Gaffney, CL; (2012) Complex interventions for children and young people: exploring service delivery frameworks and characterising interventions. Doctoral thesis , UCL (University College London).

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Abstract

This thesis investigates the service delivery frameworks which support complex interventions for children and young people with conduct problems, and their families. Part 1, the literature review, evaluates existing measures and other literature in the field to inform the development of a fidelity measure for the service delivery frameworks supporting complex interventions. 35 papers are examined using an approach informed by narrative synthesis to bring together the emerging themes. The service delivery frameworks which underpin interventions are little evaluated in the literature, and the review concluded that there is scope for the development of a measure to examine the service delivery elements of interventions for children and young people with conduct problems, which might be best informed by drawing on existing measures and literature on effective delivery of complex interventions. Part 2, the empirical paper, describes the development and administration of the Children and Young People – Resource, Evaluation and Systems Schedule (CYPRESS) as part of the Systemic Therapy for At Risk Teens (START) randomised controlled trial (RCT) comparing multisystemic therapy (MST) with management as usual (MAU). CYPRESS was developed on the basis of a review of existing measures in the field, as well as research into the central aspects of service delivery which support complex interventions, as an interview-based measure of the service delivery frameworks supporting complex interventions. CYPRESS was piloted with two non-START trial teams, and subsequently administered to 16 teams (8 MST and 8 MAU) taking part in the START trial. The results of these interviews were used to compare the service delivery elements supporting MST and MAU, and to characterise the MAU services in the trial. The importance of further development and testing of CYPRESS is noted. Part 3, the critical appraisal, addresses methodological considerations arising from the research, discusses implications of the work, and reflects on the process of carrying out the research, and the context in which research of this nature occurs.

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