methods of research social work

Social Work Research Methods That Drive the Practice

Social workers advocate for the well-being of individuals, families and communities. But how do social workers know what interventions are needed to help an individual? How do they assess whether a treatment plan is working? What do social workers use to write evidence-based policy?

Social work involves research-informed practice and practice-informed research. At every level, social workers need to know objective facts about the populations they serve, the efficacy of their interventions and the likelihood that their policies will improve lives. A variety of social work research methods make that possible.

Data-Driven Work

Data is a collection of facts used for reference and analysis. In a field as broad as social work, data comes in many forms.

Quantitative vs. Qualitative

As with any research, social work research involves both quantitative and qualitative studies.

Quantitative Research

Answers to questions like these can help social workers know about the populations they serve — or hope to serve in the future.

• How many students currently receive reduced-price school lunches in the local school district?
• How many hours per week does a specific individual consume digital media?
• How frequently did community members access a specific medical service last year?

Quantitative data — facts that can be measured and expressed numerically — are crucial for social work.

Quantitative research has advantages for social scientists. Such research can be more generalizable to large populations, as it uses specific sampling methods and lends itself to large datasets. It can provide important descriptive statistics about a specific population. Furthermore, by operationalizing variables, it can help social workers easily compare similar datasets with one another.

Qualitative Research

Qualitative data — facts that cannot be measured or expressed in terms of mere numbers or counts — offer rich insights into individuals, groups and societies. It can be collected via interviews and observations.

• What attitudes do students have toward the reduced-price school lunch program?
• What strategies do individuals use to moderate their weekly digital media consumption?
• What factors made community members more or less likely to access a specific medical service last year?

Qualitative research can thereby provide a textured view of social contexts and systems that may not have been possible with quantitative methods. Plus, it may even suggest new lines of inquiry for social work research.

Mixed Methods Research

Combining quantitative and qualitative methods into a single study is known as mixed methods research. This form of research has gained popularity in the study of social sciences, according to a 2019 report in the academic journal Theory and Society. Since quantitative and qualitative methods answer different questions, merging them into a single study can balance the limitations of each and potentially produce more in-depth findings.

However, mixed methods research is not without its drawbacks. Combining research methods increases the complexity of a study and generally requires a higher level of expertise to collect, analyze and interpret the data. It also requires a greater level of effort, time and often money.

The Importance of Research Design

Data-driven practice plays an essential role in social work. Unlike philanthropists and altruistic volunteers, social workers are obligated to operate from a scientific knowledge base.

To know whether their programs are effective, social workers must conduct research to determine results, aggregate those results into comprehensible data, analyze and interpret their findings, and use evidence to justify next steps.

Employing the proper design ensures that any evidence obtained during research enables social workers to reliably answer their research questions.

Research Methods in Social Work

The various social work research methods have specific benefits and limitations determined by context. Common research methods include surveys, program evaluations, needs assessments, randomized controlled trials, descriptive studies and single-system designs.

Surveys involve a hypothesis and a series of questions in order to test that hypothesis. Social work researchers will send out a survey, receive responses, aggregate the results, analyze the data, and form conclusions based on trends.

Surveys are one of the most common research methods social workers use — and for good reason. They tend to be relatively simple and are usually affordable. However, surveys generally require large participant groups, and self-reports from survey respondents are not always reliable.

Program Evaluations

Social workers ally with all sorts of programs: after-school programs, government initiatives, nonprofit projects and private programs, for example.

Crucially, social workers must evaluate a program’s effectiveness in order to determine whether the program is meeting its goals and what improvements can be made to better serve the program’s target population.

Evidence-based programming helps everyone save money and time, and comparing programs with one another can help social workers make decisions about how to structure new initiatives. Evaluating programs becomes complicated, however, when programs have multiple goal metrics, some of which may be vague or difficult to assess (e.g., “we aim to promote the well-being of our community”).

Needs Assessments

Social workers use needs assessments to identify services and necessities that a population lacks access to.

Common social work populations that researchers may perform needs assessments on include:

• People in a specific income group
• Everyone in a specific geographic region
• A specific ethnic group
• People in a specific age group

In the field, a social worker may use a combination of methods (e.g., surveys and descriptive studies) to learn more about a specific population or program. Social workers look for gaps between the actual context and a population’s or individual’s “wants” or desires.

For example, a social worker could conduct a needs assessment with an individual with cancer trying to navigate the complex medical-industrial system. The social worker may ask the client questions about the number of hours they spend scheduling doctor’s appointments, commuting and managing their many medications. After learning more about the specific client needs, the social worker can identify opportunities for improvements in an updated care plan.

In policy and program development, social workers conduct needs assessments to determine where and how to effect change on a much larger scale. Integral to social work at all levels, needs assessments reveal crucial information about a population’s needs to researchers, policymakers and other stakeholders. Needs assessments may fall short, however, in revealing the root causes of those needs (e.g., structural racism).

Randomized Controlled Trials

Randomized controlled trials are studies in which a randomly selected group is subjected to a variable (e.g., a specific stimulus or treatment) and a control group is not. Social workers then measure and compare the results of the randomized group with the control group in order to glean insights about the effectiveness of a particular intervention or treatment.

Randomized controlled trials are easily reproducible and highly measurable. They’re useful when results are easily quantifiable. However, this method is less helpful when results are not easily quantifiable (i.e., when rich data such as narratives and on-the-ground observations are needed).

Descriptive Studies

Descriptive studies immerse the researcher in another context or culture to study specific participant practices or ways of living. Descriptive studies, including descriptive ethnographic studies, may overlap with and include other research methods:

• Informant interviews
• Census data
• Observation

By using descriptive studies, researchers may glean a richer, deeper understanding of a nuanced culture or group on-site. The main limitations of this research method are that it tends to be time-consuming and expensive.

Single-System Designs

Unlike most medical studies, which involve testing a drug or treatment on two groups — an experimental group that receives the drug/treatment and a control group that does not — single-system designs allow researchers to study just one group (e.g., an individual or family).

Single-system designs typically entail studying a single group over a long period of time and may involve assessing the group’s response to multiple variables.

For example, consider a study on how media consumption affects a person’s mood. One way to test a hypothesis that consuming media correlates with low mood would be to observe two groups: a control group (no media) and an experimental group (two hours of media per day). When employing a single-system design, however, researchers would observe a single participant as they watch two hours of media per day for one week and then four hours per day of media the next week.

These designs allow researchers to test multiple variables over a longer period of time. However, similar to descriptive studies, single-system designs can be fairly time-consuming and costly.

Learn More About Social Work Research Methods

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In This Article Expand or collapse the "in this article" section Social Work Research Methods

Introduction.

• History of Social Work Research Methods
• Feasibility Issues Influencing the Research Process
• Measurement Methods
• Existing Scales
• Group Experimental and Quasi-Experimental Designs for Evaluating Outcome
• Single-System Designs for Evaluating Outcome
• Program Evaluation
• Surveys and Sampling
• Introductory Statistics Texts
• Advanced Aspects of Inferential Statistics
• Qualitative Research Methods
• Qualitative Data Analysis
• Historical Research Methods
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• Research Ethics
• Culturally Competent Research Methods
• Teaching Social Work Research Methods

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• Community-Based Participatory Research
• Economic Evaluation
• Evidence-based Social Work Practice
• Evidence-based Social Work Practice: Finding Evidence
• Evidence-based Social Work Practice: Issues, Controversies, and Debates
• Experimental and Quasi-Experimental Designs
• Impact of Emerging Technology in Social Work Practice
• Implementation Science and Practice
• Interviewing
• Measurement, Scales, and Indices
• Meta-analysis
• Occupational Social Work
• Postmodernism and Social Work
• Qualitative Research
• Research, Best Practices, and Evidence-based Group Work
• Social Intervention Research
• Social Work Profession
• Systematic Review Methods
• Technology for Social Work Interventions

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Social Work Research Methods by Allen Rubin LAST REVIEWED: 14 December 2009 LAST MODIFIED: 14 December 2009 DOI: 10.1093/obo/9780195389678-0008

Social work research means conducting an investigation in accordance with the scientific method. The aim of social work research is to build the social work knowledge base in order to solve practical problems in social work practice or social policy. Investigating phenomena in accordance with the scientific method requires maximal adherence to empirical principles, such as basing conclusions on observations that have been gathered in a systematic, comprehensive, and objective fashion. The resources in this entry discuss how to do that as well as how to utilize and teach research methods in social work. Other professions and disciplines commonly produce applied research that can guide social policy or social work practice. Yet no commonly accepted distinction exists at this time between social work research methods and research methods in allied fields relevant to social work. Consequently useful references pertaining to research methods in allied fields that can be applied to social work research are included in this entry.

This section includes basic textbooks that are used in courses on social work research methods. Considerable variation exists between textbooks on the broad topic of social work research methods. Some are comprehensive and delve into topics deeply and at a more advanced level than others. That variation is due in part to the different needs of instructors at the undergraduate and graduate levels of social work education. Most instructors at the undergraduate level prefer shorter and relatively simplified texts; however, some instructors teaching introductory master’s courses on research prefer such texts too. The texts in this section that might best fit their preferences are by Yegidis and Weinbach 2009 and Rubin and Babbie 2007 . The remaining books might fit the needs of instructors at both levels who prefer a more comprehensive and deeper coverage of research methods. Among them Rubin and Babbie 2008 is perhaps the most extensive and is often used at the doctoral level as well as the master’s and undergraduate levels. Also extensive are Drake and Jonson-Reid 2007 , Grinnell and Unrau 2007 , Kreuger and Neuman 2006 , and Thyer 2001 . What distinguishes Drake and Jonson-Reid 2007 is its heavy inclusion of statistical and Statistical Package for the Social Sciences (SPSS) content integrated with each chapter. Grinnell and Unrau 2007 and Thyer 2001 are unique in that they are edited volumes with different authors for each chapter. Kreuger and Neuman 2006 takes Neuman’s social sciences research text and adapts it to social work. The Practitioner’s Guide to Using Research for Evidence-based Practice ( Rubin 2007 ) emphasizes the critical appraisal of research, covering basic research methods content in a relatively simplified format for instructors who want to teach research methods as part of the evidence-based practice process instead of with the aim of teaching students how to produce research.

Drake, Brett, and Melissa Jonson-Reid. 2007. Social work research methods: From conceptualization to dissemination . Boston: Allyn and Bacon.

This introductory text is distinguished by its use of many evidence-based practice examples and its heavy coverage of statistical and computer analysis of data.

Grinnell, Richard M., and Yvonne A. Unrau, eds. 2007. Social work research and evaluation: Quantitative and qualitative approaches . 8th ed. New York: Oxford Univ. Press.

Contains chapters written by different authors, each focusing on a comprehensive range of social work research topics.

Kreuger, Larry W., and W. Lawrence Neuman. 2006. Social work research methods: Qualitative and quantitative applications . Boston: Pearson, Allyn, and Bacon.

An adaptation to social work of Neuman's social sciences research methods text. Its framework emphasizes comparing quantitative and qualitative approaches. Despite its title, quantitative methods receive more attention than qualitative methods, although it does contain considerable qualitative content.

Rubin, Allen. 2007. Practitioner’s guide to using research for evidence-based practice . Hoboken, NJ: Wiley.

This text focuses on understanding quantitative and qualitative research methods and designs for the purpose of appraising research as part of the evidence-based practice process. It also includes chapters on instruments for assessment and monitoring practice outcomes. It can be used at the graduate or undergraduate level.

Rubin, Allen, and Earl R. Babbie. 2007. Essential research methods for social work . Belmont, CA: Thomson Brooks Cole.

This is a shorter and less advanced version of Rubin and Babbie 2008 . It can be used for research methods courses at the undergraduate or master's levels of social work education.

Rubin, Allen, and Earl R. Babbie. Research Methods for Social Work . 6th ed. Belmont, CA: Thomson Brooks Cole, 2008.

This comprehensive text focuses on producing quantitative and qualitative research as well as utilizing such research as part of the evidence-based practice process. It is widely used for teaching research methods courses at the undergraduate, master’s, and doctoral levels of social work education.

Thyer, Bruce A., ed. 2001 The handbook of social work research methods . Thousand Oaks, CA: Sage.

This comprehensive compendium includes twenty-nine chapters written by esteemed leaders in social work research. It covers quantitative and qualitative methods as well as general issues.

Yegidis, Bonnie L., and Robert W. Weinbach. 2009. Research methods for social workers . 6th ed. Boston: Allyn and Bacon.

This introductory paperback text covers a broad range of social work research methods and does so in a briefer fashion than most lengthier, hardcover introductory research methods texts.

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Scientific Inquiry in Social Work

(9 reviews)

Matthew DeCarlo, Radford University

Copyright Year: 2018

ISBN 13: 9781975033729

Publisher: Open Social Work Education

Language: English

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Reviewed by Shannon Blajeski, Assistant Professor, Portland State University on 3/10/23

This book provides an introduction to research and inquiry in social work with an applied focus geared for the MSW student. The text covers 16 chapters, including several dedicated to understanding how to begin the research process, a chapter on... read more

Comprehensiveness rating: 5 see less

This book provides an introduction to research and inquiry in social work with an applied focus geared for the MSW student. The text covers 16 chapters, including several dedicated to understanding how to begin the research process, a chapter on ethics, and then eight chapters dedicated to research methods. The subchapters (1-5 per chapter) are concise and focused while also being tied to current knowledge and events so as to hold the reader's attention. It is comprehensive, but some of the later chapters covering research methods as well as the final chapter seem a bit scant and could be expanded. The glossary at the end of each chapter is helpful as is the index that is always accessible from the left-hand drop-down menu.

Content Accuracy rating: 4

The author pulls in relevant current and recent public events to illustrate important points about social research throughout the book. Each sub-chapter reads as accurate. I did not come across any inaccuracies in the text, however I would recommend a change in the title of Chapter 15 as "real world research" certainly encompasses more than program evaluation, single-subject designs, and action research.

Relevance/Longevity rating: 5

Another major strength of this book is that it adds currency to engage the reader while also maintaining its relevance to research methods. None of the current events/recent events that are described seem dated nor will they fade from relevance in a number of years. In addition, the concise nature of the modules should make them easy to update when needed to maintain relevancy in future editions.

Clarity rating: 5

Clarity is a major strength of this textbook. As described in the interface section, this book is written to be clear and concise, without unnecessary extra text that detracts from the concise content provided in each chapter. Any lengthy excerpts are also very engaging which lends itself to a clear presentation of content for the reader.

Consistency rating: 5

The text and content seems to be presented consistently throughout the book. Terminology and frameworks are balanced with real-world examples and current events.

Modularity rating: 5

The chapters of this textbook are appropriately spaced and easily digestible, particularly for readers with time constraints. Each chapter contains 3-5 sub-chapters that build upon each other in a scaffolding style. This makes it simple for the instructor to assign each chapter (sometimes two) per weekly session as well as add in additional assigned readings to complement the text.

Organization/Structure/Flow rating: 5

The overall organization of the chapters flow well. The book begins with a typical introduction to research aimed at social work practitioners or new students in social work. It then moves into a set of chapters on beginning a research project, reviewing literature, and asking research questions, followed by a chapter on ethics. Next, the text transitions to three chapters covering constructs, measurement, and sampling, followed by five chapters covering research methods, and a closing chapter on dissemination of research. This is one of the more logically-organized research methods texts that I have used as an instructor.

Interface rating: 5

The modular chapters are easy to navigate and the interface of each chapter follows a standard presentation style with the reading followed by a short vocabulary glossary and references. This presentation lends itself to a familiarity for students that helps them become more efficient with completing reading assignments, even in short bursts of time. This is particularly important for online and returning learners who may juggle their assignment time with family and work obligations.

Grammatical Errors rating: 5

No grammatical errors were noted.

Cultural Relevance rating: 4

At first glance at the table of contents, the book doesn't seem to be overtly committed to cultural representation, however, upon reading the chapters, it becomes clear that the author does try to represent and reference marginalized groups (e.g., women, individuals with disabilities, racial/ethnic/gender intersectionality) within the examples used. I also am very appreciative that the bottom of each introduction page for each chapter contains content trigger warnings for any possible topics that could be upsetting, e.g., substance abuse, violence.

As the author likely knows, social work students are eager to engage in learning that is current and relevant to their social causes. This book is written in a way that engages a non-researcher social worker into reading about research by weaving research information into topics that they might find compelling. It also does this in a concise way where short bits of pertinent information are presented, making the text accessible without needing to sustain long periods of attention. This is particularly important for online and returning learners who may need to sit with their readings in short bursts due to attending school while juggling work and family obligations.

Reviewed by Lynn Goerdt, Associate Professor, University of Wisconsin - Superior on 9/17/21

Text appears to be comprehensive in covering steps for typical SWK research class, taking students from the introduction of the purpose and importance of research to how to design and analyze research. Author covers the multitude of ways that... read more

Text appears to be comprehensive in covering steps for typical SWK research class, taking students from the introduction of the purpose and importance of research to how to design and analyze research. Author covers the multitude of ways that social workers engage in research as way of building knowledge and ways that social work practitioners conduct research to evaluate their practice, including outcome evaluation, single subject design, and action research. I particularly appreciated the last section on reporting research, which should be very practical.

Overall, content appears mostly accurate which few errors. Definitions and citations are mostly thorough and clear. Author does cite Wikipedia in at least one occasion which could be credible, depending on the source of the Wikipedia content. There were a few references within the text to comic or stories but the referenced material was not always apparent.

Relevance/Longevity rating: 4

The content of Scientific Inquiry for Social Work is relevant, as the field of social work research methods does not appear to change quickly, although there are innovations. The author referenced examples which appear to be recent and likely relatable to interests of current students. Primary area of innovation is in using technology for the collection and analysis of data, which could be expanded, particularly using social media for soliciting research participants.

Style is personable and content appears to be accessible, which is a unique attribute for a research textbook. Author uses first person in many instances, particularly in the beginning to present the content as relatable.

Format appears to be consistent in format and relative length. Each chapter includes learning objectives, content advisory (if applicable), key takeaways and glossary. Author uses color and text boxes to draw attention to these sections.

Modularity rating: 4

Text is divided into modules which could easily be assigned and reviewed in a class. The text modules could also be re-structured if desired to fit curricular uniqueness’s. Author uses images to illuminate the concepts of the module or chapter, but they often take about 1/3 of the page, which extends the size of the textbook quite a bit. Unclear if benefit of images outweighs additional cost if PDF version is printed.

Textbook is organized in a very logical and clear fashion. Each section appears to be approximately 6-10 pages in length which seems to be an optimal length for student attention and comprehension.

