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

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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.