Family nursing researchers are charged with addressing the conceptual and methodological underpinnings of family research when developing family-focused interventions. Step-by-step guidance is needed that integrates current science of intervention development with family science and helps researchers progress from foundational work to experimental work with policy integration. The purpose of this manuscript is to provide pragmatic, evidence-based guidance for advancing family intervention research from foundational work through efficacy testing. Guidance regarding the development of family interventions is presented using the first three of Sidani’s five-stage method: (a) foundational work to understand the problem targeted for change; (b) intervention development and assessment of acceptability and feasibility; and (c) efficacy testing. Each stage of family intervention development is described in terms of process, design considerations, and policy and practice implications. Examples are included to emphasize the family lens. This manuscript provides guidance to family scientists for intervention development and implementation to advance family nursing science and inform policy.
AdamsK. F.JrZannadF. (1998). Clinical definition and epidemiology of advanced heart failure. American Heart Journal, 135(6), S204-S215.
2.
AlaviM.ArchibaldM.McMasterR.LopezV.ClearyM. (2018). Aligning theory and methodology in mixed methods research: Before design theoretical placement. International Journal of Social Research Methodology, 21(5), 527–540. https://doi.org/10.1080/13645579.2018.1435016
3.
Alfaro-DíazC.SvavarsdottirE. K.EsandiN.KlinkeM. E.Canga-ArmayorA. (2022). Effectiveness of nursing interventions for patients with cancer and their family members: A systematic review. Journal of Family Nursing, 28(2), 95–114. https://doi.org/10.1177/10748407211068816
4.
APA Council of Representatives. (2021). Advancing health equity in psychology. American Psychological Association.
5.
BellJ. M. (1995). Wanted: Family nursing interventions [Editorial]. Journal of Family Nursing, 1(4), 355–358.
6.
BerryD.SheehanR.HeschelR.KnaflK.MelkusG.GreyM. (2004). Family- based interventions for childhood obesity: A review. Journal of Family Nursing, 10(4), 429–449. https://doi.org/10.1177/1074840704269848
7.
BettencourtA. F.GrossD.BreitensteinS. (2019). Evaluating implementation fidelity of a school-based parenting program for low-income families. The Journal of School Nursing, 35(5), 325–336. https://doi.org/1177/1059840518786995
8.
BourgaultA. M.VossJ. G.StanfillA. G.McCarthyA. M.MatthewsE. E.TalsmaA.LoerzelV.HendersonW. A.KinserP. A.HershbergerP. E. (2022). Strategies to enhance the success of mid-career nurse scientists. Nursing Outlook, 70(1), 127–136. https://doi.org/10.1016/j.outlook.2021.06.015
9.
BowenD. J.KreuterM.SpringB.Cofta-WoerpelL.LinnanL.WeinerD.BakkenS.KaplanC. P.SquiersL.FabrizioC.FernandezM. (2009). How we design feasibility studies. American Journal of Preventive Medicine, 36(5), 452–457. https://doi.org/10.1016/j.amepre.2009.02.002
10.
BreitensteinS. M.GrossD.FoggL.RidgeA.GarveyC.JulionW.TuckerS. (2012). The Chicago Parent Program: Comparing 1-year outcomes for African American and Latino parents of young children. Research in Nursing & Health, 35(5), 475–489. https://doi.org/10.1002/nur.21489
ButterfieldP. G. (2017). Thinking upstream: A 25-year retrospective and conceptual model aimed at reducing health inequities. Advances in Nursing Science, 40(1), 2–11. https://doi.org/10.1097/ANS.0000000000000161
DeatrickJ. A. (2017). Where is “family” in the social determinants of health? Implications for family nursing practice, research, education, and policy [Editorial]. Journal of Family Nursing, 23(4), 423–433. https://doi.org/10.1177/1074840717735287
17.
DeatrickJ. A.HobbieW. L.BarakatL.OgleS.ReillyM.HardieT.TothJ.KnaflG. J.KnaflK. A. (2016). 1. Using mixed methods analyses to tailor theory-based family interventions. Nursing Outlook, 64(1), 109. https://doi.org/10.1016/j.outlook.2015.11.002
18.