Interface rating: 4

There were some distortions of the text (size and visibility) but they were a fairly minor distraction and did not appear to reduce access to the content. Otherwise text was easy to navigate.

Grammatical Errors rating: 4

No grammatical errors were noted but hyperlinks to outside content were referenced but not always visible which occasionally resulted in an awkward read. Specific link may be in resources section of each chapter but occasionally they were also included in the text.

I did not recognize any text which was culturally insensitive or offensive. Images used which depicted people, appeared to represent diverse experiences, cultures, settings and persons. Did notice image depicting homelessness appeared to be stereotypical person sleeping on sidewalk, which can perpetuate a common perception of homelessness. Would encourage author to consider images representing a wider range of experiences of a social phenomena. Content advisories are used for each section, which is not necessarily cultural relevance but is respectful and recognizes the diversity of experiences and triggers that the readers may have.

Overall, I was very impressed and encouraged with the well organized content and thoughtful flow of this important textbook for social work students and instructors. The length and readability of each chapter would likely be appreciated by instructors as well as students, increasing the extent that the learning outcomes would be achieved. Teaching research is very challenging because the content and application can feel very intimidating. The author also has provided access to supplemental resources such as presentations and assignments.

Reviewed by elaine gatewood, Adjunct Faculty, Bridgewater State University on 6/15/21

The book provides concrete and clear information on using research as consumers, It provides a comprehensive review of each step to take to develop a research project from beginning to completion, with examples. read more

The book provides concrete and clear information on using research as consumers, It provides a comprehensive review of each step to take to develop a research project from beginning to completion, with examples.

Content Accuracy rating: 5

From my perspective, content is highly accurate in the field of learning research method and unbiased. It's all there!

The content is highly relevant and up-to-date in the field. The book is written and arranged in a way that its easy to follow along with adding updates.

The book is written in clear and concise. The book provides appropriate context for any jargon/technical terminology used along with examples which readers are able to follow along and understand.

The contents of the book flow quite well. The framework in the book is consistent.

The text appears easily adaptable for readers and the author also provides accompanying PowerPoint presentations; these are a good foundation tools for readers to use and implement.

Organization/Structure/Flow rating: 4

The contents of the book flow very well. Readers would be able to put into practice the key reading strategies shared in the book ) because its organization is laid out nicely

Interface rating: 3

The interface is generally good, but I was only able to download the .pdf. This may present issues for some student readers.

There are no grammatical errors.

The text was culturally relevant and provided diverse research and practice examples. The text could have benefited from sexamples of intersectional and anti-oppressive lenses for students to consider in their practice.

This text is a comprehensive introduction to research that can be easily adapted for a BSW/MSW research course.

Reviewed by Taylor Hall, Assistant Professor, Bridgewater State University on 6/30/20

This text is more comprehensive than the text I currently use in my Research Methods in Social Work course, which students have to pay for. This text not only covers both qualitative and quantitative research methods, but also all parts of the... read more

This text is more comprehensive than the text I currently use in my Research Methods in Social Work course, which students have to pay for. This text not only covers both qualitative and quantitative research methods, but also all parts of the research process from thinking about research ideas to questions all the way to evaluation after social work programs/policies have been employed.

Not much to say here- with research methods, things are black and white; it is or isn't. This content is accurate. I also like to way the content is explained in light of social work values and ethics. This is something our students can struggle with, and this is helpful in terms of showing why social work needs to pay attention to research.

There are upcoming changes to CSWE's competencies, therefore lots of text materials are going to need to be updated soon. Otherwise, case examples are pertinent and timely.

Clarity rating: 4

I think that research methods for social workers is a difficult field of study. Many go into the field to be clinicians, and few understand (off the bat) the importance of understanding methods of research. I think this textbook makes it clear to me, but hard to rate a 5 as I know from a student's perspective, lots of the terminology is so new.

Appears to be so- I was able to follow, seems consistent.

Yes- and I think this is a strong point of this text. This was easy to follow and read, and I could see myself easily divvying up different sections for students to work on in groups.

Yes- makes sense to me and the way I teach this course. I like the 30,000 ft view then honing in on specific types of research, all along the way explaining the different pieces of the research process and in writing a research paper.

I sometimes struggle with online platforms versus in person texts to read, and this OER is visually appealing- there is not too much text on the pages, it is spaced in a way that makes it easier to read. Colors are used well to highlight pertinent information.

Not something I found in this text.

Cultural Relevance rating: 3

This is a place where I feel the text could use some work. A nod to past wrongdoings in research methods on oppressed groups, and more of a discussion on social work's role in social justice with an eye towards righting the wrongs of the past. Updated language re: person first language, more diverse examples, etc.

This is a very useful text, and I am going to recommend my department check it out for future use, especially as many of our students are first gen and working class and would love to save money on textbooks where possible.

Reviewed by Olubunmi Oyewuwo-Gassikia, Assistant Professor, Northeastern Illinois University on 5/5/20

This text is an appropriate and comprehensive introduction to research methods for BSW students. It guides the reader through each stage of the research project, including identifying a research question, conducting and writing a literature... read more

This text is an appropriate and comprehensive introduction to research methods for BSW students. It guides the reader through each stage of the research project, including identifying a research question, conducting and writing a literature review, research ethics, theory, research design, methodology, sampling, and dissemination. The author explains complex concepts - such as paradigms, epistemology, and ontology - in clear, simple terms and through the use of practical, social work examples for the reader. I especially appreciated the balanced attention to quantitative and qualitative methods, including the explanation of data collection and basic analysis techniques for both. The text could benefit from the inclusion of an explanation of research design notations.

The text is accurate and unbiased. Additionally, the author effectively incorporates referenced sources, including sources one can use for further learning.

The content is relevant and timely. The author incorporates real, recent research examples that reflects the applicability of research at each level of social practice (micro, meso, and macro) throughout the text. The text will benefit from regular updates in research examples.

The text is written in a clear, approachable manner. The chapters are a reasonable length without sacrificing appropriate depth into the subject manner.

The text is consistent throughout. The author is effective in reintroducing previously explained terms from previous chapters.

The text appears easily adaptable. The instructions provided by the author on how to adapt the text for one's course are helpful to one who would like to use the text but not in its entirety. The author also provides accompanying PowerPoint presentations; these are a good foundation but will likely require tailoring based on the teaching style of the instructor.

Generally, the text flows well. However, chapter 5 (Ethics) should come earlier, preferably before chapter 3 (Reviewing & Evaluating the Literature). It is important that students understand research ethics as ethical concerns are an important aspect of evaluating the quality of research studies. Chapter 15 (Real-World Research) should also come earlier in the text, most suitably before or after chapter 7 (Design and Causality).

The interface is generally good, but I was only able to download the .pdf. The setup of the .pdf is difficult to navigate, especially if one wants to jump from chapter to chapter. This may present issues for the student reader.

The text was culturally relevant and provided diverse research and practice examples. The text could have benefited from more critical research examples, such as examples of research studies that incorporate intersectional and anti-oppressive lenses.

This text is a comprehensive introduction to research that can be easily adapted for a BSW level research course.

Reviewed by Smita Dewan, Assistant Professor, New York City College of Technology, Department of Human Services on 12/6/19

This is a very good introductory research methodology textbook for undergraduate students of social work or human services. For students who might be intimidated by social research, the text provides assurance that by learning basic concepts of... read more

Comprehensiveness rating: 4 see less

This is a very good introductory research methodology textbook for undergraduate students of social work or human services. For students who might be intimidated by social research, the text provides assurance that by learning basic concepts of research methodology, students will be better scholars and social work or human service practitioners. The content and flow of the text book supports a basic assignment of most research methodology courses which is to develop a research proposal or a research project. Each stage of research is explained well with many examples from social work practice that has the potential to keep the student engaged.

The glossary at the end of each chapter is very comprehensive but does not include the page number/s where the content is located. The glossary at the end of the book also lacks page numbers which might make it cumbersome for students seeking a quick reference.

The content is accurate and unbiased. Suggested exercises and prompts for students to engage in critical thinking and to identify biases in research that informs practice may help students understand the complexities of social research.

Content is up-to-date and concepts of research methodology presented is unlikely to be obsolete in the coming years. However, recent trends in research such as data mining, using algorithms for social policy and practice implications, privacy concerns, role of social media are topics that could be considered for inclusion in the forthcoming editions.

Content is presented very clearly for undergraduate students. Key takeaways and glossary for each section of the chapter is very useful for students.

Presentation of content, format and organization is consistent throughout the book.

Subsections within each chapter is very helpful for the students who might be assigned readings just in parts for the class.

Students would benefit from reading about research ethics right after the introductory chapter. I would also move Chapter 8 to right after the literature review which might inform creating and refining the research question. Content on evaluation research could also be moved up to follow the chapter on experimental designs. Regardless of the organization, the course instructors can assign chapters according to the course requirements.

PDF version of the book is very easy to use especially as students can save a copy on their computers and do not have to be online. Charts and tables are well presented but some of the images/photographs do not necessarily serve to enhance learning. Image attributions could be provided at the end of the chapter instead of being listed under the glossary. Students might also find it useful to be able to highlight the content and make annotations. This requires that students sign-in. Students should be able to highlight and annotate a downloaded version through Adobe Reader.

I did not find any grammatical errors.

Cultural Relevance rating: 5

Content is not insensitive or offensive in any way. Supporting examples in chapters are very diverse. Students would benefit from some examples of international research (both positive and negative examples) of protection of human subjects.

Reviewed by Jill Hoffman, Assistant Professor, Portland State University on 10/29/19

This text includes 16 chapters that cover content related to the process of conducting research. From identifying a topic and reviewing the literature, to formulating a question, designing a study, and disseminating findings, the text includes... read more

This text includes 16 chapters that cover content related to the process of conducting research. From identifying a topic and reviewing the literature, to formulating a question, designing a study, and disseminating findings, the text includes research basics that most other introductory social work research texts include. Content on ethics, theory, and to a lesser extent evaluation, single-subject design, and action research are also included. There is a glossary at the end of the text that includes information on the location of the terms. There is a practice behaviors index, but not an index in the traditional sense. If using the text electronically, search functions make it easy to find necessary information despite not having an index. If using a printed version, this would be more difficult. The text includes examples to illustrate concepts that are relevant to settings in which social workers might work. As most other introductory social work research texts, this book appears to come from a mainly positivist view. I would have appreciated more of a discussion related to power, privilege, and oppression and the role these play in the research topics that get studied and who benefits, along with anti-oppressive research. Related to evaluations, a quick mention of logic models would be helpful.

The information appears to be accurate and error free. The language in the text seems to emphasize "right/wrong" choices/decisions instead of highlighting the complexities of research and practice. Using gender-neutral pronouns would also make the language more inclusive.

Content appears to be up-to-date and relevant. Any updating would be straightforward to carry out. I found at least one link that did not work (e.g., NREPP) so if you use this text it will be important to check and make sure things are updated.

The content is clearly written, using examples to illustrate various concepts. I appreciated prompts for questions throughout each chapter in order to engage students in the content. Key terms are bolded, which helps to easily identify important points.

Information is presented in a consistent manner throughout the text.

Each chapter is divided into subsections that help with readability. It is easy to pick and choose various pieces of the text for your course if you're not using the entire thing.

There are many ways you can organize a social work research text. Personally, I prefer to talk about ethics and theory early on, so that students have this as a framework as they read about other's studies and design their own. In the case of this text, I'd put those two chapters right after chapter 1. As others have suggested, I'd also move up the content on research questions, perhaps after chapter 4.

In the online version, no significant interface issues arose. The only thing that would be helpful is to have chapter titles clearly presented when navigating through the text in the online version. For example, when you click through to a new chapter, the title simply says "6.0 Chapter introduction." In order to see the chapter title you have to click into the contents tab. Not a huge issue but could help with navigating the online version. In the pdf version, the links in the table of contents allowed me to navigate through to various sections. I did notice that some of the external links were not complete (e.g., on page 290, the URL is linked as "http://baby-").

Cultural representation in the text is similar to many other introductory social work research texts. There's more of an emphasis on white, western, cis-gendered individuals, particularly in the images. In examples, it appeared that only male/female pronouns were used.

Reviewed by Monica Roth Day, Associate Professor, Social Work, Metropolitan State University (Saint Paul, Minnesota) on 12/26/18

The book provides concrete and clear information on using research as consumers, then developing research as producers of knowledge. It provides a comprehensive review of each step to take to develop a research project from beginning to... read more

The book provides concrete and clear information on using research as consumers, then developing research as producers of knowledge. It provides a comprehensive review of each step to take to develop a research project from beginning to completion, with appropriate examples. More specific social work links would be helpful as students learn more about the field and the uses of research.

The book is accurate and communicates information and largely without bias. Numerous examples are provided from varied sources, which are then used to discuss potential for bias in research. The addition of critical race theory concepts would add to this discussion, to ground students in the importance of understanding implicit bias as researchers and ways to develop their own awareness.

The book is highly relevant. It provides historical and current examples of research which communicate concepts using accessible language that is current to social work. The text is written so that updates should be easy. Links need to be updated on a regular basis.

The book is accessible for students at it uses common language to communicate concepts while helping students build their research vocabulary. Terminology is communicate both within the text and in glossaries, and technical terms are minimally used.

The book is consistent in its use of terminology and framework. It follows a pattern of development, from consuming research to producing research. The steps are predictable and walk students through appropriate actions to take.

The book is easily readable. Each chapter is divided in sections that are easy to navigate and understand. Pictures and tables are used to support text.

Chapters are in logical order and follow a common pattern.

When reading the book online, the text was largely free of interface issues. As a PDF, there were issues with formatting. Be aware that students who may wish to download the book into a Kindle or other book reader may experience issues.

The text was grammatically correct with no misspellings.

While the book is culturally relevant, it lacks the application of critical race theory. While students will learn about bias in research, critical race theory would ground students in the importance of understanding implicit bias as researchers and ways to develop their own awareness. It would also help students understand why the background of researchers is important in relation to the ways of knowing.

Reviewed by Jennifer Wareham, Associate Professor, Wayne State University on 11/30/18

The book provides a comprehensive introduction to research methods from the perspective of the discipline of Social Work. The book borrows heavily from Amy Blackstone’s Principles of Sociological Inquiry – Qualitative and Quantitative Methods open... read more

The book provides a comprehensive introduction to research methods from the perspective of the discipline of Social Work. The book borrows heavily from Amy Blackstone’s Principles of Sociological Inquiry – Qualitative and Quantitative Methods open textbook. The book is divided into 16 chapters, covering: differences in reasoning and scientific thought, starting a research project, writing a literature review, ethics in social science research, how theory relates to research, research design, causality, measurement, sampling, survey research, experimental design, qualitative interviews and focus groups, evaluation research, and reporting research. Some of the more advanced concepts and topics are only covered at superficial level, which limits the intended population of readers to high school students, undergraduate students, or those with no background in research methods. Since the book is geared toward Social Work undergraduate students, the chapters and content address methodologies commonly used in this field, but ignore methodologies that may be more popular in other social science fields. For example, the material on qualitative methods is narrow and focuses on commonly used qualitative methods in Social Work. In addition, the chapter on evaluation is limited to a general overview of evaluation research, which could be improved with more in-depth discussion of different types of evaluation (e.g., needs assessment, evaluability assessment, process evaluation, impact/outcomes evaluation) and real-world examples of different types of evaluation implemented in Social Work. Overall, the author provides examples that are easy for practitioners in Social Work to understand, which are also easily relatable for students in similar disciplines such as criminal justice. The book provides a glossary of key terms. There is no index; however, users can search for terms using the find (Ctrl-F) function in the PDF version of the book.

Overall, the content inside this book is accurate, error-free, and unbiased. However, the content is limited to the Social Work perspective, which may be considered somewhat biased or inaccurate from the perspective of others in different disciplines.

The book describes classic examples used in most texts on social science research methods. It also includes contemporary and relevant examples. Some of the content (such as web addresses and contemporary news pieces) will need to be updated every few years. The text is written and arranged in such a way that any necessary updates should be relatively easy and straightforward to implement.

The book is written in clear and accessible prose. The book provides appropriate context for any jargon/technical terminology used. Readers from any social science discipline should be able to understand the content and context of the material presented in the book.

The framework and use of terminology in the book are consistent.

This book is highly modular. The author has even improved upon the modularity of the book from Blackstone’s open text (which serves as the basis of the present text). Each chapter is divided into short, related subsections. The design of the chapters and their subsections make it easy to divide the material into units of study across a semester or quarter of instruction.

Generally, the book is organized in a similar manner as other texts on social science research methods. However, the organization could be improved slightly. Chapters 2 through 4 describe the process of beginning a research project and conducting a literature review. Chapter 8 describes refining a research question. This chapter could be moved to follow the Chapter 4. Chapter 12 describes experimental design, while Chapter 15 provides a description and examples of evaluation research. Since evaluation research tends to rely on experimental and quasi-experimental design, this chapter should follow the experimental design chapter.

For the online version of the book, there were no interface issues. The images and charts were clear and readable. The hyperlinks to sources mentioned in the text worked. The Contents menu allowed for easy and quick access to any section of the book. For the PDF version of the book, there were interface issues. The images and charts were clear and readable. However, the URLs and hyperlinks were not active in the PDF version. Furthermore, the PDF version was not bookmarked, which made it more difficult to access specific sections of the book.

I did not find grammatical errors in the book.

Overall, the cultural relevance and sensitivity were consistent with other social science research methods texts. The author does a good job of using both female and male pronouns in the prose. While there are pictures of people of color, there could be more. Most of the pictures are of white people. Also, the context is generally U.S.-centric.

Table of Contents

• Chapter 1: Introduction to research
• Chapter 2: Beginning a research project
• Chapter 3: Reading and evaluating literature
• Chapter 4: Conducting a literature review
• Chapter 5: Ethics in social work research
• Chapter 6: Linking methods with theory
• Chapter 7: Design and causality
• Chapter 8: Creating and refining a research question
• Chapter 9: Defining and measuring concepts
• Chapter 10: Sampling
• Chapter 11: Survey research
• Chapter 12: Experimental design
• Chapter 13: Interviews and focus groups
• Chapter 14: Unobtrusive research: Qualitative and quantitative approaches
• Chapter 15: Real-world research: Evaluation, single-subjects, and action research
• Chapter 16: Reporting and reading research

Ancillary Material

• Open Social Work Education

About the Book

As an introductory textbook for social work students studying research methods, this book guides students through the process of creating a research project. Students will learn how to discover a researchable topic that is interesting to them, examine scholarly literature, formulate a proper research question, design a quantitative or qualitative study to answer their question, carry out the design, interpret quantitative or qualitative results, and disseminate their findings to a variety of audiences. Examples are drawn from the author's practice and research experience, as well as topical articles from the literature.

