Evidence-making interventions in health: A conceptual framing

We outline a framework for conceptualising interventions in health as ‘evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of lo...

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Published in:	Social science & medicine (1982) Vol. 238; p. 112488
Main Authors:	Rhodes, Tim, Lancaster, Kari
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01.10.2019 Pergamon Press Inc
Subjects:	Concept formation Context Evidencing Frame analysis Health Implementation science Intervention Local knowledge Materialism Ontology Performativity Relational materialism Translation Intervention Translation Evidencing Relational materialism Ontology Implementation science
ISSN:	0277-9536, 1873-5347, 1873-5347
Online Access:	Get full text
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Abstract	We outline a framework for conceptualising interventions in health as ‘evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasises relational materiality and performativity, engaging with interventions, and their knowing, as matters-of-practice. Rather than concentrating on how ‘evidenced interventions' are implemented ‘into’ given ‘contexts' – as if evidence, intervention and context were stable and separate – an EMI approach focuses on the processes and practices through which ‘evidence’, ‘intervention’ and ‘context’ come to be. There are two strands to our analysis. First, we identify concepts to think-with in an EMI approach; and second, we illustrate their implications through case examples. We first reflect on developments in ‘implementation science’ to distinguish how an EMI approach thinks differently. We note a ‘within-limits contingency’ of implementation science in contrast to the ‘open contingency’ of an EMI approach. This helps notice the performativity of science and intervention as evidencing-making practices. We next conceptualise an EMI approach in relation to: ‘objects and practices'; ‘effects and events'; and ‘concerns and care’. We position an EMI approach in relation to theories of ‘relational materialism’, arguing that this affords a more critical, as well as more careful, way of knowing and doing health intervention. •Outlines a framework for conceptualising interventions in health as ‘evidence-making interventions'.•Offers conceptual tools for building a ‘relational material’ approach to implementation science.•Calls attention to the ‘within-limits contingency’ of current implementation science approaches.•Uses examples to illustrate the potential benefits of an evidence-making intervention approach.
AbstractList	We outline a framework for conceptualising interventions in health as 'evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasises relational materiality and performativity, engaging with interventions, and their knowing, as matters-of-practice. Rather than concentrating on how 'evidenced interventions' are implemented 'into' given 'contexts' - as if evidence, intervention and context were stable and separate - an EMI approach focuses on the processes and practices through which 'evidence', 'intervention' and 'context' come to be. There are two strands to our analysis. First, we identify concepts to think-with in an EMI approach; and second, we illustrate their implications through case examples. We first reflect on developments in 'implementation science' to distinguish how an EMI approach thinks differently. We note a 'within-limits contingency' of implementation science in contrast to the 'open contingency' of an EMI approach. This helps notice the performativity of science and intervention as evidencing-making practices. We next conceptualise an EMI approach in relation to: 'objects and practices'; 'effects and events'; and 'concerns and care'. We position an EMI approach in relation to theories of 'relational materialism', arguing that this affords a more critical, as well as more careful, way of knowing and doing health intervention.We outline a framework for conceptualising interventions in health as 'evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasises relational materiality and performativity, engaging with interventions, and their knowing, as matters-of-practice. Rather than concentrating on how 'evidenced interventions' are implemented 'into' given 'contexts' - as if evidence, intervention and context were stable and separate - an EMI approach focuses on the processes and practices through which 'evidence', 'intervention' and 'context' come to be. There are two strands to our analysis. First, we identify concepts to think-with in an EMI approach; and second, we illustrate their implications through case examples. We first reflect on developments in 'implementation science' to distinguish how an EMI approach thinks differently. We note a 'within-limits contingency' of implementation science in contrast to the 'open contingency' of an EMI approach. This helps notice the performativity of science and intervention as evidencing-making practices. We next conceptualise an EMI approach in relation to: 'objects and practices'; 'effects and events'; and 'concerns and care'. We position an EMI approach in relation to theories of 'relational materialism', arguing that this affords a more critical, as well as more careful, way of knowing and doing health intervention. We outline a framework for conceptualising interventions in health as ‘evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasises relational materiality and performativity, engaging with interventions, and their knowing, as matters-of-practice. Rather than concentrating on how ‘evidenced interventions' are implemented ‘into’ given ‘contexts' – as if evidence, intervention and context were stable and separate – an EMI approach focuses on the processes and practices through which ‘evidence’, ‘intervention’ and ‘context’ come to be. There are two strands to our analysis. First, we identify concepts to think-with in an EMI approach; and second, we illustrate their implications through case examples. We first reflect on developments in ‘implementation science’ to distinguish how an EMI approach thinks differently. We note a ‘within-limits contingency’ of implementation science in contrast to the ‘open contingency’ of an EMI approach. This helps notice the performativity of science and intervention as evidencing-making practices. We next conceptualise an EMI approach in relation to: ‘objects and practices'; ‘effects and events'; and ‘concerns and care’. We position an EMI approach in relation to theories of ‘relational materialism’, arguing that this affords a more critical, as well as more careful, way of knowing and doing health intervention. •Outlines a framework for conceptualising interventions in health as ‘evidence-making interventions'.•Offers conceptual tools for building a ‘relational material’ approach to implementation science.•Calls attention to the ‘within-limits contingency’ of current implementation science approaches.•Uses examples to illustrate the potential benefits of an evidence-making intervention approach. We outline a framework for conceptualising interventions in health as 'evidence-making interventions'. An evidence-making intervention (EMI) approach is distinct from a mainstream evidence-based intervention (EBI) approach in that it attends to health, evidence and intervention as matters of local knowledge-making practice. An EMI approach emphasises relational materiality and performativity, engaging with interventions, and their knowing, as matters-of-practice. Rather than concentrating on how 'evidenced interventions' are implemented 'into' given 'contexts' - as if evidence, intervention and context were stable and separate - an EMI approach focuses on the processes and practices through which 'evidence', 'intervention' and 'context' come to be. There are two strands to our analysis. First, we identify concepts to think-with in an EMI approach; and second, we illustrate their implications through case examples. We first reflect on developments in 'implementation science' to distinguish how an EMI approach thinks differently. We note a 'within-limits contingency' of implementation science in contrast to the 'open contingency' of an EMI approach. This helps notice the performativity of science and intervention as evidencing-making practices. We next conceptualise an EMI approach in relation to: 'objects and practices'; 'effects and events'; and 'concerns and care'. We position an EMI approach in relation to theories of 'relational materialism', arguing that this affords a more critical, as well as more careful, way of knowing and doing health intervention.
ArticleNumber	112488
Author	Rhodes, Tim Lancaster, Kari
Author_xml	– sequence: 1 givenname: Tim orcidid: 0000-0003-2400-9838 surname: Rhodes fullname: Rhodes, Tim email: tim.rhodes@lshtm.ac.uk organization: Centre for Social Research in Health, University of New South Wales, Sydney, Australia – sequence: 2 givenname: Kari orcidid: 0000-0002-2411-7970 surname: Lancaster fullname: Lancaster, Kari organization: Centre for Social Research in Health, University of New South Wales, Sydney, Australia
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Snippet	We outline a framework for conceptualising interventions in health as ‘evidence-making interventions'. An evidence-making intervention (EMI) approach is... We outline a framework for conceptualising interventions in health as 'evidence-making interventions'. An evidence-making intervention (EMI) approach is...
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SubjectTerms	Concept formation Context Evidencing Frame analysis Health Implementation science Intervention Local knowledge Materialism Ontology Performativity Relational materialism Translation
Title	Evidence-making interventions in health: A conceptual framing
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