DeatrickJ. A.KnaflK. A.KnaflG. J.BresslerS. N.StevensE. M.Ver HoeveE. S.ZukinH.RhodesG.LeriD.HobbieW. (2022). Development of training in problem solving for caregivers of childhood brain tumor survivors. Cancer Nursing, 45(4), E746–E757. https://doi.org/10.1097/NCC.0000000000001041
19.
FeethamS. (2018). Revisiting Feetham’s criteria for research of families to advance science and inform policy for the health and well-being of families [Guest editorial]. Journal of Family Nursing, 24(2), 115–127. https://doi.org/10.1177/1074840718767831
20.
FeethamS.DoeringJ. J. (2015). Career cartography: A conceptualization of career development to advance health and policy. Journal of Nursing Scholarship, 47(1), 70–77. https://doi.org/10.1111/jnu.12103
21.
FernandezM. E.GillA.van LieshoutS.RodriguezS. A.BeidasR. S.ParcelG.RuiterR. A. C.MarkhamC. M.KokG. (2019). Implementation mapping: Using intervention mapping to develop implementation strategies. Frontiers in Public Health, 7, Article 158. https://doi.org/10.3389/fpubh.2019.00158
22.
Ford-GilboeM.WathenC. N.VarcoeC.HerbertC.JacksonB. E.LavoieJ. G.PaulyB.PerrinN. A.SmyeV.WallaceB.WongS. T.BrowneA. J. (2018). How equity-oriented health care affects health: Key mechanisms and implications for primary health care practice and policy. The Milbank Quarterly, 96(4), 635–671. https://onlinelibrary.wiley.com/doi/pdf/10.1111/1468-0009.12349
23.
FordJ. H.WiseM.KrahnD.OliverK. A.HallC.SayerN. (2014). Family care map: Sustaining family-centered care in Polytrauma Rehabilitation Centers. Journal of Rehabilitation Research and Development, 51(8), 1311–1324. https://doi.org/10.1682/JRRD.2014.03.0066
24.
FreedlandK. E.KingA. C.AmbrosiusW. T.Mayo-WilsonE.MohrD. C.CzajkowskiS. M.ThabaneL.CollinsL. M.RebokG. W.TreweekS. P.CookT. D.EdingerJ. D.StoneyC. M.CampoR. A.Young-HymanD.RileyW. T. (2019). The selection of comparators for randomized controlled trials of health-related behavioral interventions: Recommendations of an NIH expert panel. Journal of Clinical Epidemiology, 110, 74–81. https://doi.org/10.1016/j.jclinepi.2019.02.011
25.
GanongL. (2011). Return of the “intimate outsider”: Current trends and issues in family nursing research revisited. Journal of Family Nursing, 17(4), 416–440. https://doi.org/10.1177/1074840711425029
26.
García-VivarC.KonradsenH.Kolbrun SvavarsdóttirE.BrødsgaardA.DieperinkK. B.LuttikM.Mahrer-ImhofR.ØstergaardB.ImhofL. (2023). Healthcare interventions for older people with dementia and family caregivers in Europe: A scoping review. International Journal of Nursing Practice. Advance online publication. e13172. https://doi.org/10.1111/ijn.13172
27.
GartlehnerG.HansenR.NissmanD.LohrK.CareyT. (2010). Criteria for distinguishing effectiveness from efficacy trials in systematic reviews. Agency for Healthcare Research and Quality.
28.
GlynnS. M. (2013). Family-centered care to promote successful community reintegration after war: It takes a nation. Clinical Child and Family Psychology Review, 16(4), 410–414. https://doi.org/10.1007/s10567-013-0153-z
29.
GolfenshteinN.SruloviciE.DeatrickJ. A. (2016). Interventions for reducing parenting stress in families with pediatric conditions. Journal of Family Nursing, 22(4), 460–492. https://doi.org/10.1177/1074840716676083
30.