There are ancillary materials available for this book.  

About the Contributors

Matt DeCarlo earned his PhD in social work at Virginia Commonwealth University and is an Assistant Professor of Social Work at Radford University. He earned an MSW from George Mason University in 2010 and a BA in Psychology from the College of William and Mary in 2007. His research interests include open educational resources, self-directed Medicaid supports, and basic income. Matt is an Open Textbook Network Campus Leader for Radford University. He is the founder of Open Social Work Education, a non-profit collaborative advancing OER in social work education.

Article Contents

Introduction, what is practice research and why (and for whom) does it matter, practice research as an organisationally rooted participatory research methodology, practice research frameworks, how can service users benefit from participating in practice research, integrating practice research processes into social service organisational analysis, applications of practice research for social service organisations, methodological and ethical considerations for practice research-based organisational analysis, implications and an agenda for social work researchers, acknowledgements.

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Practice research methods in social work: Processes, applications and implications for social service organisations

• Article contents
• Figures & tables
• Supplementary Data

Bowen McBeath, Michael J Austin, Sarah Carnochan, Emmeline Chuang, Practice research methods in social work: Processes, applications and implications for social service organisations, The British Journal of Social Work , Volume 52, Issue 6, September 2022, Pages 3328–3346, https://doi.org/10.1093/bjsw/bcab246

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Although social work research is commonly rooted within social service settings, it can be difficult for social work researchers and practitioners to develop and sustain participatory studies that specifically promote knowledge sharing and service improvement involving organisational practice. One participatory approach is practice research (PR), which involves social work researchers and practitioners collaborating to define, understand and try to improve the delivery of health and social care services and organisational structures and processes. The two goals of this commentary are to introduce essential methods and approaches to PR and to identify points of connection involving PR and social service organisational studies. Our specific focus on PR in statutory, voluntary and private social service organisations reflects efforts to connect practice, theory and qualitative and quantitative research methods to develop and share organisationally-situated knowledge.

This paper offers an overview of practice research (PR) that focuses on the delivery of social work services in social service organisations. PR is a participatory method used by researchers to address the needs of vulnerable populations, notably poor communities of colour, who receive health and social care services in formal organisational settings. PR is ‘a knowledge development process that focuses primarily on the roles of the service provider, service user, and the service researcher who all participate in defining the research questions and interpreting the findings’ ( Fisher et al. , 2016 ). PR therefore seeks to improve social work and other social services and promote the well-being of service users; and functions as a collaborative process that minimises power differentials between participants ( Austin, 2020 ).

The macro-organisational context of PR studies includes concerns of managerialism amidst neoliberalism, involving increased professionalisation, the use of evidence-based practices and the structuring of service programmes around carefully defined performance measures in response to administrative and policy requirements ( Hasenfeld and Garrow, 2012 ; Harlow et al. , 2013 ; Yan et al. , 2017 ). The meso-organisational context of PR studies involves the development and sustainment of organisational spaces for reflection and sharing that support practitioner engagement in evidence-informed practice ( Carnochan et al. , 2017 ; Brandt et al. , 2020 ). The immediate context for PR is the bureaucratic encounters that involve staff and service users as well as practitioner use of research to promote organisational learning ( Austin and Carnochan, 2020 ). With its specific focus on statutory, voluntary and private social service organisations, PR aims to strengthen the collaborative capacity of practitioners and researchers to support service improvement and responsiveness to the perspectives of service users (capturing the expertise of experience).

In order to describe PR within organisations providing health and social care services, our paper is divided into four sections. First, we provide a brief introduction to PR to characterise its core elements. We also provide a brief review of the major approaches to PR, distinguishing between PR frameworks at different levels of practice and in different geographic contexts. We then identify how service users can benefit from PR. Secondly, we identify how PR processes can be integrated within social service organisational analysis, focusing in particular on how practice researchers and their agency partners (notably front line staff and managers) collaboratively seek to improve social service delivery, support organisational learning and promote interorganisational knowledge sharing. We also summarise PR processes that are based on the core concepts embedded in the science of the concrete (SOC) ( Flyvbjerg, 2001 ). Thirdly, we illustrate the applications of PR for local authorities/counties and voluntary social service organisations with the use of three brief examples featuring methodological and ethical considerations for researchers using PR approaches. Finally, we conclude by identifying implications for social work organisational researchers participating in PR studies and proposing a future research agenda.

At its core, PR is a negotiated process involving multiple stakeholders ( Uggerhøj, 2011 ). These stakeholders include statutory, voluntary and private social service organisations; managers, staff and service users within the organisation; researchers; and policymakers and community leaders. They all function within the context of intergroup communications, negotiation and shared learning needed to address the gap between research and practice and support learning across role-based social, cultural and organisational distances ( Austin and Carnochan, 2020 ).

In order to address this gap, PR involves elements of both practice and research. The elements of practice include: (1) engaging and including diverse types of stakeholders; (2) an effort to rebalance power relationships across organisational contexts, by validating the experiences and expertise of participants at different levels of the organisation; (3) open and frequent conversations to promote dialogue and sustain norms of trust and reciprocity; and (4) an appreciation for the critical role of organisational supports (notably managers) for exploring service innovation ( Uggerhøj, 2011 ).

Essential research elements of PR include the use of quantitative and qualitative data, as well as the reliance on evidence collected within the agency setting. The use of different types of evidence can generate two major research tensions; namely, balancing the breadth (as seen in large organisational surveys and administrative service databases) and depth (e.g. analysis of client case records, in-depth interviews) of research while navigating the tension between research rigour and practice wisdom displayed by practitioners and service users ( Julkunen, 2011 ).

These practice and research elements are integrated into PR studies that evolve in response to ongoing and changing agency needs and priorities. Facilitated group dialogue is used to collaboratively identify practice concerns, conduct research in response to the concerns, and share findings with a focus on assessing current social work practices and identifying opportunities for improvement ( Austin, 2020 ). PR involves power sharing and role shifting through reciprocal learning, as traditionally less-engaged stakeholders explore new roles (e.g. from service user to PR partner); and as managers and researchers reframe their traditional roles (e.g. exploring the emergence of practice-informed management research and research-informed management practice) ( Fisher et al. , 2016 ).

As one of several participatory social science research methods, PR reflects the emphasis of researchers on practice-in-context. In particular, PR shares a number of characteristics with participatory action research (PAR) and empowerment evaluation. In each method, collaboration with service users and other stakeholder groups is central to identifying basic research questions that relate to practices, programmes and/or policies as expressions of larger institutional forces. Furthermore, these approaches draw on diverse sources of literature, including practice and policy reports as well as academic research studies, to inform research questions. Lastly, collaborative collection and analysis of qualitative and/or quantitative data is carried out by research and practice partners across the three research traditions ( Healy, 2001 ; Fetterman et al. , 2017 ).

However, while PR shares many similarities with PAR and programme evaluation principles, it also differs in several important ways related to goals, data sources, data interpretation and the nature of knowledge development and dissemination (see Table 1 ). For example, a main goal of programme evaluation includes the central role of specifying programme objectives to inform funder or organisational decision making in a narrowly defined area (e.g. continue, modify or eliminate a programme). In contrast, PR goals may be much broader, and intended to inform participants’ conceptual thinking about current practice or service delivery and create dialogical opportunities without the same emphasis on direct implications for organisational decision making. Differences also appear in the area of research dissemination. Specifically, programme evaluation results are often used to support organisational planning in response to formal funding and policy requirements, and PAR is often used to support socio-political action or community change. In comparison, PR focuses more on service and practice improvement as well as the relationship between theory and practice, with the goal of encouraging more research-minded practitioners and more practice-minded researchers ( Saurama and Julkunen, 2012 ).

Comparing PR with other research frameworks a

Adapted from Austin and Carnochan (2020 , p. 199).

Another critical factor that distinguishes PR from other participatory research methods is the connection between social work practice and social service managers. Compared to action research and empowerment evaluation methodologies, PR is more explicitly organisational in understanding how managers, front line staff and service users make sense of their diverse roles and often competing statuses. PR is also more attentive to the collaborative interrelationships of service users, front line agency staff and managers in their interorganisational and institutional context. Finally, PR demonstrates an awareness of how questions of service delivery reflect the professionalisation of social work and social services vis-à-vis questions of organisational learning ( Fisher et al. , 2016 ).

Finally, another key difference between PR and its related methodologies can be found in the relationship of organisationally situated theories vis-à-vis practice. For practice researchers, considerations of theory-informed practice and practice-informed theory are important ( Fisher, 2011 ). The exploration and development of diverse theories (e.g. cultural–historical activity theory; Foot, 2014 ) helps practice researchers and participants identify shared practice challenges and explore possible solutions. For example, practice researchers can share lessons learned and practice implications of different theories of group-based learning and relational work, so that managers, workers and service users can determine how each theory enhances shared understanding of service problems and possible solutions ( Austin, 2020 ; Muurinen and Kaarianen, 2021 ).

In sum, PR is explicitly rooted within social service organisations, with a basic goal of collaborating to improve the delivery of health and social care services and organisational capacity within and between organisations ( Austin and Carnochan, 2020 ). Practice researchers pay close attention to the delivery of front line services as well as multilevel practice issues relating to managers, staff and service users.

The evolution of PR has reflected theoretical and practical developments. Practice researchers have used person-in-organisation theories of practice in an effort to explain the ‘everyday actions’ ( Feldman and Orlikowski, 2011 , p. 1241) and ‘concrete activities’ ( Barley and Kunda, 2001 , p. 76) that capture the relationship between agency-based service providers and service users. Researchers have also proposed ways of enhancing the practical relevance of research that involves social work researchers and practitioners promoting shared learning, with a goal of resolving fundamental service delivery dilemmas ( Austin et al. , 2014 ).

In response to these developments, the interrelated streams of PR have been explored in the form of collaboration and negotiation. For example, the foundational perspective of PR invites practitioners and service users to collaboratively identify opportunities to improve social work practices and organisational processes—particularly in response to administrative requirements and statutory mandates ( Fook and Gardner, 2007 ; Epstein, 2009 ). Similarly, there are opportunities to negotiate across differing approaches and perspectives that practitioners, service users and researchers bring to the knowledge production process ( Uggerhøj, 2011 ).

Based on the original formulation of PR, Julkunen (2011) developed a typology of PR studies, distinguishing between practitioner-oriented, generative, method-oriented and democratic models. In the practitioner-oriented model, the practitioner reflectively dialogues with others in order to address pressing practice issues. The generative model involves cycles of agency practice and research designed to connect practical knowledge to action by testing and evaluating potential practice innovations. The method-oriented model involves the service user, practitioner and researcher collaboratively developing practice-based knowledge as well as knowledge that can inform theory development and application. Finally, the democratic model focuses specifically on service users, practitioners, researchers and organisational and system leaders using PR to advocate for practice reforms, thereby connecting PR to policy change (also see Fisher, 2013 ).

Although scholarship on PR has historically reflected the perspectives of Nordic and US academic institutions and social welfare states, a globally diverse body of PR literature is emerging ( Chan and Sim, 2020 ). This literature demonstrates that different PR studies may reflect different: political, policy and organisational contexts of social service delivery; research methods; understandings of service user and practitioner involvement and collaboration and understandings of practice ( Sim et al. , 2018 ).

Empirical research on benefits accrued by service users when engaging in PR is currently limited. However, preliminary evidence suggests that benefits can be organised in terms of empowerment processes and measurable outcomes built on the service user premise of ‘nothing about us, without us’ ( Beresford and McLaughlin, 2020 ). Such processes invite PR participants to learn how to participate in non-hierarchical relationships that ensure diversity, equity and inclusion among service users and providers. This partnership relationship often involves joint problem-solving as well as developing a critical consciousness leading to an alliance through the articulation of shared and different needs and challenges ( Fook and Gardner, 2007 ). Engaging in this process can help service users gain a greater understanding of the contextualised nature of social problems they face.

Another key benefit of participating in PR involves expanding the capacities of service users to amplify their own voices and assume the position of representing the perspectives of peer-colleagues ( Austin and Carnochan, 2020 ). Service users may advocate internally (in response to management directives) and externally (in response to policy dicta and fiscal requirements). As they engage in advocacy efforts, service users can also increase their skills in identifying and accessing community resources (e.g. job training programmes that enhance employability). The process of engaging in humanising power-sharing relationships using dialogical communications between service users, staff and managers can thus involve a shared search for community resources and organisational funding needed to maintain service delivery at needed levels ( Ramon et al. , 2019 ).

The benefits of service user involvement do not necessarily lead to major organisational changes when the focus is on modifying or improving direct service or managerial practice. However, service user involvement can lead to both changes in practice as well as changes in organisational policies and structures ( Julkunen, 2011 ; Fisher, 2013 ). Through involvement in PR, service users can also participate in training and other learning-oriented events as co-equals with staff and other community stakeholders. These opportunities can involve service users playing critical roles of knowledge navigation and translation within social service organisational contexts, particularly where service user perspectives are needed to translate deep knowledge of programme and policy gaps to staff, managers and policymakers ( Muurinen and Kaarianen, 2021 ). Such PR efforts can help spur organisational change and the development of new approaches to system transformation. For service users, skills acquired through participation in PR can also be leveraged in future advocacy efforts or employment opportunities (e.g. serving as a consultant or staff member based on their expertise of experience with a particular social issue) ( Voronka and Grant, 2021 ).

In summary, some of the major benefits derived from service user involvement have been documented ( Natland and Celik, 2015 ) by noting the transition of service user from functioning with a sense of shame or trauma to one of pride and empowerment, in addition to learning how services can be evaluated and improved based on timely and strategic input from service users. A major limitation related to service user involvement could be that their involvement in which their service user experiences are contextualised or revisited could result in being retraumatised (e.g. reliving the experiences of being homeless, incarcerated, unemployed, physically disabled or mentally disabled), especially when acquiring the ‘big picture understanding’ of the pervasiveness of social problems in the larger society ( Müller and Pihl-Thingvad, 2020 ).

The next section identifies common approaches for practice researchers to collaborate with agency-based practitioners and managers in support of service user preferences.

PR processes reflect the evolving interests of social service organisational researchers and practitioners, as seen in their concerns with the formal delivery of contract-based public services, with specific focus on service access and equity considerations ( Jindra et al. , 2020 ). In a similar way, PR processes capture the concerns of managerialism as a response to neoliberalism and austerity, especially in European, Australian and Asian social welfare contexts ( Yan et al. , 2017 ; Alexander and Fernandez, 2021 ). Underlying these interests is an abiding focus on studies that validate and feature the perspectives of service users and service providers ( Hasenfeld and Garrow, 2012 ; Harlow et al. , 2013 ). These studies reflect decades of organisational research, as seen in Table 2 (for a review, see Austin and Carnochan, 2020 ). The overarching effort is to democratise knowledge sharing within social service organisational settings by identifying complementary ways for service users, practitioners, researchers and advocates to contribute to social service delivery.

Complementary types of practice research with social service organisations

For social service organisational scholars, PR processes support exploratory, explanatory and interventive research aims. In exploratory research, PR is used to identify the diverse organisational experiences of service users and service providers ( Austin, 2020 ). These exploratory studies are analogous to participatory needs assessments. In contrast, explanatory PR examines connections between service, programme or policy logics, and identifies broken or missing logics reflecting needed resources (notably, time, funding and training). For example, the identification of gaps between needs and services often reflects historically and/or currently unaddressed service needs (as seen by service users), programme needs (as perceived by front line staff) and organisational learning and policy implementation needs (as viewed by agency leaders) ( Hasenfeld and Garrow, 2012 ; Spitzmueller, 2018 ). Finally, PR can support intervention studies that involve the co-design, co-development, refinement and sharing of new practices within programmes (e.g. practical innovations that benefit service users and front line workers) ( Schalock et al. , 2014 ).

PR-based social service studies can be viewed from the perspectives of the SOC ( Flyvbjerg, 2001 ) that invites researchers to propose person-oriented research questions related to those individuals and groups most impacted by the issues at hand. The SOC also asks researchers to focus on small practices that support big events or processes by exploring everyday activities and their contexts that connect people and their organisational milieu. Finally, the SOC involves engaging multiple stakeholders while reducing power differentials. In PR, managers are viewed as essential linchpins who facilitate shared learning, by validating the multiple organisational identities of participants.

Although social service organisational research based on the SOC can take many forms, it ordinarily begins with question formulation around one or more practical problems or concerns. As elucidated by Austin and Carnochan (2020) , PR questions can take a variety of forms but generally involve three fundamental questions: How can we improve social services and, more broadly, enhance opportunities for health and social care? How can we amplify the voices of service users? and How can we sustain small innovations and promising practices in social work, particularly in different organisational and policy settings? Jointly defining PR questions involves validating the perspectives of each type of participant. Questions derived from the perspectives of service users and staff require considerable outreach in order to engage and amplify service user and practitioner voices (e.g. via service user- and staff-led meetings) ( Uggerhøj, 2011 ).

In comparison, organisational and policy-focused research questions are often formulated by senior management in regards to intra-organisational issues (e.g. cross-departmental coordination and collaboration) and inter-organisational issues (e.g. contracting and implementation challenges involving statutory, voluntary and private social service organisations) ( Fisher, 2013 ). Negotiating among the diverse types of research questions involves explaining why the questions are relevant for different groups, how each envisioned research study can support mutually beneficial goals, and what benefits and challenges might arise as a result.

Other key concepts of the SOC that support PR studies include collaboration and engagement with partners based on persistent communication, representation of diverse memberships, fostering inclusiveness, engaging in difficult conversations and consensus building. Other needed skills involve managing critical tensions, often relating to the responsibilities and expectations of different PR stakeholders. Additional tensions reflect the evolving demands of the organisation vis-à-vis its institutional environment. These tensions need to be addressed through shared dialogue in PR teams ( Julkunen, 2011 ).

As the PR team coalesces, it informs research design, data collection, data interpretation and research dissemination and utilisation in unique ways ( Austin, 2020 ). For example, the more traditional use of literature reviews is to ensure that the research questions and study design are informed by the latest peer-reviewed research studies, by reflecting their findings, key concepts, research methods and implications for future research. In comparison, building on existing knowledge in PR may also involve review of organisational documents, grey literature and the practice wisdom of practitioners and service users ( Austin and Carnochan, 2020 ).

