research Council published a framework for developing and evaluating complex interventions (next update due 2019). Complex interventions include a ‘black box’ of multiple, interacting components and mechanisms which are modified by the context in which the intervention is delivered. Understanding these factors is critical to ensuring a novel intervention is fit for purpose, can be reproduced/implemented elsewhere, and is likely to result in important health benefits whilst minimising unintended consequences.

What we do

We use mixed methods approaches, combining evidence synthesis, qualitative and quantitative methods, to deliver evidence-based intervention development and process evaluation. We work across a range of conditions (e.g. cancer, musculoskeletal disease, surgical specialties) and settings (e.g. acute care, primary care) with a shared characteristic that these interventions are, to varying degrees, complex in nature and require careful design to optimise their effectiveness when implemented real world settings.

Who we are 

The diversity of methodological approaches applied in intervention development and process evaluation studies can appear daunting. Established in 2019, LUCID is a virtual network of researchers from diverse methodological backgrounds who are brought together by a shared academic interest. LUCID will create opportunities for: (1) high quality methodological research embedded within clinical research programmes; and (2) provide a platform for research groups in the School of Medicine and beyond to facilitate knowledge generation and transfer, as well as, sharing expertise regarding the evidence-based approaches to healthcare intervention development.

Read more about complex interventions research within the School of Medicine.

Prof Suzanne Richards, Head of LUCID

Email: Lucid@leeds.ac.uk

Twitter: @Lucid_leeds

 

Upcoming events

LUCID Seminar Series

We are currently running a virtual series of monthly methodological seminars. If you would like to find out more, please contact LUCID@leeds.ac.uk.

Continuing Professional Development Series

We are developing a programme of CPD courses related to intervention development and process evaluation methods. If you would like to be kept up to date with upcoming CPD courses please email LUCID@leeds.ac.uk. We will post more information here soon.

 

Core LUCID team members

Suzanne Richards (Head of Unit)

Rebecca Beeken

Hilary Bekker

Susanne Coleman

Amanda Farrin

Robbie Foy

Ian Kellar

Rebecca King

Matthew Mulvey

Samuel Smith

Nikki Rousseau

Rebecca Walwyn

Lucy Ziegler

 

Areas of Expertise

Our aim is to develop and apply complex interventions that can be implemented in real-world settings, and which improve health care and health outcomes. Our expertise is in applying appropriate study designs and methods to develop, optimise, and evaluate the processes of embedding complex interventions in applied health settings. We are a mixture of applied health researchers and clinical trial methodologists, and we use a range of methods (including qualitative and quantitative study designs) to inform the content and implementation of complex interventions. We also undertake research to improve study methods and to inform the design and conduct of clinical trials.

Our experts in specific methods are listed are listed below: complex intervention development, mixed method research and process evaluation, and randomised trial design and evaluation.

 

Complex intervention development

The design, development, optimisation and testing of complex interventions within health and social care settings to support health care professionals, prevent ill health and improve patient outcomes. We apply a range of theoretical frameworks and approaches to support evidence-based intervention development in our specialist areas.

 

Who?

What they specialise in?

Rebecca Beeken

Methodological expertise: qualitative research; randomised trial design (including feasibility & pilot designs), survey research, systematic reviews

Specialist interest areas: cancer prevention and control; health behaviours; obesity & weight management

Hilary Bekker

Methodological expertise: critical review methods; experimental and evaluation methods, qualitative methods, survey methods

Specialist interest areas: patient and professional decision support interventions for long-term conditions (kidney failure, multiple sclerosis), screening and testing procedures (cancer, genetic, prenatal)

Susanne Coleman

Methodological expertise: consensus methods, instrument development and evaluation methods, cognitive pre-testing methods (focus groups, think out loud interviews), complex intervention development and evaluation methods, participatory research, realist evaluation

Specialist interest areas: skin wound care, pressure ulcer prevention, healthcare interventions for older people, frailty

Ian Kellar

Methodological expertise: co-production, evidence synthesis for intervention components, quantitative process evaluation

