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The TRIPLE C study aims to:

  1. Analyse the contribution of case study methods to our understanding of contextual influences on complex interventions in health systems and public health research
  2. Consult case study experts to develop and publish guidance on the design, conduct, analysis and reporting of case studies for use in health systems and public health research
  3. Stimulate the development of a community of practice which will collaborate on extending and improving the use of case studies in the evaluation of complex health interventions.


There has been growing interest in developing research methods that support improved development and implementation in health care, and in ways that account for the contexts (communities, organisations and so on) in which complex interventions are intended. Case study research is widely recognised as offering such methods, and as a vital resource for understanding the influence of context on complex interventions.

A significant literature on case study research already exists in health services research and the social sciences. This literature has evolved out of different disciplines (e.g. psychology, sociology, management), and research traditions (e.g. qualitative or quantitative). It has yet to be interrogated in a way that can support improved development and implementation of complex interventions in health care and public health.


Meta-narrative review: a systematic, theory-driven approach to synthesising a wide-ranging literature. This approach will help us to understand how case study methods have been differently conceptualised and used by different groups of researchers, with a focus on the relationship between context and interventions.

Having synthesised the relevant literature, the focus will then be on conducting a DELPHI survey with experts in case study research in which we will share our synthesis of the literature to stimulate reflection and work towards getting as close as possible to consensus on the use of case study when researching complex interventions.

Evolving guidance will be tested on pilot case studies, workshops and ongoing debates. We will develop methodological guidance on how to design and carry out case studies of complex interventions in health care, and publish standards for case study-based research on complex interventions.

The Triple C reporting guideline under development is now live in the EQUATOR Network website. You can visit it here.  

The TRIPLE C review is registered on PROSPERO.

Team publications

  1. Paparini S, Papoutsi C, Murdoch J, Green J, Petticrew M, Greenhalgh T, Shaw SE. Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches. BMC medical research methodology. 2021 Dec;21(1):1-22.
  2. Paparini S, Green J, Papoutsi C, Murdoch J, Petticrew M, Greenhalgh T, Hanckel B, Shaw S. Case study research for better evaluations of complex interventions: rationale and challenges. BMC Medicine. 2020 Dec;18(1):301
  3. Hanckel B, Petticrew M, Thomas J, Green J. The use of Qualitative Comparative Analysis (QCA) to address causality in complex systems: a systematic review of research on public health interventions. BMC public health. 2021 Dec;21(1):1-22.

TEAM Presentations

1. Murdoch, J. Paparini, S. Papoutsi, C. and Shaw, S.  Enhancing precision in the investigation of context Study findings from Triple C. 4th UK Implementation Science Research Conference, King’s College London, London, UK, 15 and 16 July 2021

2. Paparini, S. Murdoch, J. Papoutsi, C. and Shaw, S. ‘Constructions of context in case study research: findings from a methodological study about case study, context and complex health interventions’. BSA Medical Sociology 2021 Annual Conference (online only) September 2021. 



Medical Research Council.


External collaborators:

Dr Jamie Murdoch (King's College London)

Prof Judith Green (University of Exeter)

Prof Mark Petticrew (London School of Hygiene and Tropical Medicine)