Comparison of a phased experimental approach and a single randomized clinical trial for developing multicomponent behavioral interventions.
Comparison of a phased experimental approach and a single randomized clinical trial for developing multicomponent behavioral interventions.
复制标题
DOI：
10.1177/1740774508100973
复制
发表时间：
2009-02
期刊：
影响因子：
--
通讯作者：
Strecher V
中科院分区：
文献类型：
--
作者：
Collins LM;Chakraborty B;Murphy SA;Strecher V
当今健康科学中的许多干预措施都是多成分的，而且往往有一个或多个成分是行为的。可以确定两种建立经验性行为干预的方法。更常用的方法，在这里被称为经典方法，包括先验地构建可能的最佳干预，然后在标准的随机对照试验(RCT)中评估干预。相比之下，新出现的分阶段实验方法包括旨在确定个别干预组成部分的影响以及组成部分和水平的最佳组合的实证研究和发现的方案阶段。本文的目的是对经典实验方法和阶段性实验方法进行正面比较，从而突出这些方法在选择计划组成部分和水平时的相对优势和劣势，以达到最有效的干预。对同样随机产生的数据进行了计算机模拟，其中干预发展的经典和分阶段实验方法被应用于相同的随机产生的数据。当干预效应大小为中等或较大时，分阶段实验法的平均干预效果较好，而当干预效应大小较小时，经典实验方法的平均干预效果较好。阶段性实验方法在所有条件下以比经典方法更高的速度识别正确的干预成分和水平集。一些潜在的重要因素在模拟中没有变化，例如基本的结构模型和干预组件的数量。阶段性实验方法值得认真考虑，因为它有可能使干预科学家开发出更有效的行为干预措施。
Many interventions in today’s health sciences are multicomponent, and often one or more of the components are behavioral. Two approaches to building behavioral interventions empirically can be identified. The more typically used approach, labeled here the classical approach, consists of constructing a likely best intervention a priori, and then evaluating the intervention in a standard randomized controlled trial (RCT). By contrast, the emergent phased experimental approach involves programmatic phases of empirical research and discovery aimed at identifying individual intervention component effects and the best combination of components and levels. The purpose of this article is to provide a head-to-head comparison between the classical and phased experimental approaches and thereby highlight the relative advantages and disadvantages of these approaches when they are used to select program components and levels so as to arrive at the most potent intervention. A computer simulation was performed in which the classical and phased experimental approaches to intervention development were applied to the same randomly generated data. The phased experimental approach resulted in better mean intervention outcomes when the intervention effect size was medium or large, whereas the classical approach resulted in better mean intervention outcomes when the effect size was small. The phased experimental approach led to identification of the correct set of intervention components and levels at a higher rate than the classical approach across all conditions. Some potentially important factors were not varied in the simulation, for example the underlying structural model and the number of intervention components. The phased experimental approach merits serious consideration, because it has the potential to enable intervention scientists to develop more efficacious behavioral interventions.
登录
查看更多内容
DOI：
10.2165/00024677-200302050-00003
发表时间：
2003-01-01
期刊：
Treatments in endocrinology
影响因子：
--
作者：
Narayan, K M Venkat;Kanaya, Alka M;Gregg, Edward W
通讯作者：
Gregg, Edward W
DOI：
10.1177/107424840300800304
发表时间：
2003-09-01
影响因子：
2.6
作者：
Rukshin, Vladimir;Santos, Raul;Kaul, Sanjay
通讯作者：
Kaul, Sanjay
影响因子：
2.3
作者：
Cofta-Woerpel, Ludmila;Wright, Kelh L.;Wetter, David W.
通讯作者：
Wetter, David W.
制定和评估复杂的干预措施：新的医学研究委员会指南。
DOI：
10.1136/bmj.a1655
发表时间：
2008-09-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Craig P;Dieppe P;Macintyre S;Michie S;Nazareth I;Petticrew M;Medical Research Council Guidance
通讯作者：
Medical Research Council Guidance
影响因子：
45.3
作者：
Green, S;Liu, PY;O'Sullivan, J
通讯作者：
O'Sullivan, J