Problematisations of Complexity: On the Notion and Production of Diverse Complexities in Healthcare Interventions and Evaluations

Within the literature on the evaluation of health (policy) interventions, complexity is a much-debated issue. In particular, many claim that so-called ‘complex interventions’ pose different challenges to evaluation studies than apparently ‘simple interventions’ do. Distinct ways of doing evaluation entail particular ontologies and epistemologies of complexity. They differ in terms of whether they define complexity as a quantitative trait of interventions, whether they see evaluation as part of or outside the intervention, and whether complexity can be regarded as an emergent property of the intervention and its evaluation. In practice, evaluators and commissioners of large health care improvement programmes rely on different, sometimes contradictory, repertoires about what it means to conduct a ‘good’ evaluation. This is an ongoing matter negotiated between and among commissioners, researchers, and—sometimes—programme managers. In particular, notions of evaluability, usefulness and distance/independence are problematised in different ways and with diverse consequences, which, in turn, produce other notions and layers of complexity such as temporal, institutional and affective complexities. When (social science) researchers claim that one method or another is better able to grasp complexity, they elide the issue that any methodological choice emphasises some complexities and lets others fade into the background. Analysing the practicalities and emotions involved in evaluation studies opens up the notion of complexity to analytical scrutiny, and suggests a basis for co-theorising between biomedical, public health and social scientists (including Science and Technology Studies scholars).     

An integrative framework on the impact of allies: How identity-based needs influence intergroup solidarity and social movements

What impact do advantaged group allies have within social movements? Although solidarity between advantaged and disadvantaged group members is often encouraged to achieve long-term social change, allies run the risk of being ineffective or counterproductive, therefore making it important to shift our focus towards understanding the impact of allies. We propose an integrative theoretical framework describing the positive and negative impact of allies based on their distinct identity-based needs: advantaged group members’ need for moral acceptance and disadvantaged group members’ need for empowerment and respect. By consolidating extant literature and identifying gaps in prior research, we propose a set of hypotheses concerning (a) tensions that arise within intergroup solidarity efforts for social change between advantaged group allies and disadvantaged group members, and (b) the role of allies in influencing broader public opinion to advance the psychology of social change.