Specialist interest areas: behaviour change, digital technology interventions, self-management of long-term conditions

Rebecca King

Methodological expertise: participatory methods, qualitative methods

Specialist interest areas: antimicrobial resistance, community engagement, global health

Matthew Mulvey

Methodological expertise: feasibility & pilot trial design, intervention adaptation, patient reported outcome measures (PROMS), quantitative process evaluation, systematic reviews and meta-analysis

Specialist interest areas: advanced cancer and palliative care, quantitative symptoms assessment

Suzanne Richards

Methodological expertise: consensus methods, observational study design, qualitative methods, randomised trial designs (feasibility, pilot & definitive trials), survey methods (including psychometrics), systematic reviews and meta-analysis

Specialist interest areas: health and social care interventions for older people, primary care, rehabilitation, multi-morbidity and frailty

Nikki Rousseau

Methodological expertise: qualitative methods, mixed methods

Specialist interest areas: Surgery, diagnostics and devices

Sam Smith

Methodological expertise: survey research, co-design, systematic reviews, qualitative research, user-testing, randomised trial designs (including feasibility, pilot & optimisation trials), SWATs

Specialist interest areas: cancer prevention and control, health behaviours, medication adherence, weight management

Lucy Ziegler

Methodological expertise: patient reported outcome measure (PROM) development and validation, qualitative methods, systematic reviews

Specialist interest areas: advanced cancer and palliative care, advance care planning

 

Mixed-methods research and process evaluation

The use of mixed-methods process evaluation to build robust interventions that can be implemented in real-word settings. This approach provides an understanding of context, mechanism, acceptability, feasibility and fidelity of the complex interventions and how these affect health outcomes. Process evaluations also inform the design of clinical trial methods to maximise participant engagement.

 

Who?

What they specialise in?

Susanne Coleman

Methodological expertise: consensus methods, instrument development and evaluation methods, cognitive pre-testing methods (focus groups, think out loud interviews), complex intervention development and evaluation methods, participatory research, realist evaluation

Specialist interest areas: skin wound care, pressure ulcer prevention, healthcare interventions for older people, frailty

Ian Kellar

Methodological expertise: co-production, evidence synthesis for intervention components, quantitative process evaluation

Specialist interest areas: behaviour change, digital technology interventions, self-management of long-term conditions

Rebecca King

Methodological expertise: participatory methods, qualitative methods

Specialist interest areas: antimicrobial resistance, community engagement, global health

Suzanne Richards

Methodological expertise: consensus methods, observational study design, qualitative methods, randomised trial designs (feasibility, pilot & definitive trials), survey methods (including psychometrics), systematic reviews and meta-analysis

Specialist interest areas: health and social care interventions for older people, primary care, rehabilitation, multi-morbidity and frailty

Nikki Rousseau

Methodological expertise: qualitative methods, mixed methods

Specialist interest areas: Surgery, diagnostics and devices

 

Randomised trial design and evaluation

The development and application of randomised trials in early phase intervention development and optimisation, later phase pragmatic evaluation, and of methods to implement effective interventions, including both complex and efficient designs (including primary, secondary and routinely collected data). Further information on our trials evaluating complex interventions can be found here.

 

Who?

What they specialise in?

Rebecca Beeken

Methodological expertise: qualitative research; randomised trial design (including feasibility & pilot designs), survey research, systematic reviews

Specialist interest areas: cancer prevention and control; health behaviours; obesity & weight management

Amanda Farrin

Methodological expertise: medical statistics, randomised trial designs (feasibility, pilot & definitive trials), SWATs

Specialist interest areas: health and social care for older people, primary care, stroke management

Robbie Foy

Methodological expertise: cluster randomised trial design, interrupted time series design

Specialist interest areas: implementation science, primary care

Suzanne Richards

Methodological expertise: consensus methods, observational study design, qualitative methods, randomised trial designs (feasibility, pilot & definitive trials), survey methods (including psychometrics), systematic reviews and meta-analysis

