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Randomized Controlled Trial
. 2017 Sep 4;17(1):689.
doi: 10.1186/s12889-017-4695-8.

Development of a Framework for the Co-Production and Prototyping of Public Health Interventions

Free PMC article
Randomized Controlled Trial

Development of a Framework for the Co-Production and Prototyping of Public Health Interventions

Jemma Hawkins et al. BMC Public Health. .
Free PMC article


Background: Existing guidance for developing public health interventions does not provide information for researchers about how to work with intervention providers to co-produce and prototype the content and delivery of new interventions prior to evaluation. The ASSIST + Frank study aimed to adapt an existing effective peer-led smoking prevention intervention (ASSIST), integrating new content from the UK drug education resource Talk to Frank ( ) to co-produce two new school-based peer-led drug prevention interventions. A three-stage framework was tested to adapt and develop intervention content and delivery methods in collaboration with key stakeholders to facilitate implementation.

Methods: The three stages of the framework were: 1) Evidence review and stakeholder consultation; 2) Co-production; 3) Prototyping. During stage 1, six focus groups, 12 consultations, five interviews, and nine observations of intervention delivery were conducted with key stakeholders (e.g. Public Health Wales [PHW] ASSIST delivery team, teachers, school students, health professionals). During stage 2, an intervention development group consisting of members of the research team and the PHW ASSIST delivery team was established to adapt existing, and co-produce new, intervention activities. In stage 3, intervention training and content were iteratively prototyped using process data on fidelity and acceptability to key stakeholders. Stages 2 and 3 took the form of an action-research process involving a series of face-to-face meetings, email exchanges, observations, and training sessions.

Results: Utilising the three-stage framework, we co-produced and tested intervention content and delivery methods for the two interventions over a period of 18 months involving external partners. New and adapted intervention activities, as well as refinements in content, the format of delivery, timing and sequencing of activities, and training manuals resulted from this process. The involvement of intervention delivery staff, participants and teachers shaped the content and format of the interventions, as well as supporting rapid prototyping in context at the final stage.

Conclusions: This three-stage framework extends current guidance on intervention development by providing step-by-step instructions for co-producing and prototyping an intervention's content and delivery processes prior to piloting and formal evaluation. This framework enhances existing guidance and could be transferred to co-produce and prototype other public health interventions.

Trial registration: ISRCTN14415936 , registered retrospectively on 05 November 2014.

Keywords: Adolescence; Co-production; Drug prevention; Intervention development; Prototyping; Public health; Transdisciplinary action research.

Conflict of interest statement

Ethics approval and consent to participate

The ASSIST + Frank study was granted ethical approval by the Cardiff University School of Social Sciences Ethics Committee (REF: SREC/ 1103) and participants provided written informed consent to participate in the study.

Consent for publication

Not applicable, the published data does not contain details that could be traced to any individual participant.

Competing interests

Rona Campbell and Laurence Moore were Directors of DECIPHer Impact, a not for profit company that Licences and supports the implementation of the ASSIST smoking prevention programme. Laurence Moore remains a scientific adviser to the company. Both have received modest fees for their roles within it. All other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Fig. 1
Fig. 1
Framework for intervention co-production and prototyping. a Stakeholders comprise those within or external to the delivery setting (e.g. school-based: school teachers, head teacher, contact teacher, head of Personal, Social, Health and Economic (PSHE) education, head of year, receptionist; national and local policy leads; parents/ guardians/ caregivers)

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