Increasing value and reducing waste by optimizing the development of complex interventions: Enriching the development phase of the Medical Research Council (MRC) Framework

This is the final version of the article. Available from Elsevier via the DOI in this record.Background In recent years there has been much emphasis on ‘research waste’ caused by poor question selection, insufficient attention to previous research results, and avoidable weakness in research design, conduct and analysis. Little attention has been paid to the effect of inadequate development of interventions before proceeding to a full clinical trial. Objective We therefore propose to enrich the development phase of the MRC Framework by adding crucial elements to improve the likelihood of success and enhance the fit with clinical practice Methods Based on existing intervention development guidance and synthesis, a comprehensive iterative intervention development approach is proposed. Examples from published reports are presented to illustrate the methodology that can be applied within each element to enhance the intervention design. Results A comprehensive iterative approach is presented by combining the elements of the MRC Framework development phase with essential elements from existing guidance including: problem identification, the systematic identification of evidence, identification or development of theory, determination of needs, the examination of current practice and context, modelling the process and expected outcomes leading to final element: the intervention design. All elements are drawn from existing models to provide intervention developers with a greater chance of producing an intervention that is well adopted, effective and fitted to the context. Conclusion This comprehensive approach of developing interventions will strengthen the internal and external validity, minimize research waste and add value to health care research. In complex interventions in health care research, flaws in the development process immediately impact the chances of success. Knowledge regarding the causal mechanisms and interactions within the intended clinical context is needed to develop interventions that fit daily practice and are beneficial for the end-user

Determinants of Satisfaction at Different Adoption Stages of Internet-Based Services

Early IS research on satisfaction investigated system characteristics affecting end-user satisfaction, relying mostly on the IS success model. More recent research, on the other hand, studied satisfaction formation in the context of web-based products and services, using the disconfirmation theory. The IS context, however, is different from the marketing context where the theory was originally developed. One important difference is the novelty effect associated with the constant and rapid advancement of information technology. Previous satisfaction studies did not account for the dynamic nature of satisfaction and the changeability of its determinants. Such variability may be more salient in the IS context due to the novelty effect. In this paper, we develop, operationalize and empirically test a model for explaining/predicting satisfaction with Internet-based services at adoption and post-adoption stages. We argue and empirically demonstrate the need to consider the evolutionary nature of satisfaction and the variability of its determinants. Our results show that desires and expectations are both important factors that need to be considered simultaneously in explaining satisfaction at adoption. The role of desires, however, diminishes significantly in the post-adoption stage. The results also show no significant relationship between post-adoption satisfaction and satisfaction at adoption. The augmented disconfirmation model resulting from this study constitutes an important step towards the development of an IS satisfaction theory that accounts for the evolution of satisfaction over adoption stages