Specialist interest areas: health and social care interventions for older people, primary care, rehabilitation, multi-morbidity and frailty

Sam Smith

Methodological expertise: survey research, co-design, systematic reviews, qualitative research, user-testing, randomised trial designs (feasibility, pilot & optimisation trials), SWATs

Specialist interest areas: cancer prevention and control, health behaviours, medication adherence, weight management

Rebecca Walwyn

Methodological expertise: medical statistics, randomised trial designs (feasibility, pilot, optimisation & definitive trials), using Design of Experiments applied to health and social care, SWATs, systematic reviews and meta-analysis

Specialist interest areas: mental health including dementia, implementation science

 

Academic capacity development

LUCID offers a vibrant, supportive environment in which to undertake a higher research degree in the field of complex intervention development. We also support and mentor researchers looking to build/consolidate their skills as part of post-doctoral training awards working with colleagues from the wider School of Medicine and external partnerships with other Universities. We work flexibly offering both full-time and part-time registration; many of our higher degree candidates combine study with clinical practice. If you would like to find out more about supervision opportunities, please do contact us to discuss your interests.

 

PhD candidates supervised by LUCID academics:

Asma Abahussin (King Saud University) – (2018-2021) with Lucy Ziegler

Sadia Ahmed – MRC-NIHR Trials Methodology Research Partnership doctoral studentship (2019-22) with Amanda Farrin & Suzanne Richards

Amy Barradell (University of Leicester) – NIHR Doctoral Fellowship (2020-23) with Hilary Bekker (Lead S Singh, Leicester)

Aarthi Bhuvaraghan – Doctoral researcher (2020-26) with Rebecca King

Joanne Butterworth (University of Exeter) – NIHR doctoral fellowship (2019-24) with Suzanne Richards (Lead J Campbell, Exeter)

Neil Corrigan – NIHR Doctoral Fellowship (2018-25) with Rebecca Walwyn

Louise Englebrecht Buur (Aarhus University) - (2020-23) with Hilary Bekker

Adam Galloway – NIHR/HEE (ICA) Clinical Doctoral Fellowship (2021-25) with Suzanne Richards

William Goodman – White Rose Doctoral Training Partnership ESRC Award (2019-22) with Rebecca Beeken

Sophie Green – University of Leeds Studentship (supported by NIHR Advanced Fellowship awarded to Dr Smith) (2021-24) with Sam Smith & Nikki Rousseau

Kate Kenny - NIHR Doctoral Fellowship (2021-25) with Robbie Foy

Arthur Lau – University of Leeds Scholarship (2017-22) with Hilary Bekker

Kelly Lloyd – White Rose DTP ESRC and Yorkshire Cancer Research Doctoral Studentship (2019-23) with Sam Smith, Lucy Ziegler and Robbie Foy

Catherine Malia - St Gemma’s Hospice (2021-25) with Lucy Ziegler

Laura Marsden – University of Leeds & MRC (2019-23) with Rebecca Walwyn & Amanda Farrin

Molly Megson - White Rose DTP ESRC (2019-22) with Lucy Ziegler, Sam Smith

Yousuf Mokhallalati - Yorkshire Cancer Research (2018-22) with Lucy Ziegler

Mercy Mwansa – Doctoral Researcher (2021-26) with Suzanne Richards

Nicola Shaw – NIHR/HEE (ICA) Clinical Doctoral Fellowship (2021-25) with Nikki Rousseau & Ian Kellar

Janet Tonge – University of Leeds Scholarship (2018-23) with Hilary Bekker

Sean White (University of Sheffield) – NIHR Doctoral Fellowship (2021-24) with Hilary Bekker (Leads A O’Caithain & C McDermott, Sheffield)

 

Capacity building fellowships (pre- and post-doctoral awards):

Susanne Coleman – NIHR Development and Skills Enhancement Fellow (2021-22)

Colin Everett – NIHR Pre-Doctoral Fellowship (2020-22) with Rebecca Walwyn

Adam Grice – NIHR In-Practice Fellowship (2019-21) with Suzanne Richards & Robbie Foy

