A mixed-method synthesis to develop a mid-range theory for interventions aiming to generate demand for contraception among adolescents

Enhancing evidence transferability

Helen Burchett

London School of Hygiene & Tropical Medicine

International Centre for Reproductive Health, Mozambique
EPPI-Centre, University College London

January 2020 to June 2021 (TBC)

Evidence synthesis

Low- and middle-income countries

This study will use a novel means of bringing different types of research together to develop a theory about how to increase adolescents’ demand for contraceptives in low- and middle-income countries. It will address the following research questions:

1. What types of interventions aimed at generating contraceptive demand among adolescents in LMICs have been evaluated?
2. What theories underpin existing interventions aimed at generating contraceptive demand among adolescents?
3. What characteristics of the interventions, their implementation and contexts may facilitate or hinder their success?
4. What mid-range theory could explain how adolescent contraceptive demand interventions work?

As part of the project, it will also examine these questions:

1. How useful could integrative review methods be for building middle-range theory in development?
2. What study types are most helpful for this theory-building process?

First, the study team will conduct a systematic search of the literature.

Second, they will extract data that will include information such as the study design, location, population targeted and intervention characteristics. This will allow them to identify which studies will be included in each synthesis.

Third, the team will carry out a narrative synthesis of evidence on existing interventions to develop a map of the types of interventions that have been evaluated.

Fourth, the team will carry out a thematic synthesis of qualitative studies on adolescent, provider and other stakeholder views (e.g. experiences of adolescent family planning demand generation interventions) to explore which characteristics of interventions, their implementation and contexts may affect their success.

Finally, test whether our mid-range theory can be successfully applied to explain how evaluated interventions work.

The study will draw on evidence databases and extract data from included studies.

The mid-range theory developed on contraceptive demand generation will useful to policymakers, implementers and funders to maximise the effectiveness of interventions in this area.

• CEDIL research design paper: Upstream interventions aiming to encourage adolescents’ use of contraception in low- and middle-income countries: A rationale and protocol for a mixed-methods synthesis to develop a mid-range theory
• Blog: “But HOW does it work?” Innovating family planning interventions
• CEDIL Syntheses Working Paper 5: Structural interventions aiming to enable adolescent use of contraception in low- and middle-income countries
• CEDIL Evidence Brief 3: Structural interventions to enable adolescent contraceptive use in low and middle income countries: What has been evaluated and how should future interventions be developed?
• Journal paper: Burchett, H. E. D., D. Kneale, S. Griffin, M., de Melo, J. J. Picardo and R. S. French (2022) ‘Which structural interventions for adolescent contraceptive use have been evaluated in low- and middle-income countries?’, International Journal of Environmental Research and Public Health, 19(18), 11715, https://doi.org/10.3390/ijerph191811715
• Journal paper: Burchett, H. E. D., S. Griffin, M. de Melo, J. J. Picardo, D. Kneale and R. S. French (2022) ‘Structural interventions to enable adolescent contraceptive use in LMICs: a mid-range theory to support intervention  development and evaluation’, International Journal of Environmental Research and Public Health, 19(21), 14414;  https://doi.org/10.3390/ijerph192114414
• Webinar: Economic empowerment, school participation and changing social norms: How can we best develop structural interventions to enable adolescent contraceptive use in LMICs
• Blog post (CEDIL blog): How can structural interventions enable adolescent contraceptive use in low- and middle-income countries?
• Blog post (MARCH blog): How can structural interventions enable adolescent contraceptive use in low- and middle-income countries?