A framework for process evaluations of psychological interventions

Student thesis: Doctoral ThesisDoctor of Philosophy


Randomised controlled trials are the gold standard for testing whether a new intervention produces change in outcome measures but they do not assess underlying mechanisms of action. Process evaluation is an overarching framework for studying potential mechanisms in complex interventions but is rarely applied. Researchers and funders have increasingly called for the inclusion of process evaluations alongside randomised controlled trials of complex interventions but there is no standardised approach. This has led to wide variation in frameworks and methods used. Psychological interventions are particularly complex as they use the collaboration between patient and provider as the conduit for change. Many psychological interventions are being tested in healthcare settings for people with long-term conditions, such as type 2 diabetes. Patients with type 2 diabetes require intensive daily management and have many psychological problems, which contribute to sub optimal control. The clinical setting for this thesis is the D6 study, which tested whether a nurse led psychological intervention could improve glycaemic control in people with type 2 diabetes compared to an attention control condition. A process evaluation of D6 is conducted using a process evaluation framework derived from the literature.
Date of Award1 Sept 2020
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorKhalida Ismail (Supervisor) & Kirsty Winkley (Supervisor)

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