GraffignaG.GheduzziE.MorelliN.BarelloS.CorboM.GinexV.FerrariR.LascioliA.FeritiC.MasellaC. (2021). Place4Carers: A multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings. BMC Health Services Research, 21(1), Article 591. https://doi.org/10.1186/s12913-021-06563-5
31.
GreenhalghT.HintonL.FinlayT.MacfarlaneA.FahyN.ClydeB.ChantA. (2019). Frameworks for supporting patient and public involvement in research: Systematic review and co-design pilot. Health Expectations, 22(4), 785–801. https://doi.org/10.1111/hex.12888
GrossD.BelcherH. M. E.BudhathokiC.OfoneduM. E.DutrowD.UvegesM. K.SladeE. (2019). Reducing preschool behavior problems in an urban mental health clinic: A pragmatic, non-inferiority trial. Journal of the American Academy of Child & Adolescent Psychiatry, 58(6), 572–581. https://doi.org/10.1016/j.jaac.2018.08.013
34.
GrossD.GarveyC.JulionW.FoggL.TuckerS.MokrosH. (2009). Efficacy of the Chicago Parent Program with low-income African American and Latino parents of young children. Prevention Science, 10, 54–65. https://doi.org/10.1007/s11121-008-0116-7
35.
KneippS. M.SchwartzT. A.DrevdahlD. J.CanalesM. K.SantacroceS.SantosH. P. J.AndersonR. (2018). Trends in health disparities, health inequity, and social determinants of health research: A 17-year analysis of NINR, NCI, NHLBI, and NIMHD funding. Nursing Research, 67(3), 231–241. https://doi.org/10.1097/NNR.0000000000000278
KonradsenH.BrødsgaardA.ØstergaardB.SvavarsdottirE.DieperinkK. B.ImhofL.LuttikM. L.Mahrer-ImhofR.García-VivarC. (2021). Health practices in Europe towards families of older patients with cancer: A scoping review. Scandinavian Journal of Caring Sciences, 35(2), 375–389. https://doi.org/10.1111/scs.12855
38.
LamuraG.MnichE.NolanM.WojszelB.KreversB.MestheneosL.DöhnerH. (2008). Family carers’ experiences using support services in Europe: Empirical evidence from the EUROFAMCARE study. The Gerontologist, 48(6), 762–771. https://doi.org/10.1093/geront/48.6.752
39.
LawE.FisherE.EcclestonC.PalermoT. M. (2019). Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database of Systematic Reviews, 3, CD009660. https://doi.org/10.1093/heapro/dar097
40.
LoerzelV.RiceM.WarshawskyN.KinserP. A.MatthewsE. E. (2021). Areas of satisfaction and challenges to success of mid-career nurse scientists in academia. Nursing Outlook, 69(5), 805–814. https://doi.org/DOI: 10.1016/j.outlook.2021.03.011
41.
LoperA.WooB.MetzA. (2021). Equity Is Fundamental to Implementation Science. Stanford Social Innovation Review, 19(3), A3–A5. https://doi.org/10.48558/QNGV-KG05
42.
LordB. (2019). Parent perspective and response to challenges and priorities for pediatric palliative care research. Journal of Pain and Symptom Management, 58(5), e9-e10. https://doi.org/10.1016/j.jpainsymman.2019.08.007
43.
LordS.MooreC.BeattyM.CohenE.RapoportA.HellmannJ.NettenK.AminR.OrkinJ. (2020). Assessment of bereaved caregiver experiences of advance care planning for children with medical complexity. JAMA Network Open, 3(7), e2010337. https://doi.org/10.1001/jamanetworkopen.2020.10337
44.
Mahrer-ImhofR.ØstergaardB.BrødsgaardA.KonradsenH.SvavarsdóttirE. K.DieperinkK. B.ImhofL.García-VivarC.LuttikM. (2022). Healthcare practices and interventions in Europe towards families of older patients with cardiovascular disease: A scoping review. Scandinavian Journal of Caring Sciences, 36(2), 320–345. https://doi.org/10.1111/scs.13045
45.
