Methods for exploring implementation variation and local context within a cluster tandomised community intervention trial
Hawe, Penelope, Shiell, Alan, Riley, Therese and Gold, Lisa 2004, Methods for exploring implementation variation and local context within a cluster tandomised community intervention trial, Journal of epidemiology and community health, vol. 58, no. 9, pp. 788-793.
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Insignificant or modest findings in intervention trials may be attributable to poorly designed or theorised interventions, poorly implemented interventions, or inadequate evaluation methods. The pre-existing context may also account for the effects observed. A combination of qualitative and quantitative methods is outlined that will permit the determination of how context level factors might modify intervention effectiveness, within a cluster randomised community intervention trial to promote the health of mothers with new babies. The methods include written and oral narratives, key informant interviews, impact logs, and inter-organisational network analyses. Context level factors, which may affect intervention uptake, success, and sustainability are the density of inter-organisational ties within communities at the start of the intervention, the centrality of the primary care agencies expected to take a lead with the intervention, the extent of context-level adaptation of the intervention, and the amount of local resources contributed by the participating agencies. Investigation of how intervention effects are modified by context is a new methodological frontier in community intervention trial research.
This article has been accepted for publication in of Epidemiology and Community Health (JECH). The definitive copyedited, typeset version : Hawe, Penelope, Shiell, Alan, Riley, Therese and Gold, Lisa 2004-09, Methods for exploring implementation variation and local context within a cluster tandomised community intervention trial, Journal of epidemiology and community health, vol. 58, no. 9, pp. 788-793, is available online at : http://jech.bmj.com
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