In PR, literature reviews can also become ends in themselves. For example, PR-informed literature reviews can assist in reframing service processes (i.e. identifying how service users and practitioners understand the theories of action underlying service logic models); help staff to become more evidence-informed by reflecting on diverse practice literature and inform managerial decision-making processes. Similarly, in contrast to the traditional scholarly approach of disseminating research findings via peer-reviewed publications in academic journals, practice researchers also share findings directly with service providers and service users in the form of reports and presentations so that practice partners can identify novel applications and more effective approaches to practice.

This section provides three brief examples of PR-based organisational studies. The institutional context of the examples reflects a longstanding PR centre located in a US public research university, a regional consortium of county organisations that administer statutorily required social services and a regional consortium of non-profit organisations that provide voluntary social services. Regionalisation of PR efforts is not uncommon, particularly when organised through academic–practice partnerships involving research, education and training and service functions (often in metropolitan areas).

PR centres serve as network hubs for developing service, workforce and programme studies in response to institutional and local demands (e.g. new policy implementation requirements impacting service delivery). They share PR-based knowledge in order to advocate with local and regional policy and practice bodies, and work to promote mutual support and shared leadership among social service organisations. From the social service organisational perspective, consortium membership and affiliation with the PR centre can advance knowledge development and utilisation that might not otherwise be possible due to considerations of cost, research capacity or timing ( Schalock et al. , 2014 ). Whilst some PR centres are university-based ( Austin et al. , 1999 ), others are located in public settings (e.g. ministries of health and social services) ( Muurinen and Kaarianen, 2021 ). However, the general purpose of PR centres is similar to centres providing applied evaluation and technical assistance.

For over twenty-five years, the PR centre from which the following examples are drawn has supported collaborative, usable knowledge related to the management and improvement of social work services across the public and non-profit social service sectors ( Austin, 2018 ). Its studies have involved research at the front line, organisational and inter-organisational levels, ranging from qualitative agency-based case studies to large quantitative surveys that span public and non-profit organisations across the region. The studies have supported the collection and sharing of three types of research evidence as noted by Nutley et al. (2007) . The first type relates to conceptual evidence that is often drawn from exploratory PR studies that are designed to support future applications. The second type includes persuasive research evidence that often involves explanatory PR, and is used to advocate (within organisations) and externally (notably, with policymakers, funders and civic leaders). And the third type involves instrumental evidence that often relates to explanatory or interventive PR that is designed to support practice improvements (notably in response to identified service and training needs).

To illustrate some of these PR-informed studies of service delivery, we note the purpose of each study, and then summarise its use by study partners and the consortia of local authorities/counties and non-profit social service organisations. As each study evolved, practice researchers attended to the perspectives of organisational partners through persistent communications, relational work centred in interpersonal and small group meetings, managing tensions in response to ongoing and new challenges and celebrating successes.

The first example involved an exploration of the attributes and sustainability of pioneering non-profit social service organisations through in-depth case histories ( Austin, 2013 ) and focused on the organisational developmental needs of long-serving nonprofits. The study partners and regional consortium of non-profit social service organisations expressed significant interest in findings, leading to requests for self-assessment-based organisational and management support tools designed to promote front line service improvement.

The second example was a survey-based study of how front line and management practitioners across eleven county-based public social service organisations engaged in evidence-informed practice. The quantitative aspect of the study noted the importance of organisational roles and resources, and individual practitioner attitudes towards practice and innovation, in supporting different levels of evidence use ( McBeath et al. , 2015 ). The qualitative component of the study identified the specific cognitive, interactive, action and compliance dimensions of evidence-informed practice that are embedded within agency-based social and organisational practices and priorities ( Carnochan et al. , 2017 ). This explanatory study resulted in the provision of recommendations to the eleven county social service organisations, focused on identifying needed resources and opportunities for peer sharing and social support.

The third example involved a mixed methods study examining the collaborative nature of non-profit contracting amidst technical challenges that reflect the underlying complexity of social service delivery. Qualitative, comparative case study analysis was used to explore the multiple dimensions of relational contracting between non-profit and county social service organisations in three counties ( McBeath et al. , 2017 ). The quantitative component of the study entailed surveying non-profit and county social service organisations across different counties to assess the importance of cross-sector communications, trust-building and shared client accountability for collaborative contracting and social service outcome achievement ( Carnochan et al. , 2019 ; Chuang et al. , 2020 ). Study findings identified the need for public-non-profit social service contracting support structures and processes, including: regularly scheduled cross-sector meetings to identify emergent needs and promising service approaches; and cross-sector training and technical assistance to promote collaborative contracting and improved service outcomes.

Each example involved engagement with agency directors, division heads, senior managers and line staff. In each study, the research design and reporting process was iterative between levels, in support of facilitating communication on broadly relevant topics involving diverse staff groups. Overall, these and other studies from the specific PR centre have regularly featured critical information exchange sessions, involving agency staff presentations of local practices as well as research staff presentations of research syntheses, and in which the audience is cross-division and multi-level.

PR methods complement social service organisational research methodologies in at least two ways. First, PR offers an alternative to traditional organisational research that relies on quantitative analysis of elite surveys (notably agency directors). In comparison, PR studies incorporate diverse types of data (e.g. use of agency documents, interviews, focus groups, surveys) and the perspectives of individuals at different levels of analysis (including administrators and managers, front line staff and service users). These qualitative and quantitative data collection methods are intended to address common source bias and validity concerns. Mixed methods PR studies therefore need to anticipate concerns about the perceived trustworthiness, credibility, confirmability and dependability of the data (e.g. by pilot testing survey instruments and interview guides). (For a summative review concerning how to promote the rigour and relevance of PR studies, see Austin and Carnochan (2020 , pp. 183–189)).

Secondly, PR provides a balanced response to the understanding of researchers as either directing and managing the research process, or serving in subsidiary roles. In comparison, PR is a participatory process in which the research interests and perspectives of the researchers and practitioners are actively negotiated, and often reflect multiple objectives ( Fisher et al. , 2016 ). As noted previously, these include instrumental objectives (e.g. to use PR to enhance understanding of services and programmes, and/or to support organisational learning) along with process and interactional objectives (e.g. to support PR-based participation and collaboration). Among the most challenging aspects embedded in negotiations are values-based objectives that are designed to enhance equity and empowerment through PR projects.

Practice researchers therefore need to be prepared to take on co-facilitative roles on issues ranging from research question formulation to the interpretation, use and wider sharing of PR findings in organisations and broader contexts. These co-roles are essential for addressing group dynamics and cross-sector challenges, celebrating shared wins and fostering inclusiveness and active dialogue. Working through these critical tensions depends on power sharing—particularly for practice researchers and senior agency staff vis-à-vis front line staff and service users—and reflects key elements of intergroup dialogue amidst difference ( Austin, 2020 ).

Whilst there is a wide range of ethical issues associated with PR that draws heavily from social science research, some of the more prominent issues include service user and case record confidentiality, final report contributor equity, teamwork accountability derived from participatory decision making in search of consensus and adherence to data source protocols. The theme of confidentiality is wide ranging. It includes respecting the confidential nature of service user information collected as part of a PR project. It also involves the confidential discussions among research team members, who can include service users and staff. A final concern relates to the ethics of the timely reporting of the research to service users, other agency stakeholders and the larger community (e.g. elected officials, other organisations and researchers). In essence, PR involves the various ethical views of three different communities; namely, the research community, the service provider community and the service user community. The convergence of these three perspectives can be challenging for the various participants to both understand and accept.

These methodological and ethical considerations lead to four suggestions for social service organisational researchers when co-facilitating PR studies to enhance their ability to anticipate common PR challenges. First, PR presents communication-based coordination challenges (involving questions of trust, ethical dilemmas and available expertise), as practice and research partners may need to dialogue regularly amidst already-demanding work schedules. Secondly, partners may face changing and/or limited capacity for and engagement with PR, particularly as practice and research roles and priorities evolve. Thirdly, navigating PR projects requires attending to differing perspectives on the time frame to generate research results, viewed as fast by university standards and slow by agency standards. Fourthly, practice researchers need to demonstrate the capacity to convert research implications into practical recommendations for organisational change given the limited experience with the unique aspects of organisational cultures that differ across participating agencies and research institutions. Underscoring these suggestions is the importance of practice researchers and agency partners remaining flexible with respect to different role-based expectations and university versus agency-based priorities.

We conclude with two major recommendations for social work researchers and practitioners in the social service organisational milieu. First, developing, maintaining and supporting collaborative, trust-based relationships is essential for PR studies. Relationship-building involves recognising mutually beneficial capabilities and shared objectives across different organisational roles (e.g. service users, staff and managers within the agency, and practice-informed researchers inside and outside the agency) to advance collaborative planning. Supporting relationships can involve power-sharing to promote mutual respect and trust as well as social support, particularly amidst the complex dynamics of PR teams. Sustaining relationships calls for transparent information-sharing, consistent communication to address evolving practice and research dilemmas and reciprocal risk-taking that respects the negotiated boundaries of various partners. Finally, sustained relationships often require continuous boundary spanning within the organisation and between agency and university partners.

For productive PR relationships to evolve, an ongoing assessment of practice and research relationships includes monitoring evolving organisational and community contexts, revisiting shared goals in light of changes, and managing PR project expectations in response to evolving stakeholder needs and ethical challenges. Relational work is perhaps the most essential dimension of collaborative, participatory research with social service organisational partners.

Secondly, for practice researchers and agency-based practitioners, the balancing of diverse relational commitments requires sustained self-reflection . Self-reflection involves considering the tensions between the breadth and depth possible in empirical research as well as between the commitment to peer-reviewed empirical research and the investment in practice-based research (e.g. grey literature, agency statistics, practice wisdom). Self-reflection also relates to addressing the different expectations and emphases of service users, staff, managers and other agency stakeholders as well as the different collaborative roles that researchers are required to play when they are invited to step up as co-leaders or step back (e.g. comfortably serving as a research consultant), depending on the specific needs of the research team in its organisational context. These reflexive considerations are centred in an ethos of collaboratively improving service delivery to enhance service user well-being.

While reflecting on identified tensions is a critical aspect of the efforts of practice researchers in relationship with agency-based partners, it is also essential for researchers located in university-based settings. Self-reflection on these tensions can involve deeper questions of how to: (1) reconcile the often-competing expectations of one’s academic home, one’s social service organisational partners and one’s role as a scholar–researcher and (2) reframe these competing expectations into complementary aims. Regular dialogue involving practice and research partners concerning these two issues can involve iterative processes of shared debriefing, deconstructing and redefining key needs. The overall goal is to find win–wins that benefit the university, agency and oneself in carrying out research and disseminating practical knowledge in community-based organisational settings.

In order to identify mutually beneficial PR opportunities for social service organisational researchers, we propose a research agenda in the form of ten questions designed to promote speculation and dialogue as illustrated in Table 3 . The array of questions captures the tensions related to the different ways that practice researchers: engage and consider collaborating with possible agency partners; transition from the development of participatory research studies to their dissemination in complex agency contexts and sustain participatory studies in larger institutional settings. The questions seek to capture a lifecycle of participatory research projects at different stages of organisational development and across different contexts.

New directions for practice research-informed social service organisational analysis.

In summary, PR is a participatory, organisationally focused approach that combines the search for practice-relevant knowledge with qualitative and quantitative research methods in order to enhance services and promote organisational improvement in diverse contexts. PR therefore complements participatory methodologies as well as other applied social science methods used in social service organisational analysis. The future challenges include promoting more participatory studies of social service organisations as well as articulating additional perspectives on PR processes, applications and implications.

The authors would like to express their appreciation to the anonymous peer reviewers and Editors for their very helpful suggestions regarding the manuscript.

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• APA PsycInfo (EBSCOhost) (1887+) American Psychological Association's (APA) renowned resource for abstracts of scholarly journal articles, book chapters, books, and dissertations, is the largest resource devoted to peer-reviewed literature in behavioral science and mental health. more... less... "contains approximately 3 million citations and summaries dating as far back as the 1600s with DOIs for over 1.4 million records. Ninety-eight percent of the covered material is peer-reviewed. The database also includes information about the psychological aspects of related fields such as medicine, psychiatry, nursing, sociology, education, pharmacology, technology, linguistics, anthropology, business, law and others. Journal coverage, which spans from the1800s to present, includes international material selected from around 2,500 periodicals in dozens of languages." Psychological Abstracts: * 1927-1947 Microfilm BF1.P65 * 1948-2004 print in remote storage
• Social Services Abstracts (ProQuest) (1979+) Research focused on social work, human services, and related areas, including social welfare, social policy, and community development.

General books & ebooks

Quantitative vs. Qualitative Research

Quantitative research "uses deductive logic to arrive at conclusions; develops theories and/or hypotheses, then gathers and analyzes data to seek support for them [and] focuses on events that occurred and can be verified" (13)

Qualitative research"uses inductive logic; data are collected and analyzed before theories and/or hypotheses are developed. Focus is on how individuals experienced or perceived events" (13)

• Pocket Guides to Social Work Research Series This growing series consists of succinct and user-friendly volumes about established and emerging research methodologies, written with social workers in mind. Filled with practical advice and detailed examples, the Pocket Guides are a handy library of research methods for fledgling as well as seasoned social work researchers.

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SW 4100: Social Work Research Methods: Research Methods

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• SAGE Research Methods Links over 100,000 pages of SAGE's book, journal, and reference content with advanced search and discovery tools. Researchers can explore methods concepts to help them design research projects, understand particular methods or identify a new method, conduct their research, and write up their findings.
• Pocket Guides to Social Work Research Methods A series from Oxford University Press. In print at the library.
• APA Handbook of Research Methods in Psychology In three volumes, this handbook provides information on tools used in psychology research design, measurement, and analysis. These volumes describe many techniques psychologists and others have developed to help understand why humans, think, feel, and behave the way they do.

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What is empirical research.

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Social Work Research and Evaluation Foundations

Studying social work and its effect on societies is essential to understanding and enhancing human and community well-being. By effectively measuring and evaluating social work outcomes, practitioners can employ evidence-based social work practices and evidence-based treatments (EBTs) to provide structured approaches to addressing client needs. For example, in the case of a client with an anxiety disorder, cognitive behavioral therapy (CBT) and behavioral science can be applied as efficient and ethical frameworks to address communication and collaboration problems. 1

Read on to learn more about the essential role of social work research and evaluation.

The Importance of Research and Evaluation in Social Work Practice

By rigorously assessing and evaluating social work studies, researchers can better identify the most effective strategies to achieve their client’s objectives. 2 Instead of trial and error, a data-driven approach ensures researchers make better use of the resources available to them.

Evidence-based interventions result from analyzing past research findings. After choosing a solution, researchers test it to verify replicability in multiple real-world scenarios before it’s deemed successful. 3 New intervention methods are constantly being standardized across the social work field of study, letting practitioners choose from a wider range of tools and techniques suitable for their study. These are usually taught in more advanced research courses in graduate or master's programs.

For example, at Wurzweiler School of Social Work, students participate in individual research projects and learn the basics of conducting social work research . This includes learning how to use measurement instruments; logic of research design, including sampling and design selection; ethical and legal issues; quantitative and qualitative modes of observation; analysis of data; use of computers and computer programs; and research report writing.

Methodologies and Approaches for Conducting Social Work Research

Conducting social work research requires access to large amounts of data supplied by study participants, which can be historical data or up-to-date surveys. 4 Due to social work’s multifaceted nature, researchers must then use their understanding of how psychosocial factors intersect. They need to develop and adhere to strict research methodologies that are evidence-based instead of preconceived notions of a particular social issue. 5

Action Research and Participatory-Action Research (PAR)

By emphasizing the importance of direct collaboration with communities, researchers can hope to identify and address a demographic’s needs. 6

Empowerment Research

Studies, surveys and experiments aim to increase the feelings of empowerment, equality and social justice among people in communities by having them participate directly in the research process. 7

Constructivist Research

Constructivist research begins with the individual and their social contexts instead of the community as a whole. 8 It highlights the importance of perspective and social standing in shaping communities .

Designing Effective Evaluation Frameworks for Social Programs

Data collected from participants in a target demographic is considered raw data that needs to go through several stages of cleaning and refining before any insights can be extracted. 9 That’s why researchers need to be able to develop robust evaluation frameworks that facilitate access to the data.

Logic Models

Logic models are often used to evaluate a single program or intervention. 10 Logic models are designed to offer:

• Development approaches: Using forward logic to develop models starts from activities to predict outcomes, or vice versa in the case of reverse logic
• Framework utility: Frameworks guide the implementation and reporting of the logic model by clarifying its methodology and expected results
• Visual representation: Graphical depictions of data illustrate the connections between a study’s input, activities and outputs, showcasing the anticipated outcomes
• Components: Key elements include the problem statement, outcomes, outputs, resources and strategies

Theories of Change and Program Theory

Merging theories with logic models adds depth to frameworks by outlining the research process, mechanisms and the logic behind the expected outcomes. 11 Furthermore, theories explain the “how” and “why” the desired changes and outcomes are expected to occur in the program’s context, including factors outside the program’s control.

Furthermore, leveraging resources such as The Kellogg Foundation Logic Model Development Guide and the CDC Framework for Program Evaluation in Social Work can offer guidance and tools for constructing and utilizing robust evaluation frameworks. 12,13

Data Collection and Analysis Techniques in Social Work Research

Researchers can collect relevant data in a variety of ways , such as surveys, in-person focus groups, observations and official census reports. They can then select the suitable social work data analysis technique based on the type of data they have and the nature of the insights they’re looking for. 14 These techniques include:

• Thematic analysis: A qualitative approach that identifies, analyzes and reports patterns and anomalies
• Descriptive statistics: Mean, medians, modes and averages of datasets
• Inferential statistics: Predictive models that provide insights based on patterns

Ethical Considerations in Social Work Research and Evaluation

Ethical considerations determine the efficacy of social work research methods and evaluations. 15 Participants in the study must give informed consent to the data being collected on them without attempts to persuade or influence their answers. 16 Similarly, confidentiality and anonymity, especially when handling socially sensitive topics, are needed to ensure candid responses from study participants.

Utilizing Research Findings to Inform Evidence-Based Practice

In order to use results from past studies to inform future practices, researchers need to translate the studies’ outcomes through systematic reviews and guideline development. 17 The outcomes of earlier implementations often require constant monitoring to detect any underlying biases that can be addressed early on.

Challenges and Limitations in Social Work Research and Evaluation

Research in social work often faces numerous challenges that might impact the quality and efficacy of studies. Some of the most common ones include:

• Time constraints
• Hard-to-reach populations
• Inadequate strategies
• Financial constraints

Case Study of Successful Research and Evaluation Initiative

Despite the many complexities, many research studies can be successfully conducted in the field of social studies. One example is the study of developing new treatments for post-traumatic stress disorder (PTSD) patients.