MartireL. M.LustigA. P.SchulzR.MillerG. E.HelgesonV. S. (2004). Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 23(6), 599–611. https://doi.org/10.1037/0278-6133.23.6.599
46.
MichieS.van StralenM. M.WestR. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1), 42. https://doi.org/10.1186/1748-5908-6-42
47.
MilatA. J.KingL.BaumanA. E.RedmanS. (2013). The concept of scalability: Increasing the scale and potential adoption of health promotion interventions into policy and practice. Health Promotion International, 28(3), 285–298. https://doi.org/10.1093/heapro/dar097
Mooney-DoyleK.BurleyS.LudemannE.RawlettK. (2021). Multifaceted support interventions for siblings of children with cancer: A systematic review. Cancer Nursing, 44(6), E609–E635. https://doi.org/100.1097/NCC.0000000000000966
50.
Mooney-DoyleK.DeatrickJ. A. (2016). Parenting in the face of childhood life-threatening conditions: The ordinary in the context of the extraordinary. Palliative and Supportive Care, 14(3), 187–198. https://doi.org/10.1017/S1478951515000905
Mooney-DoyleK.LindleyL. C. (2020). Family and child characteristics associated with caregiver challenges for medically complex children. Family and Community Health, 43(1), 74–81. https://doi.org/10.1097/FCH.0000000000000245
MoriartyH.WinterL.RobinsonK. E.PiersolC. V.Vause-EarlandT.IacovoneD. B.NewhartB.TrueG.FishmanD.HodgsonN.GitlinL. N. (2016). A randomized controlled trial to evaluate the veterans’ in-home program (VIP) for military veterans with traumatic brain injury and their families: Report on impact for family members. Physical Medicine and Rehabilitation, 8(6), 495–509. https://doi.org/10.1016/j.pmrj.2015.10.008
O’CathainA.CrootL.DuncanE.RousseauN.SwornK.TurnerK. M.YardleyL.HoddinottP. (2019). Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open, 9(8), Article e029954. https://doi.org/10.1136/bmjopen-2019-029954
60.
ØstergaardB.Mahrer-ImhofR.ShamaliM.NørgaardB.JeuneB.PedersenK. S.LauridsenJ. (2021). Effect of family nursing therapeutic conversations on patients with heart failure and their family members: Secondary outcomes of a randomised multicentre trial. Journal of Clinical Nursing, 30(5–6), 742–756. https://doi.org/10.1111/jocn.15603
61.
ØstergaardB.Mahrer-ImhofR.WagnerL.BaringtonT.VidebækL.LauridsenJ. (2018). Effect of family nursing therapeutic conversations on health-related quality of life, self-care, and depression among outpatients with heart failure: A randomized multi-centre trial. Patient Education and Counseling, 101(8), 1385–1393. https://doi.org/10.1016/j.pec.2018.03.006
62.
ÖstlundU.PerssonC. (2014). Examining family responses to Family Systems Nursing interventions. Journal of Family Nursing, 20(3), 259–286. https://doi.org/10.1177/1074840714542962
63.
PenrodV. (2021). Eleven-Year Update: Longitudinal Study on Traumatic Brain Injury Incurred by Members of the Armed Forces in Operation IRAQI FREEDOM and Operation ENDURING FREEDOM. Department of Defense. United States.
64.
PolitD. F.BeckC. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer Health.
65.
ShamaliM.KonradsenH.StasL.ØstergaardB. (2019). Dyadic effects of perceived social support on family health and family functioning in patients with heart failure and their nearest relatives: Using the Actor–Partner Interdependence Mediation Model. PLOS ONE, 14(6), Article e0217970. https://doi.org/10.1371/journal.pone.0217970
66.
ShamaliM.KonradsenH.SvavarsdottirE. K.ShahriariM.KetilsdottirA.ØstergaardB. (2021). Factors associated with family functioning in patients with heart failure and their family members: An international cross-sectional study. Journal of Advanced Nursing, 77(7), 3034–3045. https://doi.org/10.1111/jan.14810
67.
