Table 2 Summary of actions taken in intervention development and their rationales

1. Identify a need for an intervention

Interventions that meet a recognised health need are more likely to be implemented and used in the real world

2. Select the intervention development approach

Published approaches are systematic and transparent and therefore are more likely to lead to effective interventions

3. Consider the needs and circumstances of the target population

When interventions take into account the needs and circumstances of the target population, they are more likely to be accessible, acceptable, and relevant to that population, who then are more likely to engage and adhere to them

4. Determine the level(s) that the intervention will target, i.e. individual, organisational, environmental

Identifying the nature and potential impact of interactions between the intervention and different levels of influence allows the development of components to facilitate, mitigate, or mediate these interactions

5. Identify in-depth understanding of the setting for delivering the intervention

In-depth understanding of the setting is more likely to lead to credible solutions to delivering the intervention, which in turn may lead to an intervention that is feasible to implement in that setting, and therefore more likely to be implemented in the real world if found to be effective

6. Review published evidence on existing interventions

Research wastage associated with unnecessary new intervention development may be reduced if interventions are based on existing interventions or components shown to be effective in different contexts and adapted for a different health issue, population, or setting

7. Involve stakeholders

If relevant perspectives are used to shape the intervention, then it is more likely to be relevant, culturally appropriate, credible, and acceptable to those delivering or receiving the intervention, leading to implementation and engagement in the real world if found to be effective

8. Draw on existing theory and/or generate intervention-specific theory (programme theory)

Theory can help to identify relevant intervention components likely be effective in the target population, and it can illustrate how inputs produce outcomes to enable replication and evaluation of the impact of the intervention

9. Design the intervention

Designing an intervention that is feasible and acceptable to those delivering it and accessible to the target population leads to an intervention that is more likely to be implemented and used in the real world if found to be effective

10. Refine the intervention by assessing early feasibility and acceptability with stakeholders

Obtaining feedback on early versions of the intervention is more likely to produce a final intervention that is feasible and acceptable and therefore more likely to be used by the target population and implemented in the real world