Development and application of the Demands for Population Health Interventions (Depth) framework for categorising the agentic demands of population health interventions

Garrott, K. et al. (2024) Development and application of the Demands for Population Health Interventions (Depth) framework for categorising the agentic demands of population health interventions. BMC Global and Public Health, 2, 13. (doi: 10.1186/s44263-024-00043-8)

Abstract

Background: The ‘agentic demand’ of population health interventions (PHIs) refers to the capacity, resources and freedom to act that interventions demand of their recipients to benefit, which have a socio-economical pattern. Highly agentic interventions, e.g. information campaigns, rely on recipients noticing and responding to the intervention and thus might affect intervention effectiveness and equity. The absence of an adequate framework to classify agentic demands limits the fields’ ability to systematically explore these associations. Methods: We systematically developed the Demands for Population Health Interventions (Depth) framework using an iterative approach: (1) Developing the Depth framework by systematically identifying examples of PHIs aiming to promote healthier diets and physical activity, coding of intervention actors and actions and synthesising the data to develop the framework; (2) Testing the Depth framework in online workshops with academic and policy experts and a quantitative reliability assessment. We applied the final framework in a proof-of-concept review, extracting studies from three existing equity focused systematic reviews on framework category, overall effectiveness and differential socioeconomic effects and visualised the findings in Harvest Plots. Results: The Depth framework identifies three constructs influencing agentic demand: exposure - initial contact with intervention (2 levels), mechanism of action - how the intervention enables or discourages behaviour (5 levels), and engagement - recipient response (2 levels). When combined, these constructs form a matrix of twenty possible classifications. In the proof-of-concept review, we classified all components of 31 interventions according to the Depth framework. Intervention components were concentrated in a small number of Depth classifications; Depth classification appeared to be related to intervention equity but not effectiveness. Conclusions: This framework holds potential for future research, policy and practice, facilitating the design, selection and evaluation of interventions and evidence synthesis.

• Item Type: Articles
• Additional Information: This work was funded by the Public Health Policy Research Unit (PH-PRU) (Project 05 – G109750). The PH-PRU is commissioned and funded by the National Institute for Health and Social Care Research (NIHR) Policy Research Programme. The views expressed in this study are those of the authors and not necessarily those of the NHS, the National Institute for Health and Social Care Research, the Department of Health and Social Care or its arm’s length bodies, and other Government Departments. KG, DO, JP, CPJ, CF, EL, EI, RP, DVT, RAM, MW and JA are supported by the Medical Research Council (MRC; Unit Programme number MC_UU_12015/6 & MC_UU_00006/7).
• Keywords: Population health, diet, physical activity, interventions, socioeconomic inequalities.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lawlor, Dr Emma
• Authors: Garrott, K., Ogilvie, D., Panter, J., Petticrew, M., Sowden, A., Jones, C. P., Foubister, C., Lawlor, E. R., Ikeda, E., Patterson, R., van Tulleken, D., Armstrong-Moore, R., Vethanayakam, G., Bo, L., White, M., and Adams, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: BMC Global and Public Health
• Publisher: BioMed Central
• ISSN: 2731-913X
• ISSN (Online): 2731-913X
• Copyright Holders: Copyright: © The Author(s) 2024
• First Published: First published in BMC Global and Public Health 2: 13
• Publisher Policy: Reproduced under a Creative Commons licence