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Applying the updated MRC framework for developing and evaluating complex interventions with integrated implementation

Louise Connell1,2, Suzanne Ackerley1,2, Jo Rycroft-Malone1

  • 1Lancaster Medical School, Lancaster University, Lancaster, United Kingdom.

Frontiers in Health Services
|May 21, 2025
PubMed
Summary

This study demonstrates applying the UK Medical Research Council (MRC) Framework with implementation science concepts to a telerehabilitation intervention. Integrating these frameworks enhances complex intervention development and evaluation for better healthcare delivery.

Keywords:
ERIC strategiesProctor's outcomescontextdeterminant frameworkimplementation research logic modelrehabilitationscale-upsustainability

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Area of Science:

  • Implementation Science
  • Healthcare Intervention Research
  • Rehabilitation Technology

Background:

  • The UK Medical Research Council (MRC) Framework guides complex intervention development and evaluation.
  • Limited evidence exists on the full application of the MRC Framework and its integration with implementation science knowledge.
  • This study addresses this gap by demonstrating an integrated approach using a telerehabilitation intervention.

Purpose of the Study:

  • To demonstrate the application of the updated MRC Framework incorporating implementation science frameworks, strategies, and outcomes.
  • To illustrate the integration of conceptual knowledge into the practical phases of the MRC Framework.
  • To provide a transferable example for rehabilitation and implementation research.

Main Methods:

  • Utilized the MRC Framework checklist and the Consolidated Framework for Implementation Research (CFIR) for context.
  • Employed a deliberative process to operationalize MRC phases, including adaptation and feasibility testing of the NeuroRehabilitation OnLine (NROL) intervention.
  • Integrated stakeholder input throughout, using the CFIR-ERIC matching tool for strategy identification and Proctor's outcomes for evaluation.

Main Results:

  • The MRC Framework provided a structured approach for addressing implementation uncertainties iteratively.
  • Stakeholder co-production was crucial across all phases and iterations.
  • An added sustainment phase informed decision-making for scaling up the NROL intervention, supported by co-produced Logic Models.

Conclusions:

  • The synergistic application of the MRC Framework and implementation science knowledge enriched the conceptualization and enactment of implementation.
  • This integrated approach enhances the development and evaluation of complex interventions, particularly in rehabilitation.
  • The study offers transferable knowledge to advance implementation research and practice.