First developed in the 1980s by Francine Shapiro, eye movement desensitization and reprocessing has been successful in treating emotional distress associated with PTSD. The method’s application was then expanded to include a wide range of issues from trauma and anxiety to addiction.

It’s been supported by over 30 controlled outcomes studies and has since been recognized by the World Health Organization and the Department of Veterans Affairs (VA) as an effective therapeutic method. 18

Deepen Your Impact Through Social Work

The intersection between theoretical research and practical evaluation in the field of social work produces solutions that make a profound impact on the quality of life of communities and individuals. 19 This is a testament to the commitment of researchers to advance the field through progressively available means, particularly technology for data collection and mathematical algorithms for Big Data analytics.

Yeshiva University’s online Master of Social Work focuses on cultural responsiveness, social justice, and human transformation. You will gain hands-on experience in the field of social work and obtain CSWE accreditation that qualifies you for the post-graduate state exam. The expert faculty will equip you with the tools to create positive change in the world. Make an appointment to speak with an admissions outreach advisor today.

• Retrieved on April 10, 2024, from hbr.org/podcast/2021/01/using-behavioral-science-to-improve-well-being-for-social-workers
• Retrieved on April 10, 2024, from researchgate.net/publication/323370072_Evaluating_effectiveness_in_social_work_sharing_dilemmas_in_practice
• Retrieved on April 10, 2024, from ncbi.nlm.nih.gov/books/NBK547524/
• Retrieved on April 10, 2024, from researchgate.net/publication/298697140_Big_data_in_social_work_The_development_of_a_critical_perspective_on_social_work’s_latest_electronic_turn
• Retrieved on April 10, 2024, from https://caseworthy.com/articles/why-is-evidence-based-practice-important-in-social-work/
• Retrieved on April 10, 2024, from nature.com/articles/s43586-023-00214-1
• Retrieved on April 10, 2024, from academic.oup.com/bjsw/article/51/4/1482/6202975
• Retrieved on April 10, 2024, from journals.sagepub.com/doi/full/10.1177/16094069231186257
• Retrieved on April 10, 2024, from journals.sagepub.com/doi/10.1177/17456916221137350
• Retrieved on April 10, 2024, from sopact.com/guides/theory-of-change-vs-logic-model
• Retrieved on April 10, 2024, from betterevaluation.org/frameworks-guides/rainbow-framework/define/develop-programme-theory-theory-change
• Retrieved on April 10, 2024, from naccho.org/uploads/downloadable-resources/Programs/Public-Health-Infrastructure/KelloggLogicModelGuide_161122_162808.pdffrom-being-a-breeding-ground-for-threats/
• Retrieved on April 10, 2024, from cdc.gov/evaluation/framework/index.htm
• Retrieved on April 10, 2024, from nesta.org.uk/feature/eight-ways-councils-are-using-data-create-better-services/the-data-driven-social-worker/
• Retrieved on April 10, 2024, from cmsindia.org/sites/myfiles/Guidelines-for-Ethical-Considerations-in-Social-Research-Evaluation-In-India_2020.pdf
• Retrieved on April 10, 2024, from researchsupport.admin.ox.ac.uk/governance/ethics/resources/consent
• Retrieved on April 10, 2024, from health-policy-systems.biomedcentral.com/articles/10.1186/s12961-020-00662-1
• Retrieved on April 10, 2024, from ptsd.va.gov/understand_tx/emdr.asp
• Retrieved on April 10, 2024, from researchgate.net/publication/8480043_Future_directions_in_evaluation_research_People_organizational_and_social_issues

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13 Social Work Methods & Interventions for Helping Others

While social work as a profession has remained in a state of flux for some years, dedicated professionals continue to support individuals, families, and communities at their most troubled times.

Their professional dedication remains underpinned by core skills, including a “commitment to human, relation-based practice” and methods and interventions garnered from multiple disciplines (Rogers, Whitaker, Edmondson, & Peach, 2020, p. 9).

This article introduces how social workers select the best approaches and interventions for meeting the needs of their service users.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

Selecting an appropriate method & intervention, top 5 methods used by social workers, 8 best social work interventions, social work & domestic violence: 4 helpful methods, positivepsychology.com’s useful resources, a take-home message.

The “constantly evolving nature of social life” has made it difficult to build a single and standard model for social work (Parker, 2013, p. 311). A framework that offers a clear process for social workers to engage with service users and implement appropriate interventions is, however, vital.

As a result, social work has combined various interdisciplinary concepts and social work theories with firsthand, experiential knowledge to develop an evidence base for social workers’ decisions.

While more than one model is used to describe social work practice, Parker (2013) offers a simplified perspective built from three elements: assessment , intervention , and review.

The model is not linear; the stages merge, overlap, and require a degree of flexibility, analysis, and critical thinking to implement (Parker, 2013).

Although the final review stage is vital to social workers’ “statutory and legal obligations” and in ensuring care plans remain appropriate, this article focuses on choosing suitable methods of assessment  and intervention  (Parker, 2013, p. 317).

What is an assessment?

The assessment stage aims to understand the situation affecting the service user, directly or via referral. It can be complex, often involving many contributing factors, and sometimes seem as much art as science (Parker, 2013).

Typically, assessments are perspectives constructed at a particular time and place, and include the following elements (Parker, 2013):

• Preparation , planning , and engagement involve working with the individual requiring support to introduce the need to perform an assessment and agree how the social worker will carry it out.
• Collecting data and forming a picture help social workers understand the situation better.
• Preliminary analysis includes interpreting the data and testing out “thoughts and hunches” (Parker, 2013, p. 314).
• Deeper analysis and shared negotiation are required following testing to put together an interpretation. This can offer the client or referrer an alternative way of viewing the problem.
• Construct an action plan collaboratively.

Throughout the assessment, it is essential to engage and partner with all interested parties, sharing the reasons for the evaluation, how it will be used, and the rights of those involved.

“A good assessment allows the social worker to plan openly with service users what comes next” (Parker, 2013, p. 315). The plan forms the basis for selecting or putting together the intervention and how goals and objectives will be met.

What is an intervention?

The selection of methods and interventions is further influenced by the social worker’s underlying belief systems, value bases, and theoretical preferences.

The term intervention is sometimes challenged within social work because of its suggestion of doing something to others without their consent. As with counseling and therapy, it is most valuable when put together as part of an alliance between social workers and service users (Parker, 2013).

The process must be transparent, with the social worker able to explain the evidence base leading to informed decisions. Such openness requires a detailed understanding of the theories and knowledge underpinning the models chosen and why they are appropriate and effective (Parker, 2013).

Finding appropriate methods and models can help make sense of the experiences of others.

Care management

Popular in the United Kingdom, care management is closely linked to the use of community care to meet the needs of adult health and social care. Earlier implementations were managed from the top down and accessed via the benefits system, leading to ever-increasing governmental social security bills. Over time, more autonomy has been given to the community, encouraging independence, choice, and control at a local level (Hutchinson, 2013).

The most common care management approach within the UK is known as social entrepreneurship . The person’s needs are assessed by a care manager , who acts as a liaison to other services to meet the service user’s needs.

“One of the main strengths of the care management approach is the centrality of needs-led assessment from which all other plans and actions are negotiated” (Hutchinson, 2013, p. 321). However, the challenges of this approach involve the resource-limited system. Funding can be insufficient, often leading to ever-tightening eligibility criteria.

Strengths-based and solution-focused approaches

The strengths-based and solution-focused approaches to social care help develop alliances with service users while recognizing their uniqueness (Rogers et al., 2020).

These social work methods focus less on managing risk and what people lack, and more on their innate ability to grow and develop by building on their strengths.

The strengths-based method is based on several underlying principles, including (modified from Rogers et al., 2020):

• The individual, family, group, and community all have strengths.
• Trauma and adversity can provide opportunity and become a source of strength.
• Assumptions should not be made regarding the individual’s capacity to grow and change.
• Collaborative practice is best practice.
• Every environment is rich in resources.
• “Social work is about care, care-taking and hope” (Rogers et al., 2020, p. 244).

Crucially, these approaches work toward solving problems now while building resources and skills for the future. They are also flexible and efficiently combine with other social work methods and techniques (Rogers et al., 2020).

Narrative social work

Rather than professionals being seen as experts, who come in and give their (sometimes restricted) view of the situation, the narrative method takes an alternative approach (Cooper, 2020). It recognizes that problems are often found in the broader system of relationships rather than the individual.

The narrative approach states that the “problem is the problem, rather than a failing in the person themselves” (Cooper, 2020, p. 261).

However, narrative social work has received criticism. If we externalize the problem, are we absolving the individual and removing them from responsibility? Of course, that needn’t be the case.

A common approach within narrative social work is to ask the individual what advice they would give a friend when faced with a similar situation. Narrative therapy recognizes that actions are just that: ‘actions’ (they do not define a person). As such, they can be changed.

Groupwork is another essential method and  technique within social work; indeed, it has been a mainstay within the profession since the 1930s (Doel, 2013).

Groupwork offers several different functions, including social control, social action, education, and therapy. Some groups have expected outcomes or goals, while others are more organic, allowing the purpose to develop as the group evolves. For example, a social worker may create a group to support women in a particular neighborhood with severe mental health problems or veterans having trouble finding their place in society.

The group process involves an awareness of what is happening at two levels: first, the individual within the group, and second, the group itself. It includes considering the stages through which the group passes and the relationships and communication that form within (Doel, 2013).

Task-centered social work practice

The task-centered method favors developing skills in people so that they may use them to solve future problems and fostering increased autonomy (Edmondson, 2020).

Ultimately, the approach is “value-led, evidence-based and practical” (Edmondson, 2020, p. 271). It promotes positive change through forming partnerships with individuals, groups, and communities, rather than a more limiting focus on tasks (job, duty, and chores) defined by predictability and routine (Edmondson, 2020).

Task-centered social work is less about form filling and more about identifying and solving problems, and setting and achieving realistic changes and goals (Edmondson, 2020).

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With a large variety of methods and theoretical approaches available to social workers, there is an even greater choice surrounding interventions.

The following list contains some of our favorites, and while arising from several methodologies, they can be integrated and used as appropriate for the service user.

1. Problem-free talk

Problem-free talk can be used at any time, but it is particularly helpful at the start of an intervention as a reminder that “the person is more than the sum of their difficulties” (Rogers et al., 2020, p. 246).

The social worker encourages the service user to discuss aspects of their lives that are not a source of problems, adding a note of positivity often missed when focusing on obstacles and challenging aspects of their lives (Rogers et al., 2020).

2. Miracle questions

The miracle question encourages the individual to visualize their world without the problem they currently face and is often found in the toolkit of solution-focused practitioners (Rogers et al., 2020).

Imagining a better future is a powerful tool for thinking positively and motivating change.

3. Vision statement

Like the miracle question, the vision statement uses imagination to explore a possible future. Social workers can use it with families to compare where they are now versus where they would like to be (Rogers & Cooper, 2020).

For example, what might my children say about me now ? And what would I like my children to say about me 10 years from now ?

The process is a powerful intervention for identifying the changes that are needed and the obstacles to be overcome to reach happier times as a family.

How to create a personal vision statement – Pursuing Fulfillment

4. Circular questioning

Changing perspective can be a powerful and helpful process for service users. Putting someone in another’s shoes by using circular questioning , can introduce new ideas and information, and encourage a greater awareness of a situation (Rogers & Cooper, 2020).

For example, a family member might be asked to describe how a parent, sibling, or child would react to or feel about a situation. Sharing such thoughts can help them understand how others perceive them and improve their understanding of their role in the family.

5. Life-story book

A child whose life has been affected through social care involvement may be confused and unclear about what has happened and why (Cooper, 2020).

A story or book can be written for the child to explain why they were adopted or put in care to provoke open conversations and confirm that the situation was not their fault.

However, it is vital to consider that the story must be age appropriate and will most likely avoid certain factors of the decision making regarding care.

6. Later life letter

The reasons a child was taken from a family may be unsuitable for sharing with the child. Instead, a letter can be written that provides a complete picture (rather than the more edited life-story book) for opening sometime in the future, possibly near their 18th birthday (Cooper, 2020).

7. Exception seeking

We should not assume that a problem has always existed or that the individual can never handle similar situations.

Instead, through attentive and active listening, it is possible to pick up on coping skills or strategies that have worked in the past and may be transferable to existing or new situations. Ask the service user coping questions to identify times when they have “coped with a problem or uncover how a service user manages with a continuing issue” (Rogers et al., 2020, p. 247).

8. Competence seeking

To address or prepare for problems, it can be helpful for people to identify and understand what qualities, strengths, and resources they have available (Rogers et al., 2020).

When entrenched in a problem or difficult situation, we can remain single minded and lose sight of positive personal characteristics that can help (Rogers et al., 2020).

While there has been significant progress in multiple agencies working together to safeguard children, approaches to ensuring the safety of women and children remain fragmented (Humphreys, 2013).

However, there has been considerable success in increasing domestic violence awareness, which “has led to greater attention being paid to the development of legislation, policy and practice” (Humphreys, 2013, p. 155).

Several methods can be helpful in cases of domestic violence, including the following:

• Group work can offer a forum for groups of people who have experienced domestic violence. However, the facilitator must ensure that no one individual asserts power over the group and that there are no barriers to inclusion or participation (Rogers et al., 2020).
• Strengths-based approaches can help individuals recognize the resilience they showed in traumatic situations and how they could move on from a potentially harmful situation (Cooper, 2020).
• Good court skills “are central to social work practice” and can close the gap between the theory and practice of law surrounding domestic violence (Whitaker, 2020, p. 231).
• Self-awareness can help manage conflict between social workers and service users in cases of domestic abuse. Being aware of personal feelings and beliefs, maintaining focus, and being clear and direct can help when tensions rise (Edmondson & Ashworth, 2020).

Domestic violence is extremely damaging. It is, therefore, vital that good practice in social work is also reflected in cross-cultural practice principles and inter-agency collaboration and that an appropriate political and legal framework is in place (Edmondson & Ashworth, 2020).

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Throughout our blog, you’ll find many free tools and worksheets to help you be a more effective social worker, including the following:

• Growing Stronger From Trauma This worksheet helps clients explore the silver linings of traumatic experiences while appreciating the strengths they have developed as a result.
• Strengths in Challenging Times This worksheet presents four questions exploring how clients can apply their strengths to a current life challenge and what they might gain or learn as a result.
• Forgiveness and Acceptance Worksheet This worksheet helps clients explore their negative feelings about a past transgression and make the conscious decision to forgive.
• Active Constructive Responding This handout presents a 2×2 matrix of communication styles ranging from destructive to constructive and passive to active, highlighting the differences between each with examples.
• 17 Positive Psychology Exercises If you’re looking for more science-based ways to help others enhance their wellbeing, this signature collection contains 17 validated positive psychology tools for practitioners. Use them to help others flourish and thrive.
• Recommended Books 12 Social Work Books Every Practitioner Should Read is a great article full of highly recommended and engaging books. Helping others is made easier if you are empowered with knowledge, and a great way to start is simply by reading more.

“Social work and society are caught in an intense and changing relationship” (Cree, 2013, p. 3). The role and influence of familial, religious, and political frameworks have reduced, and social workers are increasingly called upon to help groups left at the margins and in need.

While social work may once have been informal and voluntary, it is now often enshrined in regulations and statutory agencies. As society moves forward, social work must keep up, advancing as a caring profession and collaborating with service users and other agencies to find the best outcome for all concerned.

With such growing demand and developing expectations, social workers must show professionalism while recognizing and promoting the fundamental principles of human rights. They require appropriate theories , knowledge, and methods to determine the needs of the people they support and to recognize what action will be most helpful (Rogers et al., 2020).

The methods adopted by professionals do not work in isolation but support other competencies while working with others and collaborating with the service user to provide a relation-based practice.

We hope you enjoyed reading this article and that it inspires you to learn more about this developing discipline. Don’t forget to download our three Positive Psychology Exercises for free .

• Cooper, J. (2020). Narrative social work. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 259–268). SAGE.
• Cree, V. (2013). Social work and society. In M. Davies (Ed.), The Blackwell companion to social work (pp. 151–158). Wiley Blackwell.
• Doel, M. (2013). Groupwork. In M. Davies (Ed.), The Blackwell companion to social work (pp. 369–377). Wiley Blackwell.
• Edmondson, D. (2020). Task-centered social work practice. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 259–268). SAGE.
• Edmondson, D., & Ashworth, C. (2020). Conflict management and resolution. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 259–268). SAGE.
• Humphreys, C. (2013). Domestic violence. In M. Davies (Ed.), The Blackwell companion to social work (pp. 151–158). Wiley Blackwell.
• Hutchinson, A. (2013). Care management. In M. Davies (Ed.), The Blackwell companion to social work (pp. 321–332). Wiley Blackwell.
• Parker, J. (2013). Assessment, intervention and review. In M. Davies (Ed.), The Blackwell companion to social work (pp. 311–320). Wiley Blackwell.
• Rogers, M., Whitaker, D., Edmondson, D., & Peach, D. (2020). Developing skills & knowledge for social work practice . SAGE.
• Rogers, M., & Cooper, J. (2020). Systems theory and an ecological approach. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 259–268). SAGE.
• Whitaker, D. (2020). Court skills. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 230–240). SAGE.

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• Published May 7, 2024
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LEXINGTON, Ky . (May 07, 2024) — Dr. Antonio Garcia, the Buckhorn Professor of Social Work at the University of Kentucky, has been at the forefront of addressing childhood trauma through his research.  

Garcia is a former Robert Wood Johnson Foundation’s (RWJF) fellow , and the Director of the Interdisciplinary Research Center on Families & Children. He collaborates extensively across multiple disciplines.  

“My goal is to foster a holistic approach where educators are equipped to address the psychological impacts of trauma with the same confidence as they do academic challenges,” Garcia stated.  

This approach is reflected in Garcia’s comprehensive portfolio , which includes enhancing fatherhood engagement among Black Indigenous Latinx People of Color (BILPOC) communities and integrating evidence-based interventions for youth in child welfare and juvenile justice systems. 

Garcia recently concluded three major research projects: 

• “COVID-19: Preparing Schools to Address Childhood Trauma”  

In this pilot study funded by the UNITE/COSW, Garcia and co-investigator Ginny Sprang developed an online curriculum to increase trauma-informed care awareness among school personnel. Although the study found an increase in positive attitudes toward trauma-informed practices, Garcia notes that “the journey to full integration of these practices in schools is ongoing. We need more targeted training and clear referral pathways to truly meet the needs of our students.” Read more about the pilot grant here.  

