Using realist methods to develop a complex intervention to discourage adolescents from engaging in knife crime

背景：持刀犯罪是一个严重的公共、刑事司法和健康问题。自2015年以来，因持刀或攻击性武器犯罪而被定罪或警告的年轻人数量增加了一半以上。早些时候对携带刀具的干预措施的审查发现，很少有干预措施受到严格的研究。英国有许多倡议，但很少有评估计划。审查得出的结论是，干预发展需要专注于什么对谁管用，为什么，以及在什么情况下，而不是简单地关注“什么管用”。现实主义方法能够开发复杂的干预措施，对它们如何、为什么、为谁以及在什么情况下发挥作用有更深的理解。本研究的目的是通过定量和定性相结合的方法，更深入地了解针对持刀青少年的复杂干预方案是如何、为什么、针对谁以及在什么情况下最成功的。方法：为了了解青少年持刀干预在现实生活中是如何起作用的，本研究分四个阶段进行现实主义综合。制定一个框架，在青年咨询小组和专业利益攸关方咨询的指导下，绘制干预措施的理论和概念图景。通过对文献的探索，以及专业利益攸关方访谈的原始数据和减少暴力股的基于案例的时间排序量化数据集，形成初步的方案理论。通过更有目的、更深入地筛选文献，以及来自年轻人和专业人员的原始定性数据，提炼方案理论。将通过半结构化访谈收集数据，以探讨新出现的方案理论的具体内容。4.通过与年轻人和专业利益攸关方的访谈来检验方案理论，使用小插曲来探索具体方案理论之间的关系。分析：将使用现实主义的分析逻辑来使每个阶段的数据与上下文机制结果配置保持一致。对定量数据集进行聚类分析。然后将寻求实质性的理论来理解和解释这些发现。结果：为携带刀具的年轻人开发一种新的干预措施的现实主义知情3D逻辑模型。这一逻辑模型将被用于开发一个原型干预和干预交付平台，以供进一步测试。提供一个复杂干预的现实主义发展阶段的经验范例，以指导未来的MRC指导。

Background: Knife crime is a serious public, criminal justice and health concern. The number of young people convicted or cautioned for a knife or offensive weapon offence has increased by over half since 2015. An earlier review of knife carrying interventions, found that few interventions had been subjected to rigorous research. Many UK initiatives existed, but with few plans for evaluation. The review concluded that intervention development needs to concentrate on what works for whom, why, and in which circumstances, rather than simply on 'what works'. Realist methods enable the development of complex interventions that have a deeper understanding of how, why, for whom and in what circumstances they work. The purpose of this research is to gain a deeper understanding of how, why, for whom and in what circumstances complex intervention programmes for adolescents who carry knives are most successful to develop a new knife carrying intervention, using both quantitative and qualitative methods.Methods: To understand how adolescent knife carrying interventions work in a real-life context, a realist synthesis will be undertaken in four phases.1. Developing a framework to map the theoretical and conceptual landscape of interventions, guided by a young person advisory group and professional stakeholder consultations.2. Formulating initial programme theories though exploration of the literature, along with primary data from professional stakeholder interviews and case-based time-ordered quantitative dataset from Violence Reduction Units.3. Refining programme theories through more purposeful, in-depth screening of the literature, along with primary qualitative data from young people and professionals. Data will be collected through semi-structured interviews, to explore specific elements of the emerging programme theories. 4. Testing programme theories through interviews with young people and professional stakeholders, using vignettes to explore the relationship between specific programme theories. Analysis: A realist logic of analysis will be used to align data from each phase with context mechanism outcome configurations. Cluster analysis will be used for the quantitative datasets. Substantive theory will then be sought to understand and explain the findings.Outcomes: The development of realist informed 3D logic model for a new intervention for young people who carry knives. This logic model will be used to develop a prototype intervention and intervention delivery platform for further testing. The provision of an empirical example of a realist development phase of a complex intervention to guide future MRC guidance.