Kate Smith NIHR Pre-doctoral Clinical Academic Fellowship ,  2021-2023

Samuel Smith – NIHR Advanced Fellowship (2020-26)

Richard Wilkins – NIHR Doctoral Fellowship (2016-21) with Rebecca Walwyn

 

Key Publications

Examples of previous research by LUCID researchers:

Gardner B, Richards R, Lally P, Rebar A, Thwaite T, Beeken RJ. 2021. Breaking habits or breaking habitual behaviours? Old habits as a neglected factor in weight loss maintenance. Appetite. 162 

Koutoukidis DA, Land J, Hackshaw A, Heinrich M, McCourt O, Beeken RJ, Philpott S, DeSilva D, Rismani A, Rabin N, Popat R, Kyriakou C, Papanikolaou X, Mehta A, Paton B, Fisher A, Yong KL. 2020. Fatigue, quality of life and physical fitness following an exercise intervention in multiple myeloma survivors (MASCOT): an exploratory randomised Phase 2 trial utilising a modified Zelen design. British Journal of Cancer. 

Quaife SL, Ruparel M, Dickson JL, Beeken RJ, McEwen A, Baldwin DR, Bhowmik A, Navani N, Sennett K, Duffy SW, Wardle J, Waller J, Janes SM. 2020. Lung Screen Uptake Trial (LSUT): Randomized Controlled Clinical Trial Testing Targeted Invitation Materials. American Journal of Respiratory and Critical Care Medicine. 201(8), pp. 965-975 

Land J, McCourt O, Heinrich M, Beeken RJ, Koutoukidis DA, Paton B, Yong K, Hackshaw A, Fisher A. 2020. The adapted Zelen was a feasible design to trial exercise in myeloma survivors. Journal of Clinical Epidemiology. 

Hubbard G, Taylor C, Watson AJM, Munro J, Goodman W, Beeken RJ. 2020. A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study. Pilot and Feasibility Studies. 6(1) 

Backman R, Foy R, Michael BD, Defres S, Kneen R, Solomon T. The development of an intervention to promote adherence to national guidelines for suspected viral encephalitis. Implementation Science. 2015;20;10:37 doi: 10.1186/s13012-015-0224-2

Bennet MI, Mulvey MR, Campling N, Latter S, Richardson A, Bekker H, Blenkinsopp A, Carder P, Closs J, Farrin A, Flemming K, Gallagher J, Meads D, Morley S, O’Dwyer J, Wight-Hughes A, Hartley S. Self-management toolkit and delivery strategy for end-of-life pain: the mixed-methods feasibility study. Health Technology Assessment. 2017:21(76),1-292. doi: 10.3310/hta21760

Bryant M, Burton W, Cundill B, Farrin AJ, Nixon JE, Stevens J, Roberts K, Foy R, Rutter H, Hartley S, Tubeuf S, Collinson M, Brown J. The 'Optimising Family engagemenT in HENRY' (OFTEN) trial): Study Protocol for a randomised controlled trial. Trials. 2017;18:40. doi: 10.1186/s13063-016-1732-3

Butterworth JE, Hays R, Richards SH, Bower P, Campbell J. Interventions for involving older patients with multimorbidity in decision-making during primary care consultations. 3rd update. The Cochrane Database of Systematic Reviews, Issue 6, Art. No: CD000356. 2018. doi: 10.1002/14651858.CD000356.pub4

Caperon L, Arjyal A, K C P, Kuikel J, Newell J, Peters R, Prestwich A, King R. Developing a socio-ecological model of dietary behaviour for people living with diabetes or high blood glucose levels in urban Nepal: A qualitative investigation. PLoS One, 2019. 25;14 (3)e0214142. doi: 10.1371/journal.pone.0214142

Coleman S, Gorecki C, Nelson EA, Closs J, Defloor T, Halfens R, Farrin A, Brown JM, Schoonhoven L, Nixon J. Patient risk factors for pressure ulcer development: A systematic review. International Journal of Nursing. 2013; 50(7): 974-1003.  doi: 10.1016/j.ijnurstu.2012