• “Disciplinary Research-Practice Partnerships to Enhance Father’s Capacities to Promote Child Well-being”  

The  Unifying Fathers to Families, Communities, and Systems (UFFCS)  study is a community-based participatory initiative that originated from the desire to contend with the scarcity of culturally congruent father-centric practices and policies across child and family-serving systems. The overall objective of the  UFFCS  study was to rely upon input from fathers and service providers to inform the development of a father-centric model to achieve two major goals: 1) mitigate   the   practices and policies that sustain racial inequities in service provision among BILPOC fathers and 2) enhance fathers’ capacity to engage in healthy co-equal parenting. Read more about it here.  

• “Public Library Virtual Storytimes: Meeting School Readiness and Community Needs through a Socially Distant Approach.”  

Amidst the COVID-19 pandemic, public libraries shifted their vital story time programs online to continue supporting young children’s educational needs, particularly in areas of early literacy and school readiness. The exploratory research project aims to assess and inform the efficacy of these virtual story time (VST) programs. By engaging diverse public libraries across the U.S., the study developed evidence-based guidelines to enhance the delivery and accessibility of VST programs, ensuring they meet the needs of all children, including those from underserved communities. Read more about it here.  

By bridging academic research with practical implementation, Garcia’s work not only advances scholarly discourse but also promises real-world applications that could transform educational settings nationally. His leadership in cross-disciplinary research continues to inspire policies and practices that support the well-being of all children. 

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📷Highlights: College of Social Work Graduation May 2024

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For 85 years, the University of Kentucky College of Social Work (CoSW) has been a leader in social work education. As a college, we promote community and individual well-being through translational research and scholarship, exemplary teaching, and vital community engagement. We are committed to the people and social institutions throughout Kentucky, the nation, and the world. Like the University, CoSW is an organization that cultivates a diverse academic community characterized by interpersonal fairness and social justice. We are fiercely committed to developing outstanding social work professionals — leaders who will serve individuals, families, and communities through innovative and effective practices that are guided by cultural competency, systematic ethical analysis, and a keen and pragmatic understanding of the human condition.  

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Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

• Published: 06 May 2024

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• Daniel Devoted Matemba   ORCID: orcid.org/0009-0000-6301-4897 1 &
• Edmond Raphael Kautsire 1  

In recent years, there has been an increasing recognition of the significance of sexual and reproductive health, particularly among youth and adolescents in Malawi, a developing country. Traditional Authority (T/A) Chimwala, a rural region in Mangochi District, faces unique challenges in sexual and reproductive health for its youth. Early marriages, gender disparities, cultural norms, and limited education on reproductive health contribute to the complex landscape of adolescent health in this area. This study aimed to assess factors influencing modern contraceptive utilization among youth and adolescents in T/A Chiwaula, Mangochi. It adopted a descriptive cross-sectional research design and collected data through questionnaires from 30 adolescents. The study identified cultural and religious beliefs, social stigma, fear of side effects, and lack of knowledge as significant barriers to modern contraceptive use. Among those with knowledge of modern contraceptives, condoms were the most commonly known method, followed by combined oral pills, implants, and injections. While 97% of the respondents reported awareness of contraception, efforts are needed to reach the remaining 3% with limited knowledge. The study highlights the importance of targeted sexual and reproductive health education campaigns to empower adolescents to make informed choices. Integrating such education into the curriculum can play a vital role in promoting modern contraceptive utilization, reducing unintended pregnancies, and improving the overall well-being of adolescents in T/A Chimwala. To address the low level of knowledge on modern contraception, it is recommended that the Ministry of Education collaborates with the Ministry of Health to develop age-specific sexual and reproductive health information for adolescents. Empowering young individuals with accurate information and access to modern contraceptives can contribute to responsible decision-making and the development of the community.

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Matemba, D.D., Kautsire, E.R. Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District. J. Hum. Rights Soc. Work (2024). https://doi.org/10.1007/s41134-024-00295-2

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Original research article, a community health worker led approach to cardiovascular disease prevention in the uk—spices-sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in europe and sub-saharan africa): an implementation research project.

• 1 Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
• 2 Department of Disease Control and Environmental Health, Makerere University, Kampala, Central Region, Uganda
• 3 Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

Background: This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions.

Methods: A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework.

Results: Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme.

Conclusion: Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.

1 Introduction

Cardiovascular disease (CVD) is among the most prevalent, costly to treat, and deadly medical issues in the world ( 1 ). As part of the continual effort to combat CVD, greater emphasis is being placed on prevention. This often takes the form of behavioural or lifestyle change, focusing on the reduction of risk factors (e.g., hypertension, poor diet, obesity). Reducing these risk factors using evidence-based interventions not only works to lower rates of CVD, but also impacts rates of a variety of other medical issues, including susceptibility to severe COVID-19 infection ( 2 ), many common Noncommunicable Diseases (NCDs) including Type 2 diabetes and a wide range of cancers ( 3 ). Furthermore these preventative interventions are less expensive than reactionary care and can lower the treatment burden on strained medical systems ( 4 ).

Community-Based Participatory Research (CBPR) and Community Engagement (CE) have grown increasingly popular as potential methods to engender sustainable, long-term change in communities—particularly those communities under-served by existing medical systems and/or those at heightened risk of CVD ( 5 ). One's behaviour is influenced by their environment and the community they live in, meaning that tapping into a community's resources can be effective in changing lifestyle behaviour as well as having impacts on the wider community ( 6 , 7 ). The use of community-based practices fits within the growing South-North collaboration that this project joins as part of an international collaboration known as “Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research project” (SPICES). In the Low- and Middle-Income countries (LMIC) there is evidence for the successful implementation of evidence-based community-based interventions in increasing knowledge of, and changing behaviour related to, CVD ( 8 ) however their use in the Global North is less well tested or understood ( 9 ).

In the UK, the flagship intervention to address preventative health issues is the National Health Service's (NHS) Health Check initiative, which is free to individuals ages 40–76 and which assesses risk for long term health conditions including CVD ( 10 ). Following initial assessment by a health professional, patients are advised on a course of action which often includes some degree of preventative prescribing to address behavioural risk factors ( 11 ). Just under half of eligible individuals accepts a first health-checks appointment (44.2%)—it is associated with increased detection of CVD risk, but uptake is skewed by several demographic factors (principally, age, gender, and socio-demographics), and it has struggled to create change in underserved groups ( 12 , 13 ). Marginalised coastal communities in Sussex face overall below-average healthy-life expectancy ( 14 ). This, alongside heightening inequality and the impact of COVID-19, has left some communities in Sussex significantly deprived in terms of access and engagement with health services ( 15 ). People in these communities experience transgenerational poverty, precarity, and lifestyle behaviours ingrained into the communities that lead many to be at higher risk for CVD. CBPR and CE models have the potential to lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation ( 16 ).

CBPR and CE offer the chance to bring lessons from effective programmes in the Global South and apply them to programmes in the Global North. Community-based strategies to promote evidence-based preventative health interventions using Community Health Workers (CHWs) are often more established in the Global South where more tightly knit communities and established community health programmes fulfil a range of public health needs ( 17 , 18 ). CHWs interventions are a form of “task-sharing” intervention in which responsibility and power is shared between professional health workers and communities which have been proposed to effectively manage non-communicable disease risk ( 19 ). Lay Community Health Workers are individuals who are trained to perform of health-related functions but lack a formal professional health education. They can provide links between local communities and health care institutions thereby building and on and developing the social capital that already exists in communities ( 20 ). Although there is plenty of evidence communicating the importance and usefulness of these methods (the “what”), there remains a lack of attention given to how to do it . This article joins the work and voices attempting to begin filling that lacuna.

Within the literature on CBPR and CE, a handful of common themes emerge. The first is a push for human-centred research design ( 21 , 22 ). Yardley et al. ( 23 ) focused on this idea in their “person-based” approach to digital health interventions, where they recommended a “focus on understanding and accommodating the perspectives of the people who will use the intervention” ( 24 ). Hopkins and Rippon's ( 25 ) “asset-based” approach to CE interventions recommends recognising and adapting to the need, wants, and strengths already present in the community. Particularly the strengths, or “assets” already present in the community provide an opportunity for projects to use those assets. Such an implementation approach requires flexibility and adaptability, as well as deep involvement with the community. The second theme builds on the first, with the idea that not only should project design be person-centred, but those participants and other stakeholders in the community should be involved at every level of project planning through co-design. Yardley et al. ( 23 ) included this as a key element of their paper, writing that people from the target population should be involved in project development as well as at every stage of the intervention. Similarly, Berrera et al. ( 26 ) emphasise the need to adapt all projects to the cultural context of the community. This insight speaks to the third theme, continuous evaluation ( 27 ). As the needs of the community will be ever-shifting, so must the project adapt to those needs continually. Instead of designated periods of evaluation, a shift to continual processes of qualitative evaluation is called for to identify and adjust to the needs of the community. These processes require elevated levels of trust and participation from the community, which has its own challenges. Trust especially takes significant time and resources to develop and is an under-studied area of community engagement ( 28 ).

The SPICES-Sussex project was carried out from January 2019 and aimed to answer the following overarching research question: How can Community Health Workers (CHW) CVD prevention interventions, that have been used in the Global South, be developed, and implemented in a Global North setting and what barriers and enablers exist to their implementation? The project began with a situational analysis which included an exploration of the views and experiences of the local community with regards to CVD health and Community Health Workers and early stakeholder mapping of the research sites which was carried out between 2019 and 2020 ( 29 , 30 ).

The primary aim of the current paper is to provide a comprehensive examination of the project's implementation including complementary mixed methods analyses according to the Reach Effectiveness-Adoption Implementation and Maintenance (RE-AIM) framework ( 31 ). The secondary aims of the project are to inform future CE projects what worked (and did not work) for our project and to tie insights from our project to broader discussions in the discipline. The project is based on a protocol published in 2020 prior to the onset of COVID and was conducted through the period of the COVID-19 pandemic ( 29 ). Subsequently, several aspects of the original protocol were adapted to make implementation feasible within the constraints of this period (see Supplementary Appendix 2 ).

2.1 Study design

The project uses a type 3 hybrid implementation design ( 29 ) meaning that the primary aim of the research was to determine utility of an implementation intervention/strategy whilst the secondary aim was to assess clinical outcomes associated with the implementation trial. This means that we focused on understanding what barriers and enablers existed for the project's implementation and the context within which it operated. Effectiveness of the intervention remained important, however we were primarily interested in how and why it did (or did not) work. The project was carried out at four geographic research sites within Sussex (see Section 2.3 ) and implementation was conducted on an iterative basis from research site to research site broadly following the Medical Research Council's (MRC) framework for the development and implementation of complex interventions ( 32 ). The research team developed and then began delivering the intervention at each site before moving onto the next. At each site the following stages were carried out: (1) Development: this included stakeholder mapping, formation of implementation partners, and codesign/local adaptation of the intervention [covered in the study's pre-implementation paper ( 30 )]; (2) Implementation: this included the delivery of the CHW intervention at the research sites and collection of mixed method data pertaining to effectiveness and stakeholder experiences, and (3) Evaluation: this included the analysis of the mixed method data in line with the MRC guidance on analysis complex interventions.

2.2 Research site and voluntary and community sector enterprise partner selection

Four study sites were selected across East Sussex by identifying Middle Layer Super Output Area (MSOA) postcodes with high levels of deprivation according to the Indices of Multiple Deprivation (IMD) ( 33 ). Selection of the research sites was based on the pre-implementation community mapping phase of the project ( 30 ). Following on from CBPR practices, VCSEs and Volunteer Coordinators (VCs) were recruited to co-design and deliver the implementation strategy at each of the research sites.

VCSEs organisations were recruited as partners at each research site. The intervention was primarily run through these organisations and a paid staff member was recruited at each organisation. Their responsibilities included, CHW management, and participant recruitment. They also had a role in local adaptation activities. VCSE organisations were eligible to take part in the organisations if they were based in the research site, if they had interests and existing activities that aligned with the project's goals (CVD risk reduction and community development), and if they had existing experience of volunteer recruitment and management.

2.3 Community health worker recruitment and training

The aim was for each site to recruit a pool of five to eight CHWs. As part of this each site was asked for input into local CHW recruitment flyers, which were shared on VCSE websites and social media pages and shared on social media via existing CHWs at the VCSEs. CHWs were recruited through intermediary organisation recruitment via the VCSE partner organisation. The project was also advertised at a Virtual Volunteer Fair. Local contacts and existing volunteer pools at the VCSEs meant that the target number of CHWs was rapidly recruited at each site. CHWs were eligible to take part in the intervention if they were over 18 years of age, if they lived within the research site (determined by postcode), and if they had some kind of pre-existing relationship with the VCSE partner organisation (i.e., as a volunteer).

Potential CHWs who expressed an interest in the project were invited to attend an induction to the project, and then the local adaptation co-design meeting. Those who decided they would like to become a CHW then went on to receive five online, group training sessions (each of which lasted for 2 h, 10 h in total): an introductory session, a session covering project policies, heart health and the structure of the intervention, and three sessions on behaviour change techniques. These training sessions were developed and delivered by an external organisation (National Centre for Behaviour Change) specifically for the project after a consultation and planning process with the research team. Before the onset of the intervention at each site CHWs made various recommendations in the local adaptation meetings on the design of the training programme. These included providing information on listening techniques, engaging, and managing resistance, providing simple health information, using accessible language, using different starting points depending on the CHW's background knowledge and experience, training on conducting coaching virtually, and providing a training handbook. A Volunteer coordinator (VC) was recruited at each site. This VC was a trained and experience health coach (KFS) and provided training support and guidance through monthly group training support sessions in addition to the initial 10 h training block the received prior to the intervention onset. These monthly training and support sessions were organised into specific themes and agendas that were set with the CHW participants.

2.4 Local adaptation

Elements of the evidence-based intervention were tailored to the individuals and their community in the stakeholder-mapping phase using qualitative interviews, workshops, and focus groups with a range of stakeholders across the study site ( 30 ). Further rounds of local adaptation were carried out with VCs and CHWs at each of the research sites to tailor to individuals and their community context through iterative co-design workshops ( 34 ). CHWs and VCSE also agreed on a “volunteer charter” during the co-design session. This was a list of principles, behaviours, and practices upon which guided interactions between research staff, CHWs, VCSE and participants. The charter was designed to ensure that the practices of the project aligned with the principles of the CHW and partner organisation.

2.5 Participant recruitment and screening questionnaire

Participants (who received coaching) were eligible to take part in the eligibility screening if they lived in, or adjacent to, the study site's postcode and if they were aged eighteen or older. Participant recruitment was also based on intermediary organisation recruitment, community outreach, paid social media advertisement (through Meta™), gatekeeper and snowball sampling. Gatekeeper recruitment was conducted when interacting with a relevant statutory or non-statutory service provider (i.e., a fitness/weight loss group leader) and involved asking them to recommend the intervention to their members or to recommend participants who may be interested in taking part. Snowball sampling involved asking participants who participated in the study to sending email invitations to their social group. A social media recruitment strategy was undertaken to recruit people from the local area to the risk profiling survey to supplement the community-based recruitment through the VCSE partners. Social media was conducted on Facebook via paid advertisement in four waves of recruitment which took place over 1–2 weeks at each site. The advert targeted people who were 35+ and over and to people with 5 km of each research site. Messages were changed regularly from a list of recruitment messages drafted with CHWs during co-design sessions. Additionally, CHWs and VCSE participants were asked to send recruitment emails to any social or professional networks they thought would be interested in taking part. We did not record where participants were recruited.

Screening and risk profiling for the CVD coaching was carried out using the validated non-laboratory based INTERHEART questionnaire, presented online, for all participants that expressed an interest in the study ( 35 ). This questionnaire assessed modifiable and non-modifiable CVD risk factors and categorised participants as either “Low,” “Moderate.” Or “High” risk. See the protocol paper for further information on the INTERHEART risk profiling; for more information on the screening questionnaire, see the study protocol paper ( 29 , 35 ). Questionnaire data were collected and managed using Research Electronic Data Capture (REDCap) electronic data capture tools hosted at the University of Antwerp ( 36 ). Participants were considered to be eligible for the intervention if they were aged eighteen or over, if they lived within the research site (determined by postcode), and if they were categorised as “Moderate” risk of CVD according to the INTERHEART questionnaire. High risk participants were not included as their needs were considered to be too high for a pilot study involving CHWs. Eligible participants were then emailed by the research team with an invitation to take part in the CVD coaching intervention. After recruitment for the intervention was closed for each site, an online questionnaire survey was sent to eligible participants to gather information the reasons for not accepting the invitation to the intervention. Open response questions were used which the research team later categorised into codes.

2.6 The CVD prevention coaching intervention

The coaching intervention was based on motivational interviewing techniques which are promoted by the European commission on cardiovascular disease prevention in clinical practice ( 37 ) and which include techniques such as Open questions, Affirmation, Reflective listening and Summary reflections (OARS) ( 38 , 39 ). The use of these Behaviour Change Techniques (BCTs) used during the intervention were based on five target behaviours highlighted by the World Health Organisation including: reduce/cease smoking, increase moderate physical activity, reduce the fat, salt, and sugar content of the diet, increase fibre, oily fish (or alternatives), fruit, and vegetable content of the diet, reduce sedentary hours. The intervention involved six, one-hour long coaching sessions between participants and CHWs which were delivered every two weeks. Participants were also considered to have completed the intervention if they only completed three sessions and then notified the team of their withdrawal from the intervention.

The study team included two participant co-ordinators (PCs) who managed the participant journey through the intervention, sending welcome emails, questionnaires, and invitations to post-intervention interviews, and co-ordination between participants and CHWs to book coaching sessions. Reminders of appointments were also sent to CHWs and participants one week and two days before the session. Participants and CHWs were matched, based on gender preference and availability, and supported throughout the coaching intervention the PCs. CHWs were provided with guidance, resources, and signposting information throughout the intervention but were also given the flexibility to deliver the coaching in a way that suited them and their participant(s). Initially, counselling and goalsetting were based on their individual item INTERHEART assessment scores. Participants and CHWs were then encouraged to create an action plan with appropriate goal setting for the behaviours they wanted to change (e.g., diet, exercise habits). The goals were set in relation to when, where, and how they would undertake the behaviour, e.g., when the physical activity will be performed, where it will be performed, how often it will be performed (i.e., in a group or using specific equipment). CHWs helped participants to analyse any factors which might influence their ability to achieve the goals and to generate strategies which could help them overcome these barriers using problem solving. Full details of the participant journey through the intervention are given in Supplementary Appendix 2 in the Supplementary Material . All coaching was conducted virtually using Zoom™ to host and monitor coaching sessions and Microsoft OneDrive to store, recruit, and communicate written and visual resources with CHWs and participants. Monitoring in Zoom calls was called out by the PCs who checked whether both the participant began and ended the coaching session. If either the participants or CHW did not join, the PC could join the call to help the attendee. Feedback was obtained from the participant about the coaching session through emails after the session and by inviting participants to a follow-up interview after the intervention (see qualitative evaluation).

