When all else fails: The (mis)use of qualitative research in the evaluation of complex interventions.

RATIONAL, AIMS, AND OBJECTIVES: Qualitative research has been promoted as an important component of the evaluation of complex interventions to support the scale up and spread of health service interventions, but is currently not being maximized in practice. We aim to identify and explore the sociocultural and structural factors that impact the uses (and misuses) of qualitative research in the evaluation of complex health services interventions. METHODS: We conducted a qualitative analysis of data collected in a multiple case study of the evaluation and scale up and spread of three health service intervention. RESULTS: Our findings demonstrate the challenges of meaningfully integrating qualitative research in evaluation programmes lead by clinicians with limited qualitative expertise and operating within an environment dominated by biomedical research, even with methodological support. CONCLUSIONS: Based on these findings we encourage ongoing engagement of qualitative researchers in evaluation programmes to begin to refine our methodological understanding, while also suggesting changes to medical education and evaluation funding models to create fertile environments for interdisciplinary collaborations.