SheltonR. C.AdsulP.OhA.MoiseN.GriffithD. M. (2021). Application of an antiracism lens in the field of implementation science (IS): Recommendations for reframing implementation research with a focus on justice and racial equity. Implementation Research and Practice, 2, 26334895211049480. https://doi.org/10.1177/26334895211049482
68.
SheltonR. C.LeeM.BrotzmanL. E.CrookesD. M.JandorfL.ErwinD.Gage-BouchardE. A. (2019). Use of social network analysis in the development, dissemination, implementation, and sustainability of health behavior interventions for adults: A systematic review. Social Science & Medicine, 220, 81–101. https://doi.org/10.1016/j.socscimed.2018.10.013
SidaniS.FoxM.El-MasriM.M. (2020). Guidance for the reporting of intervention’s theory. Research and Theory for Nursing Practice: An International Journal, 34(1), 35–48.
71.
SingalA. G.HigginsP. D. R.WaljeeA. K. (2014). A primer on effectiveness and efficacy trials. Clinical and Translational Gastroenterology, 5(1), e45. https://doi.org/10.1038/ctg.2013.13
72.
SmithJ.AliP.BirksY.CurtisP.FairbrotherH.KirkS.SaltielD.ThompsonJ.SwallowV. (2020). Umbrella review of family-focused care interventions supporting families where a family member has a long-term condition. Journal of Advanced Nursing, 76(8), 1911–1923. https://doi.org/10.1111/jan.14367
SwallowV. M.CarolanI.SmithT.WebbN. J. A.KnaflK.SantacroceS.CampbellM.Harper-JonesM.HanifN.HallA. (2016). A novel Interactive Health Communication Application (IHCA) for parents of children with long-term conditions: Development, implementation, and feasibility assessment. Informatics for Health & Social Care, 41(1), 20–46. https://doi.org/10.3109/17538157.2014.948174
75.
SwallowV. M.KnaflK.SantacroceS.CampbellM.HallA. G.SmithT.CarolanI. (2014). An interactive health communication application for supporting parents managing childhood long-term conditions: Outcomes of a randomized controlled feasibility trial. JMIR Research Protocols, 3(4), e69. https://doi.org/10.2196/resprot.3716
76.
VenkateshV.ThongJ. Y. L.XuX. (2016). Unified theory of acceptance and use of technology: A synthesis and the road ahead. Journal of the Association for Information Systems, 17(5), 328–376. https://ssrn.com/abstract=2800121
77.
VoltelenBKonradsenHØstergaardB.Family Nursing Therapeutic Conversations in Heart Failure Outpatient Clinics in Denmark: Nurses' Experiences. J Fam Nurs. 2016;22(2):172-198. doi:10.1177/1074840716643879
WhallA. L. (1986). The family as the unit of care in nursing: A historical review. Public Health Nursing, 3(4), 240–249.
82.
WinterL.MoriartyH. J.RobinsonK.PiersolC. V.Vause-EarlandT.NewhartB.IacovoneD. B.HodgsonN.GitlinL. N. (2016). Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial. Brain Injury, 30(4), 373–387. https://doi.org/10.3109/02699052.2016.1144080
83.
WrayF.ClarkeD.CruiceM.ForsterA. (2021). Development of a self-management intervention for stroke survivors with aphasia using co-production and behaviour change theory: An outline of methods and processes. PLOS ONE, 16(11), Article e0259103. https://doi.org/10.1371/journal.pone.0259103
84.
WrightL. M.LeaheyM. (2012). Nurses and families: A guide to family assessment and intervention (6th ed.). F.A. Davis.
85.
WuY. P.DeatrickJ. A.McQuaidE. L.ThompsonD. (2019). A primer on mixed methods for pediatric researchers. Journal of Pediatric Psychology, 44(8), 905–913. https://doi.org/10.1093/jpepsy/jsz052
86.
YeagerK. A.Bauer-WuS. (2013). Cultural humility: Essential foundation for clinical researchers. Applied Nursing Research, 26(4), 251–256. https://doi.org/10.1016/j.apnr.2013.06.008