2.7 Evaluation

The evaluation was underpinned by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework ( 31 ) which allows for an understanding of the multifaceted and interactive effects of personal, social, and environmental factors that determine behaviour; and for identifying behavioural and organisational leverage points and intermediaries for health promotion within organisations and communities. RE-AIM has been used to evaluate programs and setting in public health and community settings and is thought to be particularly useful when evaluate interventions in “real-world” settings ( 40 , 41 ). It has also been used to evaluate public health interventions which make use of community health workers in community-based setting ( 42 – 44 ). Results are made up of quantitative measures from the participant questionnaires, qualitative interviews with the participants, the CHWs, VCSE partners, and the research team. Primary quantitative outcome measures included implementation measures such as uptake and engagement and the pre/post changes to the self-report CVD behavioural questions which included the following three questionnaires: (1) the INTERHEART CVD risk questionnaire collected during the screening process was used as the baseline and collected again after completion of the intervention. (2) Physical activity levels were measured using the International Physical Activity Questionnaire (IPAQ) ( 45 ). The IPAQ is an internationally validated instrument to capture information about weekly physical activity habits, behaviours, and routines. (3) Diet was assessed using a 20-item questionnaire based on a modified version of the UK Diet and Diabetes Questionnaire ( 46 ), a brief food frequency questionnaire designed to assess conformity to healthy eating guidelines, and to assist in the setting of dietary goals. It was used to estimate the number of portions eaten daily or weekly of fruit and vegetables, oily fish (or alternative), and foods high in fat, salt, and sugar, what proportion of the time wholegrain cereal products were chosen, weekly units of alcohol consumed and the frequency of binge drinking. Due to the small sample sizes and non-parametric data used in this study, Wilcoxon Sign test was used to evaluate for differences in continuous variables whilst McNemar's test was used for binary categorical data. The pre-intervention assessment of the primary outcome measures was sent to participants before they participated in the intervention (no participant could begin the intervention without completing the baseline measures). Post intervention primary outcome measures were collected after their participant in the intervention was completed.

Focus groups and one-to-one interviews were conducted with four groups of stakeholders: (1) VCSE partners; (2) CHWs; (3) members of the research team, (4) participants in the intervention. Individual interviews were conducted with VCs, members of the research team, and participants, while data from the CHWs was collected in focus groups. Discussion guides for VCs, CHWs and members of the research team all included questions on the respondents' role within the project, the process of community engagement, barriers, and facilitators the implementation process, recommendations for the future and sustainability. Discussion guides for participant interviews included questions on how and why participants became involved in the project, their experience of the health coaching, and their views on the impact and usefulness of the project. Interviews and focus groups were conducted online using Zoom or MS Teams. The analysis was conducted by TGJ, IR, and RD and using qualitative framework analysis based on the components of the RE-AIM framework. Following data collection interviews and focus groups were transcribed by a professional transcription service and TGJ, IR, and RD familiarised themselves with the full set of data. They then undertook line-by-line coding of the data in NVivo using descriptive primary codes which were then interlinked with secondary codes. These secondary codes were then organised under the five elements of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). The analysis was interpreted, findings were synthesised with reference to the stakeholder group and theme descriptions were produced with supplementary illustrative quotes.

The Reach of the intervention was assessed through recruitment rates for the VCSE partners, CHWs and Intervention participants and qualitative data collected from the VCSE partners, and the research team was used to understand barriers and facilitators to recruitment. Effectiveness was assessed during the primary outcome measures and barriers and facilitators to effectiveness were assessed through qualitative interviews with the participants and CHWs. Adoption was at the setting level was determined through assessment of the retention of VCSE partners and qualitatively through interviews with VCSE partners and the research team. At the individual level, Adoption was assessed through CHW retention rates and qualitatively assessed through interviews with the research team and the CHWs. Implementation was assessed qualitatively through interviews with the intervention participants focusing on intervention fidelity. Maintenance was assessed at the setting level qualitatively through interviews with VCSE partners and the research team and through a report of the status of the intervention after 6 months. No individual level maintenance data is reported. A description of the data sources which contributed to each component of the RE-AIM framework is listed in Table 1 .

Table 1 . Description of data source used to evaluate the SPICES-Sussex intervention for each of the RE-AIM components.

Ethical approval for this research was obtained from Brighton and Sussex Medical School's Research Governance and Ethics Committee (R-GEC) (application reference: ER/DG241/17BSMS9E3G/1). This ethics review covered the methods described herein, key research materials, and recruitment and consent protocols for both intervention participants and staff/CHW interviews. Due to the changes imposed on the project by COVID-19 (see Supplementary Appendix 2 ) and because of minor adaptations from research site to research sites; several minor amendments were made (final application reference: ER/BSMS9E3G/6).

Informed consent was obtained in three ways from study participants depending on the nature of their participation. (1) Online screening questionnaire: these participants were presented with an approved information sheet on the first page of the online screening questionnaire, they were then provided with an Informed Consent Form (ICF) which they had to sign with a digital signature. (2) Intervention participants: just prior to participation and data collection participants met with a research staff member to review the information sheet and to sign the ICF if they agreed to participate, consent was sought again for those intervention participants who took part in a post-intervention interview. (3) CHW and research staff members: participants were sent the information sheet and consent form several days before their interview and were asked to sign and return the ICF prior to their interview appointment.

3.1 Participant characteristics

Risk profiling data was collected from 381 participants (Females: 310, Males: 71; mean (SD) age = 58 (12.39) years. Forty-Six participants began the intervention (39 Females, 7 Males; age = 58 (11.94) years. Sixteen participants took part in one-to-one interviews at the end of the intervention (thirteen females and two males, aged 32–67 years). Seven members of the research team (6 females, 1 male), and four VCSE partners (3 females and 1 male) took part in the research team interviews. Four focus groups with a total of thirteen participants (10 females and 3 males) were conducted with CHWs from each of the research sites. Thirteen participants (no gender data collected) took part in the post-intervention questionnaire for non-participants.

3.2 Analytical framework

The remainder of these findings are organised into RE-AIM dimensions with various quantitative and qualitative methods used to evidence each dimension, see Table 1 for a description of each of the data sources. Table 2 summarises concordance and discordance with expectations of the intervention [as described in the study protocol ( 29 )] in line with the RE-AIM framework. Supplementary Appendix 3 summarises changes to the study design from the published study protocol . Throughout this section participant codes are used to attribute quotations and references to specific terminology to a respondent. The codes identify the respondent as either a member of the Research team (RT), VCSE partners (VCSE), Community Health Worker (CHW) or Participants (PP). For VCSEs, CHWs and PPs references to their sites are also made (EB, HA, NH, HG). All codes refer to gender and (F/M), and their number within each respondent category.

Table 2 . Description of concordance/discordance with our pre-implementation expectations of the SPICES intervention for each of the RE-AIM components ( 29 ).

4.1 Recruitment of voluntary and community sector enterprise partners

A community-mapping exercise was carried out during the pre-implementation phase of the project ( 30 ) in which three partner organisations were identified across three research sites in East Sussex (Hastings, East Brighton, and Newhaven). All these organisations were volunteer based community organisations with a focus on local community development and improving health, with the Hastings organisations being focused on health and wellbeing. During the intervention set up phase, the East Brighton organisations dropped out of the study due to the impact of Covid-19 whilst the Hastings, and Newhaven organisations were carried forward to deliver the intervention. The East Brighton organisations helped the research team to develop links with a health and wellbeing organisation that was associated with a local General Practice (GP) clinic in East Brighton. Finally, a fourth research site was identified in West Hove and a final VCSE partner was identified. This organisation was a local community development organisation for the area. In total four VCSE organisations were partnered with across four research sites. In each site a VC was recruited from the partner organisation to deliver the intervention with the research team.

4.2 Community health worker recruitment

The research team and VCSE partners recruited 38 individuals who attended the introductory CHW meetings (Gender: 27 females and 11 males, NH n  = 7, EB n  = 13, HG n  = 10, HA n  = 8). Twenty-seven of these individuals completed the full training for CHWs (20 females and 7 males; NH n  = 5, EB n  = 9, HG n  = 7, HA n  = 6).

4.3 Participant recruitment

Social media recruitment had a wider reach to potential participants compared with gatekeeper recruitment, however, several participants did not complete the REDCap screening questions, had a poor understanding of the study, or were not part of the study's target population. VCSE gatekeepers yielded poor recruitment results apart from when a newsletter with a particularly large reach was used. Social media was the primary strategy for recruiting participants to the study. In total the messages reached 13,086 individuals across four waves of recruitment and of these 472 (3.6%) engaged with post by clicking on the survey link. Of those who clicked on the link 80% were female and 20% were male.

The INTERHEART screening data is shown in Figure 1 and Supplementary Appendix 1 for all those who completed the screening questionnaire ( N  = 381), participants who started the intervention and then withdrew ( N  = 17), and participants who completed the intervention and on whom we have full data ( n  = 27). Of the CVD risk factors measured by the INTERHEART screening tool, the two most prevalent were stress (reported by 61% of those screened, 56% of those who started the intervention, and 78% of those who went on to complete), and physical inactivity (reported by 55%, 81% and 64% respectively).

Figure 1 . Primary outcome measures for the “Reach” and “Effectiveness” components of the SPICES-Sussex intervention. ( A ) The proportion of “Low”, “Medium”, and “High” risk participants identified during the Interheart risk profiling questionnaire; ( B ) the mean Interheart score pre and post intervention for those who completed the intervention, p value from paired t -tests; ( C ) shows the % change regularly of dietary behaviours from pre/post intervention UKDDQ score, within-group t -tests; ( D ) the change in the % of intervention participants classified as having either low or medium/high activity levels pre and post intervention, p value from McNemar's test.

Forty-six participants took part in the CVD coaching intervention across the four research sites, all of whom completed the pre-intervention quantitative questionnaires. Sixty-three percent completed the full coaching intervention, and one participant withdrew from the project after three months. We had full data for twenty-seven of twenty-nine participants who completed the full 6-month coaching intervention (note: these participants have been removed from Supplementary Appendix 1 , n  = 2), Participants' characteristics are summarised in Table 3 . Several participants withdrew (37%), reasons given for withdrawing were: ill health/poor mental health/ill health in the family (13%); the intervention was considered a poor fit for the participant/did not meet their expectations/they did not need the intervention (9%); other commitments got in the way/they were too busy with their normal lives (7%); repeated non-attendance at planned coaching sessions from the CHW (4%); did not get on well with CHW (2%), language issues (2%).

Table 3 . Facilitators and barriers to reach and recruitment.

Due to low initial recruitment rates, the recruitment areas were expanded and included more affluent adjacent areas. The proportion of those completing the screening questionnaire and of those who went on to start the intervention who were in the target population (i.e., had an address with a postcode and IMD in the most deprived three deciles) was 30% in both cases. Despite recruitment being gender neutral and without gender/sex related parameters on social media our risk profiling questionnaire recruited far more women than men (77% female, 23% male, see Supplementary Appendix 1 ). This issue was carried forward to the main intervention in which only five of the forty-six who initially took part in the study were male.

4.4 Reasons for non-participation

Reasons given for not participating included missing or not receiving an invitation to take part ( n  = 4), lack of time due to responsibilities and commitments ( n  = 4), not feeling like the intervention was a good fit for them and their circumstances ( n  = 2), not being happy with the CHW allocated to them ( n  = 2), being reluctant to take part in online activities due to a lack of privacy at home ( n  = 1). When asked what would have made them more likely to participate the most common response was more clarity/detail on what was involved ( n  = 3).

4.5 Facilitators and barriers to reach

Intervention participants referred to several intervention components that functioned as facilitators or barriers to the reach of the intervention. These barriers and facilitators were organised into themes which include: (1) Experience of CHW recruitment; (2) The value of community partnerships; (3) The experience of the risk profiling questionnaire; (4) Impacts of COVID-19. These barriers and facilitators are described in more detail in Table 3 and illustrative quotes are provided.

5 Effectiveness

5.1 primary outcomes measures.

For those participants who completed the intervention, the before and after measures of cardiovascular risk, diet, physical activity, and readiness to change were compared (see Figure 1 and Supplementary Appendix 1 ). Mean INTERHEART score fell significantly from 11.7 to 9.9, taking the mean to within the low-risk range. There were also significant improvements in the self-reported dietary measures including: an increase in the proportion of time wholegrain foods were chosen, and the daily portions of fruit and vegetables eaten, and decreases in the consumption of fatty, salty, and sugary food. No changes were observed in the consumption of oily fish. Self-reported levels of physical inactivity also dropped over the course of the intervention with the proportion of those classified in the “low” physical activity category falling from 40% to 7%. Additionally, the self-reported levels of participants' “readiness to change” during the intervention increased from 3.6 to 4.5, which indicates increased levels of motivation as a result of the intervention.

5.2 Participant reported facilitators and barriers to the effectiveness

Intervention participants referred to several intervention components that functioned as facilitators or barriers to the effectiveness of the intervention. These barriers and facilitators were organised into themes which include: (1) accountability—the ways CHWs kept participants accountable about their health behaviours; (2) connection and community—the importance of making human connections with the CHWs and feelings of community togetherness; (3) judgement-free—the importance of a judgement-free intervention experience; (4) motivation and support—the coaching role that the intervention took in the lives of participants; (5) personalisation—the feeling that the intervention was adapted to their own needs and experiences; (6) reflection—the value of reflecting on experiences during the coaching intervention; (7) self-efficacy—the ways in which CHWs made participants feel in control of their health behaviours; (8) gradual or modest impact—the feeling that the intervention largely lead to modest impacts (9) generic or inappropriate advice—the feeling that the information provided during the coaching was too generic, obvious, or inappropriate to their needs. These barriers and facilitators are described in more detail in Table 4 and illustrative quotes are provided.

Table 4 . Facilitators and barriers to intervention effectiveness.

6.1 Retention of voluntary and community sector enterprise partnerships (setting level)

Of the six VCSE organisation engaged with during the pre-implementation phase of the project, four went on to be VCSE partner organisations during the implementation phase. Disruption and staff pressures resulting from the COVID-19 pandemic were a significant barrier to recruiting partner VCSEs, with two organisations who had been involved in initial discussions deciding not to proceed for this reason. Furthermore, interruptions to communication caused by COVID-19 and research team changes led to a loss of trust and engagement in some cases. One organisation which had a group of people ready to volunteer at the beginning of the project later withdrew as this group had fragmented due to COVID-19-related delays and substantial staffing changes that took place just prior to the implementation phase between 2019 and 2020. Other factors impacting on VCSE recruitment included the availability of funding, and issues with recruiting staff to the VC role. After one of the VCSE partners dropped out of the study just prior to the implementation phase, the same organisation linked the research team with another organisation who eventually functioned as VCSE partners for the implementation phase. The need to develop trust, and having the time to achieve this, was stated by several members of the research team as being key to recruiting partner VCSEs. Quality of communication was also felt to be especially important.

6.2 Facilitators of voluntary and community sector enterprise partnerships (setting level)

VCSES and research team members referred to several intervention components that functioned as facilitators or barriers to setting level adoption. These barriers and facilitators were organised into themes which include: (1) Trust—the importance of developing trust with community- partners; (2) Local Knowledge—the value of local knowledge and to delivering appropriate community care; (3) Local Skills—the value of the skills and experiences in local communities to delivering the intervention. These barriers and facilitators are described in more detail in Table 5 and illustrative quotes are provided.

Table 5 . Facilitators and barriers to intervention setting level adoption.

6.3 Retention of community health workers (individual level)

Of the twenty-seven CHWs who were recruited and trained to be a part of the intervention, twenty-one went on to deliver one or more session as an active CHW (Gender: 15 females and 6 males NH n  = 5, EB n  = 6 HG n  = 5, HA n  = 5). Each of these CHWs completed the intervention with at least one participant and the maximum number of participants who completed the intervention with one CHW was three.

6.4 Community health worker training needs feedback (individual level)

After training sessions in our first site, a short questionnaire was conducted with CHWs who attended the training in the formof one-to-one discussions with the training coordinator and the research team. Questions were asked about the anticipated barriers that CHWs thought they would face during the coaching as well as key training needs. Anticipated barriers and challenges during the project included: a sense of mistrust amongst participants, issues of poverty and deprivation, triggers, and sensitivities to the experiences of participants (i.e., trauma or addition triggers). The key training needs identified included: the sharing of personal stories to empower participants, how to set achievable health goals, preparing CHWs with tools to challenge the participant in a supportive way, improving CHW confidence, and advice on how to communicate CVD risk to participants in a straightforward way.

6.5 Community health worker facilitators and barriers to adoption (individual level)

CHWs referred to several intervention components that functioned as facilitators or barriers to the adoption of the intervention at the individual CHW level. These barriers and facilitators were organised into themes which include: (1) Local adaptation and Codesign Sessions; (2) CHW motivation for participating; (3) CHW experiences of the training; (4) CHW experience of the support provided to them. These barriers and facilitators are described in more detail in Table 6 and illustrative quotes are provided.

Table 6 . Facilitators and barriers to intervention individual level adoption.

7 Implementation

7.1 participant retention and fidelity.

Overall, 48% ( n  = 51) of those eligible ( n  = 106) to take part in the intervention agreed to do so and provided consent, of those 90% ( n  = 46) attended their first CHW coaching session and completed the baseline questionnaire. Of those who completed their first session 63% ( n  = 29) completed three sessions and 45% completed six sessions. For the 46 participants that began the intervention there were 276 planned program contacts of which 183 (66%) were completed. Retention and attendance data are summarised in Supplementary Appendix 2 . No data was collected on the amount of time each participant spent in their coaching session.

7.2 Participant facilitators and barriers to implementation

Intervention participants referred to several intervention components that functioned as facilitators or barriers to the implementation of the intervention. These barriers and facilitators were organised into themes which include: (1) expectations of the coaching intervention, (2) the virtual coaching sessions; (3) holistic and flexible, (4) length of the coaching session, (5) administrative support, (6) past experiences, (6) mental health. These barriers and facilitators are described in more detail in Table 7 and illustrative quotes are provided.