Coleman S, Nixon J, Keen J, Wilson L, McGinnis E, Dealey C, Stubbs N, Farrin A, Dowding D, Schols JMGA, Cuddigan J, Berlowitz D, Jude E, Vowden P, Schoonhoven L, Bader DL, Gefen A, Oomens CWJ & Nelson EA. A new pressure ulcer conceptual framework. Journal of Advanced Nursing. 2014;70(10):2222-2234. doi: 10.1111/jan.12405

Coleman S, Nixon J, Keen J, Muir D, Wilson L, McGinnis E, Stubbs N, Dealey C, Nelson E. Using cognitive pre-testing methods in the development of a new evidenced-based pressure ulcer risk assessment instrument. BMC Medical Research Methodology. 2016;16:158. doi: 10.1186/s12874-016-0257-5

Freeman M, Offman J, Walter FM, Sasieni P, Smith SG. Acceptability of the Cytosponge procedure for detecting Barrett’s oesophagus: A qualitative study. BMJ Open. 2017;7:e013901. doi: 10.1136/bmjopen-2016-013901

Grant A, Treweek S, Dreisschulte T, Foy R, Guthrie B. Process evaluations for cluster-randomised trials of complex interventions: a proposed framework for design and reporting. Trials. 2013;14:15. doi: 10.1186/1745-6215-14-15

Khanal S, Elsey H, King R, Baral SC, Bhatta BR, Newell JN. Development of a Patient-Centred, Psychosocial Support Intervention for Multi-Drug-Resistant Tuberculosis (MDR-TB) Care in Nepal. 2017 PLoS ONE Mistry N (eds.). 12(1) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167559

Kliemann N, Croker H, Johnson F, Beeken RJ. Development of the Top Tips Habit-Based Weight Loss App and Preliminary Indications of Its Usage, Effectiveness, and Acceptability: Mixed-Methods Pilot Study. JMIR Mhealth and UHealth. 2019;7(4):e12326. doi: 10.2196/12326

Kliemann N, Vickerstaff V, Croker H, Johnson F, Nazareth I, Beeken RJ. The role of self-regulatory skills and automaticity on the effectiveness of a brief weight loss habit-based intervention: secondary analysis of the 10 Top Tips randomised trial. International Journal of Behavioural Nutrition and Physical Activity 2017;14:119. doi: 10.1186/s12966-017-0578-8

Koutoukidis D, Lopes S, Atkins L, Croker H, Knobf MT, Lanceley A, Beeken RJ. Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the Shape-Up following cancer treatment program. BMC Public Health. 2018;18:415. doi: 10.1186/s12889-018-5329-5

Lorencatto F, Gould NJ, McIntyre SA, During C, Bird J, Walwyn R, Cicero R, Glidewell L, Hartley S, Stanworth SJ, Foy R, Grimshaw JM, Michie S, Francis JJ, AFFINITIE Programme. A Multidimensional approach to assessing intervention fidelity in a process evaluation of audit and feedback interventions to reduce unnecessary blood transfusions: a study protocol. Implementation Science. 2016; 11(1):163. doi: 10.1186/s13012-016-0528-x

Mahmoody N, Bekker HL, King NV, Hughes J, Jones GL on behalf of the Cancer, Fertility and Me research team. Are publicly available internet resources enabling women to make informed fertility preservation decisions before starting cancer treatment: an environmental scan? BMC Medical Informatics and Decision Making. 2018;18:104. doi: 10.1186/s12911-018-0698-3

McEachan RC, Santorelli G, Bryant M, Sahota P, Farrar D, Small NA, Akhtar S, Sargent J,  Barber SE, Taylor NJ, Richardson G, Farrin AJ, Bhopal R, Bingham D, Ahern SE and Wright J. The HAPPY (Healthy and Active Parenting Programmme for early Years) feasibility randomised control trial: Acceptability and feasibility of an intervention to reduce infant obesity. BMC Public Health. 2016; 16(211). doi: 10.1186/s12889-016-2861-z

