Speaker
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Authors: Claire Collin (Université Paris Cité, France), Corinne Alberti (Université Paris Cité, France), Philippe Martin (Inserm CIC1426 / U1123), Clara Eyraud (ECEVE UMR 1123 - Inserm - Paris Cité University - France), Enora Le Roux (U1123, INSERM, Paris Cité University, Paris, France; CIC1426, INSERM, Paris, France; SHU-SMAJA, FSEF, Paris, France)
Background: Digital health interventions (DHIs) are complex and rapidly evolving, posing challenges for research programme design. Using the UK Medical Research Council’s four-phase research framework (development, feasibility, evaluation, implementation) as a reference, this study examines how researchers select and progress through phases when evaluating DHIs.
Methods: A systematic review identified DHIs promoting health among adolescents and young adults, implemented between 2017 and 2023. For each intervention, we recorded the research phases conducted and the mechanisms guiding progression between phases. We explored how intervention characteristics influenced phase selection.
Results: Of the 31 interventions, 26 reported a development (D) phase, 24 feasibility (F), 31 evaluation (E), and 6 implementation (I). Three phase arrangements were identified: sequential (>), iterative (i.e. phase repetition, (i)), and overlapping (i.e. phases conducted simultaneously, [+]). Progression mechanisms included: automatic progression, conditional progression based on qualitative appraisal of findings, and conditional progression based on quantitative criteria. Five main research programme structures (defined as combinations of arrangements and progression mechanisms) were observed across 28/31 interventions: 1) strictly linear (8/28, e.g. D>F>E>I); 2) iterative development (8/28, e.g. D(i)>F>E); 3) iterative feasibility (3/28, e.g. D>F(i)>E); 4) overlapping development and feasibility (4/28, e.g. [D+F]>E>I); 5) overlapping evaluation and implementation (5/28, e.g. D>F>[E+I]). Newly developed and multi-component interventions were more likely to involve iterative development phases.
Discussion: This study proposes a new operational framework to practically guide planning and communication of future DHI research programmes in terms of phase arrangements and progression mechanisms. Applying this framework may reduce research waste by preventing premature evaluations of underdeveloped or unfeasible interventions and by ensuring sufficient evidence generation throughout the research cycle to support endorsement from decision-makers, funders, and regulatory authorities.
| Conflict of interest | Authors declare no conflict of interest. |
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