Table 7 . Facilitators and barriers to intervention implementation .

8 Maintenance

8.1 status of the intervention after six months.

Six months after the intervention's funding period ended the program was being continued at two of the sites. One of the sites continued it as volunteer opportunity and peer support program which was covered by their existing funding for peer support programs. A second site was awarded funding from the National Health Service to continue the intervention. The latter's findings will be reported as a program evaluation in the future.

8.2 Facilitators and barriers to maintenance

Interviewees referred to several intervention components that functioned as facilitators or barriers to the maintenance of the intervention at the setting level. These barriers and facilitators were organised into themes which include: (1) continuity of the intervention; (2) funding; (3) infrastructure These barriers and facilitators are described in more detail in Table 8 and illustrative quotes are provided.

Table 8 . Facilitators and barriers to maintenance.

9 Discussion

SPICES Sussex developed strategies to implement effective community-based CVD risk reduction interventions based on behaviour change coaching with CHWs by partnering with and leveraging the experience and influence of VCSE in four underserved communities in East Sussex, UK. Despite issues with recruitment and challenges associated with COVID-19 as well as other logistic, management, and research design challenges, the project showed clear markers of success. Participants experienced the interventions positively and many made gradual, and sometimes substantial, lifestyle changes. The quantitative results showed significant reduction in participants' CVD risk after taking part in the interventions. We think these successes were due to implementing our interventions in a flexible, personalised, and holistic way, which empowered CHWs to use their skills and experiences to aid participants. These results demonstrate how CHWs-led and community-based preventative CVD interventions could be implemented, such as those seen widely across the Global South ( 17 , 18 ). They also support a “person-based” and “asset-based” approach to community-based implementation design ( 23 , 25 ) in which the strengths and assets of communities and their members are used to promote health and wellbeing.

9.1 Intervention design

The SPICES-Sussex project used community-engagement and community health worker approaches to improve CVD health that are based on practices developed and tested in Kampala, Uganda ( 47 ). As part of the SPICES consortium these practices were adapted to several global north (UK, France, Belgium) and global south settings (South Africa). In the global south social public health approaches have long advocated for the decentralisation of healthcare to community partners and for a greater focus on prevention ( 48 ). Community-based public health practices such as task-sharing are often utilised in low-resource health systems in low-and middle income countries by recruiting and training community health workers to deliver low-intensity health intervention such as health coaching and signposting ( 49 ). In global south SPICES settings, there was greater buy-in to community-based interventions from governments and much of the trust building, and infrastructure for community health workers already exists ( 50 ). These settings, including the SPICES sites that influenced the Sussex site, often rely on voluntary or unpaid volunteers to conduct public health work in order to lower cost and to make use of existing social networks.

In resource-rich global north settings, healthcare is far more institutionalised and focused on secondary care and the infrastructure for community-based and participatory interventions is far less well developed. In the UK, most health interventions must adhere to the institutional demands of the National Health Service which presents a range of resource intensive training, recruitment, safeguarding, and management practices. There is much less history of CHWs in the UK; the role of these workers is not well understood or well defined outside of the third/voluntary sector despite recent calls for their use during the COVID-19 pandemic ( 51 ). This squeezed landscape for community-based intervention and the lack of familiarity with the role makes the development and implementation of these interventions challenging. In the global north there are increasing challenges to the volunteer nature of CHWs with researchers calling for compensation, capacity building, or payment of members of the public involved in intervention delivery of research and health interventions on moral and efficacy grounds ( 52 , 53 ). In our study, the decision not to pay CHW was made as a result of us following the SPICES approach developed in the Global South ( 17 ) and because the VCSE organisations we partnered with all had existing unpaid community volunteer programs. In our post-intervention qualitative evaluation interviews, participants and CHWs both discussed the value of paying CHWs. Furthermore, the drop in CHWs and the small number of participants they were able to take on implies that the lack of payment impacted the degree to which CHWs were able to engage with the project and therefore impacted the intervention's effectiveness and sustainability. In the UK, the NIHR now recommends that members of the public who are involved in research are properly reimbursed for their involvement and provide frequently updated guidelines on how to do so ( 54 ). In the future we argue that public health intervention that make use of CHWs should reimburse and pay them in some way for their involvement.

Community volunteers with low levels of training (10 h core training plus ongoing support), such as those used during this study, are not well-suited to complex cases or acute needs that required specialised support. In our findings, participants complained of generic, inappropriate, or obvious advice from the CHWs. Participants did not seem to prioritize the knowledge or expertise of the CHWs and instead valued the personalised, holistic, and supportive relationships that were offered by the CHWs. Participants in the intervention reported having good knowledge of what they needed to do to improve their health but struggled to do it in practice. Therefore, this kind of intervention may be well-suited to providing emotional and social support to people at risk of CVD who know what they “should” do but need a support and judgement free support mechanism to make changes.

Interviews with participants revealed a tension in the study linked to the use of an individualistic lifestyle change intervention situated within a community-based and participatory study. The study design did not address community-level, socio-economic, or environmental issues known to be vital when addressing CVD health ( 55 ). Tengland ( 56 ) argues that an individualistic lens of behavioural change can limit understandings of a person's CVD health. The result can be too narrow, as the “secondary” effects of their wider environmental conditions (i.e., powerlessness, lack of control, or lack of hope), are not considered. They further suggest that interventions should focus more on the attainment of instrumental goals, such as increased real opportunities in life. For community-based projects to grow further, they should seek to become multi-faceted by combining individualistic interventions with environment/community activities such as community education ( 57 ).

The frequency with which mental health issues were raised in discussions was notable. Those who took part in the screening reported high levels of stress and depression, and rates were even higher amongst participants taking part in the programme, furthermore, participants reported lower levels of stress and depression at the end. This may show that this type of intervention is particularly well suited to people with mental health concerns for whom talking to someone can make a real difference. This was also observed in the SPICES consortium partner sites including Brest (France) ( 58 ), and Antwerp (Belgium) ( 59 ). Most non-specialist or non-clinical people do not think of their health siloed into CVD, mental health, digestive health etc ( 60 ). Instead, one's health is perceived holistically, and mental health is often the most prominent barrier and facilitator to behaviour change.

9.2 Implementation strategy

We adopted a type 3 hybrid implementation study which focused primarily on implementation factors rather than evaluation, dropping the randomisation approach and embracing flexible more emergent iterative development and growth perspective, co-design, and contextual/place-based factors. A rigid evaluation linear approach as required for a type 1/2 design, which was initially planned, caused tensions with the community-based, participatory, and “emergent” aspects of the project and (2) the pressures imposed on our voluntary sector partners by the pandemic meant that adhering to a rigid randomisation approach was less realistic ( 7 ). The planned approach placed power in the hands of the research team which negatively affected our stakeholder relationships, and a rigid adherence to study protocols would have meant we could not effectively adapt strategies or interventions to context.

Instead we adopted a type 3 approach, which has been used to assess a wide range of preventative health and eHealth interventions which operate in communities based on participatory principles ( 61 ). In their systematic review of such strategies to implement interventions, Haldane et al. ( 62 ) highlight the importance of building mutually beneficial and trust-based relationships particularly with marginalised stakeholders, and stress the importance of developing strategies and interventions contextually whilst reporting and acting on lessons learnt throughout the project. Wildman et al. ( 63 ) argue that successful community-based projects require extensive community input, learning and adaptation captured from existing programmes to facilitate the replicability of programmes in other community contexts. With the more flexible type three approach we were able to make local adaptation to meet the need and priorities of the local community and local VCSE partner organisation thereby listening to the voices of those who are involved. This iterative approach to intervention design is similar to the “scaling-out” approach suggested by Aaron et al. ( 64 ) which advocates iterative roll-out and local adaptation in place of simply “copy and pasting” interventions across context. In reality, during SPICES-Sussex the local adaption became less flexible as the intervention became more well-developed as the internal factors became more institutionalised within the research team. However, the principle of meeting the needs and priorities of the local VCSE organisation were maintained from site to site and the team sought input from local organisations where possible.

We do not know whether the changes observed will be maintained due to the short follow up period, both at an individual level or a setting level ( 65 ), and the research lacks an economic appraisal. The short follow-up period was forced on the research team because of delays to the project caused by COVID-19 which meant our funding period was not long enough to conduct a follow up assessment. An economic appraisal was not considered appropriate because the development approach taken during the study meant that any economic appraisal was not likely to reflect real-world roll-out. In the future we would advocate for greater scaling-out to include a larger sample and an economic appraisal.

9.3 Recruitment and retention

The impacts of the restrictions placed on the people, organisations, and communities involved in this research due to COVID-19 were extensive and wide-ranging. The per-implementation phase of the research began in January of 2020 with the recruitment of an implementation team and participant recruitment was due to begin in April 2020. Following the outbreak of COVID-19 in the UK, recruitment was stopped from 16 March 2020 to 1 October 2020. By June 2020, a decision was made to fully move to remote delivery of the coaching intervention using video conferencing services.

Research recruitment and retention were near constant challenges, and all activities were significantly impacted by the Covid restrictions. We believe that the use of the INTERHEART tool, presented on the REDCap platform, acted as a barrier to recruitment as evidenced through the follow sources: (1) Over 650 participants attempted to begin the screening questionnaire and our records show those who did not complete it stopped towards the beginning or mid-way through the questions, particularly when they were asked to measure their waist/hip circumference, (2) of the 380 participants who completed the survey only approximately 100 were eligible for the intervention meaning we were selecting from a very limited pool of participants, (3) many of the participants in the per implementation interviews mentioned finding the screening tool to be “clunky” or “annoying” to use. Its overly “medical” focus, as a basis for lifestyle discussions may not have been engaging for the target audience.

Our initial recruitment strategy was to rely heavily on our VCSE partners to act as gatekeepers for recruitment, a practice commonly seen in participatory research methods ( 66 ). Whilst the VCSE partners were adept in the recruitment and management of CHWs and in the development of practices and policies, they did not seem to have the reach or access for the recruitment of large numbers of potential participants. Our experience aligns with that of Williams ( 67 ), who states that VCSE and end users' relationships are often smaller in number but deep, based on trust and protection, and covered by a range of risk related policies. Instead, we relied heavily on the use of paid for social media adverts for recruitment due to our ethics restrictions. Much like the experience of other researchers who used these tools, we found that they were low cost and reached large numbers of people but engagement with the screening and risk profiling and participant recruitment was low ( 68 ). In future studies, it may be more suitable to use social media as an adjunct to mixed recruitment strategies which make use of community outreach, primary care recruitment, and media outreach ( 69 , 70 ).

The study sample was heavily skewed towards middle-aged females and much of the sample was not considered to be from vulnerable or low socio-economic groups. Furthermore, males are under-represented in both the risk profiling and intervention samples which represents a divergence with our planned recruitment targets in which we aimed for a more representative sample. The difficulties in recruiting men and vulnerable and other “seldom heard” populations to life style interventions are well-recognised ( 71 , 72 ). Recommended strategies to improve male participation in community-based interventions include engaging with male-friendly spaces, workplace-based interventions, and incorporating activity-based programming, social-support, and group activities ( 73 , 74 ). Some of these elements were suggested during the planning phase of SPICES but were not feasible due to COVID restrictions ( 30 ).

9.4 Project infrastructure

We made the key decision to bring VCSE organisations into the research team with paid roles to foster stronger community/research partnerships as promoted by CBPR researchers ( 75 ) and the NHS's PPIE (Public and Patient Involvement and Engagement) initiatives ( 76 ). Our research shows that the VCSE sector is an untapped resource within primary and community care that has a great deal of expertise, compassion, and enthusiasm to offer health provision ( 77 ). To facilitate this community-based project, we focused on the concept of trust building throughout the intervention as described by Christopher et al. ( 78 ).

VCSE partnerships brought knowledge and expertise of their local communities, policies/practices of volunteer management and, critically, perspectives of the motivations and drivers for CHWs and communities. CHWs were empowered to bring their own skills and abilities to the intervention through an asset based and flexible project development which included them in the co-design of the project ( 79 ). The strategies we used to implement the interventions were not prescriptive and did not force CHWs to follow a set of strict guidelines. This led to a highly personalised, flexible, and reflective experience for CHWs. However, our experience highlights potential problems with relying on unpaid volunteers to deliver complex interventions, including issues with volunteer commitment, attendance and drop out.

Our research highlights the importance of infrastructure when managing CHWs and partnering with VCSE sector organisations. We developed a bespoke behaviour change training course for CHWs, a range of CHW risk appraisal and mitigation policies with our VCSE partners, and a dedicated team of participant and CHW support and management coordinators. Clear protocols were developed and followed for the recruitment, onboarding, matching, and hosting of participant coaching sessions whilst CHWs were provided with multiple channels of regular communication and continuous training and feedback opportunities. We support calls for project managers, VCSEs, primary care providers, and community members to be more explicitly involved in the design and development of interventions which affect and include communities ( 80 ).

In this study, the research team also experienced issues of positionality throughout the project whereby the lines between implementor, community worker, and evaluator were blurred. Coulter et al. ( 81 ) have pointed out that research that includes CHWs in the design and delivery of interventions commonly experience a tension between fidelity of the intervention protocol and community expectations, needs, and norms. We also experienced differing goals between academic and community partners (including CHWs), where academic partners prioritized data collection and community partners prioritized funding, sustainability, and policy. This can be likened to the experience of Furman et al. ( 82 ) who discussed how community partners were hesitant to endorse their research due to conflicts with on-the-ground realities of the community members they served.

9.5 Recommendations

During this project the research team, VCSE partners, and CHWs constantly learnt lessons and were quick to make adaptations to their approach based on feedback from a range of stakeholders and capturing all of these in this paper would be an impossible task. However, several key insights can be drawn from our collective experience and evaluation of the project. They include:

1. Environmental issues are larger and more complex than any coaching intervention based on individualistic changes can hope to remedy.

2. The voluntary and community sector has a range of strengths and assets based on local experience and knowledge developed over significant periods of time that can be used for CVD prevention. However, the sector is highly under-resourced and spread thinly across a wide range of priorities. Individual VCSE partner organisations do not always have enough reach to facilitate recruitment.

3. Community engagement works best if it is built into a project early on through co-design and resources and time should be allocated to this activity.

4. CHWs bring significant advantages during the delivery of community-based interventions. They are trusted peers, they bring their own skills and experience, and they can benefit from the intervention alongside the participants.

5. Strategies to encourage the participation of men should be specifically considered during the planning phase.

6. Virtual coaching interventions are acceptable to participants, and in many cases preferable to participants, due to their flexibility and ease of use.

7. The issue of mental health must be addressed even when working with unrelated health public conditions.

8. A strong project infrastructure, made up of well-trained support/administrative staff, is essential when delivering community-based interventions.

9. CHWs should be paid or reimbursed for their involvement in research and public health interventions. Falling to do so is looked down on my stakeholders and has impacts on sustainability and effectiveness.

10. The Global North can look to innovations in the Global South for examples of success for community-based interventions, however, proper contextual or situational analyses must be conducted to understand the needs and priorities of target communities.

9.6 Conclusion

This study demonstrates the feasibility of a CHW-led preventative health interventions could be implemented with overseen and unheard communities in the UK. It highlights the wealth of untapped resources that exist with VCSE and CHWs and suggests how a beneficial community-based service could be set up to run alongside and support NHS Health Checks, to reduce the incidence of CVD. The aim was to empower CHWs to discuss health with people in their communities based on behaviour change principles. We have set out what worked well and what did not, to facilitate development of future community-based interventions in the Global North. We believe that the community-based approach need not be restricted to CVD risk reduction, and that it could easily be applied to low level mental health conditions, diabetes, or other preventable NCDs. If CHWs are confident, well supported, and well-trained, they will have the skills and ability to contribute to improving the health and wellbeing of people in their communities. The benefits do not only extend to patients but also to CHWs and to the VCSE partners involved. We believe our project shows how these interventions can become a supplementary tool that links primary care services with the VCSE sector.

Data availability statement

The datasets presented in this study can be found in the University of Sussex's data repository through the following link: https://sussex.figshare.com/ ; (doi: 10.25377/sussex.25569084).

Ethics statement

The studies involving humans were approved by Brighton and Sussex Medical School Research Governance and Ethics Committee (RGEC). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Author contributions

First Author (First Authorship): Thomas Grice-Jackson Second Authors (Equal Contribution): Imogen Rogers, Elizabeth Ford, Robert Dickson Third Authors (Equal Contribution): Kat-Frere Smith, Katie Goddard, Linda Silver, Catherine Topham Fourth Author (Equal Contribution): Papreen Nahar, Geofrey Musinguzi, Hilde Bastiens. Senior Author (Senior Authorship): Harm Van Marwijk. All authors contributed to the article and approved the submitted version.

This project was funded as part of an EU Commission Horizon. CORDIS (The Community Research and Development Information Service (CORDIS) Grant agreement number: 733356.

Acknowledgments

We thank the following voluntary and community sector organisations for their partnerships whilst designing and delivering this project: Active Hastings, Wellsbourne Healthcare Community Interest Company, Sussex Community Development Association, the Crew Club, and the Hangleton and Knoll project. We thank the National Centre for Behaviour Change for their contribution to the development and delivery of the Community Health Workers training. We thank all members of the SPICES consortium and European Commission who provide consultation and advice throughout the project. Finally, we thank all our Community Health Workers for giving up their time for this project. They were central to every part of this work and their contribution is greatly appreciated. We would also like to thank the editorial and reviewer team assigned to this manuscript. Their contributions improved the quality of our manuscript presentation, structure, and discussion.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/frhs.2024.1152410/full#supplementary-material

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Keywords: community based participatory research, implementation research, RE-AIM (reach, effectiveness, adoption, implementation and maintenance), cardiovascular disease, community health workers (CHW)

Citation: Grice-Jackson T, Rogers I, Ford E, Dickinson R, Frere-Smith K, Goddard K, Silver L, Topham C, Nahar P, Musinguzi G, Bastiaens H and Van Marwijk H (2024) A community health worker led approach to cardiovascular disease prevention in the UK—SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project. Front. Health Serv. 4:1152410. doi: 10.3389/frhs.2024.1152410

Received: 27 January 2023; Accepted: 20 March 2024; Published: 7 May 2024.

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© 2024 Grice-Jackson, Rogers, Ford, Dickinson, Frere-Smith, Goddard, Silver, Topham, Nahar, Musinguzi, Bastiaens and Van Marwijk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Thomas Grice-Jackson [email protected]

This article is part of the Research Topic

Hybrid Effectiveness-Implementation Trial Designs: Critical Assessments, Innovative Applications, and Proposed Advancements