Evidence map›Paper›PMID 32761146›Full record

ArticleHealth policy and planning2020

Applying a complex adaptive systems approach to the evaluation of a school-based intervention for intimate partner violence prevention in Mexico.

Shelly Makleff, Marissa Billowitz, Jovita Garduño, Mariana Cruz, Vanessa Ivon Silva Márquez, Cicely Marston

Open access · hybridAbstract read
In one paragraph

Article in Health policy and planning, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. From structures to systems: towards a model of ethical healthcare.Health systems (Basingstoke, England) · 2025
    Article
  4. Article
  5. Article
  6. Article
  7. "International journal of environmental research and public health · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Shelly MakleffFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
Marissa BillowitzIndependent, Juárez 208, Col. Tlalpan Centro, 14000 Mexico City, Mexico.
Jovita GarduñoFundación Mexicana para la Planeación Familiar, A.C. (Mexfam), Juárez 208, Col. Tlalpan Centro, 14000 Mexico City, Mexico.
Mariana CruzIPPF/WHR Mexico, Juárez 208, Col. Tlalpan Centro, 14000 Mexico City, Mexico.
Vanessa Ivon Silva MárquezFundación Mexicana para la Planeación Familiar, A.C. (Mexfam), Juárez 208, Col. Tlalpan Centro, 14000 Mexico City, Mexico.
Cicely MarstonFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
London School of Hygiene & Tropical Medicine · GBMexfam · MX

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite calls for evaluation practice to take a complex systems approach, there are few examples of how to incorporate complexity into real-life evaluations. This article presents the case for using a complex systems approach to evaluate a school-based intimate partner violence-prevention intervention. We conducted a post hoc analysis of qualitative evaluation data to examine the intervention as a potential system disruptor. We analysed data in relation to complexity concepts particularly relevant to schools: 'diverse and dynamic agents', 'interaction', 'unpredictability', 'emergence' and 'context dependency'. The data-two focus groups with facilitators and 33 repeat interviews with 14-17-year-old students-came from an evaluation of a comprehensive sexuality education intervention in Mexico City, which serves as a case study for this analysis. The findings demonstrate an application of complex adaptive systems concepts to qualitative evaluation data. We provide examples of how this approach can shed light on the ways in which interpersonal interactions, group dynamics, the core messages of the course and context influenced the implementation and outcomes of this intervention. This gender-transformative intervention appeared to disrupt pervasive gender norms and reshape beliefs about how to engage in relationships. An intervention comprises multiple dynamic and interacting elements, all of which are unlikely to be consistent across implementation settings. Applying complexity concepts to our analysis added value by helping reframe implementation-related data to focus on how the 'social' aspects of complexity influenced the intervention. Without examining both individual and group processes, evaluations may miss key insights about how the intervention generates change, for whom, and how it interacts with its context. A social complex adaptive systems approach is well-suited to the evaluation of gender-transformative interventions and can help identify how such interventions disrupt the complex social systems in which they are implemented to address intractable societal problems.

Indexed as

Intimate Partner ViolenceAdolescentHumansInterpersonal RelationsMexicoSchoolsSystems AnalysisComplex adaptive systemscomplexitycomprehensive sexuality educationevaluation of complex interventionsgender-transformative approachimplementation researchintimate partner violence

Identifiers

PMID32761146
PMCPMC7553757
OpenAlexW3047782611

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.