O'Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner K, Yardley L, Hoddinott P.  Guidance on how to develop complex interventions to improve health and healthcare.  BMJ Open 2019;9:e029954. doi: 10.1136/bmjopen-2019-029954

O'Cathain A, Croot L, Sworn K, Duncan E, Rousseau N, Turner K, Yardley L, Hoddinott P. Taxonomy of approaches to developing interventions to improve health: a systematic methods overview Pilot and Feasibility Studies 5, Article number: 41 (2019)

Richards SH, Campbell J, Dickens C, Anderson R, Richards DAR, Taylor R, Ukoumunne OC, Kessler D, Turner K, Kuyken W, Gandhi M, Knight L, Gibson A, Davey A, Warren F, Winder R, Wright C. Assessing the effectiveness of enhanced psychological care for patients with depressive symptoms attending cardiac rehabilitation compared with treatment as usual (CADENCE). Health Technology Assessment. 2018;22(30). doi: 10.3310/hta22300

Rousseau N, Turner KM, Duncan E, O’Cathain A, Croot L, Yardley L, et al. (2019) Attending to design when developing complex health interventions: A qualitative interview study with intervention developers and associated stakeholders. PLoS ONE 14(10): e0223615. https://doi.org/10.1371/journal.pone.0223615

Sepucha KR, Abhyankar P, Hoffman AS, Bekker HL, LeBlanc A, Levin CA, Ropka M, Shaffer VA, Sheridan SL, Stacey D, Stalmeier P, Vo H, Wills CE, Thomson R. Standard for Universal reporting of patient decision aid evaluation studies: the development of SUNDAE checklist. BMJ Quality and Safety Online First. 2018;27(5):380-388. doi: 10.1136/bmjqs-2017-006986

Smith SG, Wolf MS, Obichere A, Raine R, Wardle J & von Wagner C. The development and testing of a brief (‘gist-based’) supplementary colorectal cancer screening information leaflet. Patient Education & Counseling. 2013;93, 619-625. doi: 10.1016/j.pec.2013.08.013

Smith SG, Raine R, Obichere A, Wolf MS, Wardle J, von Wagner C. The effect of a supplementary (‘gist-based’) information leaflet on colorectal cancer knowledge and screening intention: a randomized controlled trial. Journal of Behavioral Medicine. 2015;38, 261-272. doi: 10.1007/s10865-014-9596-z

Turner KM, Rousseau N, Croot L, Duncan E, Yardley L, O’Cathain A, Hoddinott P Understanding successful development of complex health and healthcare interventions and its drivers from the perspective of developers and wider stakeholders: an international qualitative interview study BMJ Open 2019;9:e028756. doi: 10.1136/bmjopen-2018-028756

Turner KM, Winder R, Campbell J, Richards DA, Gandhi M, Dickens C, Richards S. Patients and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study. BMJ Open. 2017;7:e017510. doi: 10.1136/bmjopen-2017-017510

Winterbottom AE, Gavaruzzi T, Mooney A, Wilkie M, Davies SJ, Crane D, Tupling K, Baxter PD, Meads D, Mathers N, Bekker B. Patient acceptability of the Yorkshire dialysis decision aid (YODDA) booket: A prospective non-randomised comparison study across 6 predialysis services. Peritoneal Dialysis International 2016, vol 36, pp.374-381 doi: 10.3747/pdi.2014.00274

Wright J, Fairley L, McEachan R, Bryant M, Petherick E, Sahota P, Santorelli G, Barber S, Lawlor DA, Taylor N, Bhopal R, Cameron N, West J, Hill A, Summerbell C, Farrin AJ, Ball H, Small N, Farrar D. et al. Development and evaluation of an intervention for the prevention of childhood obesity in a multi-ethnic population: the Born in Bradford applied research programme. NIHR Journals Library. 2016 4:2. doi: 10.3310/pgfar04060