Methods for exploring implementation variation and local context within a cluster randomised community intervention trial
Methods for exploring implementation variation and local context within a cluster randomised community intervention trial
复制标题
DOI：
10.1136/jech.2003.014415
复制
发表时间：
2004-09-01
影响因子：
6.3
通讯作者：
Gold, L
中科院分区：
文献类型：
--
作者：
Hawe, P;Shiell, A;Gold, L
干预试验中不显著或不明显的发现可能归因于设计不当或理论化的干预措施、实施不当的干预措施或不适当的评估方法。先前存在的背景也可以解释观察到的影响。定性和定量方法的结合将允许在一项促进新生婴儿母亲健康的群组随机社区干预试验中确定背景水平因素如何改变干预效果。这些方法包括书面和口头叙述、关键线人访谈、影响日志和组织间网络分析。背景层面的因素可能影响干预的接受、成功和可持续性，包括干预开始时社区内部组织间联系的密度、预期主导干预的初级保健机构的中心地位、干预的背景水平适应程度以及参与机构贡献的当地资源数量。研究干预效果如何受情境影响是社区干预试验研究的一个新的方法论前沿。
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 interorganisational 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.