Abstract
Increasingly, epidemiologists are faced with the need to evaluate the impact of an intervention that is delivered at the level of a community or cluster of individuals, rather than at the individual level. This hag profound implications for the design and interpretation of a study to evaluate its impact. We start by discussing the issues arising in the extension of the randomized double-blind controlled trial methodology to the evaluation of interventions delivered to clusters of individuals, or to whole communities, where the unit of randomization is a cluster of individuals rather than an individual we then consider alternative approaches to design, discuss their relative strengths and weaknesses and present a framework of design options. Finally we propose a pragmatic approach to evaluation design in this setting. We believe that the answer lies in the judicious selection of different design elements, combined in such a way that when the evidence from each is presented together, a clear picture of the impact of the intervention emerges. We illustrate this using an example from the recent literature.
Original language | English (US) |
---|---|
Pages (from-to) | 1022-1029 |
Number of pages | 8 |
Journal | Tropical Medicine and International Health |
Volume | 2 |
Issue number | 11 |
State | Published - 1997 |
Externally published | Yes |
Keywords
- Community-based interventions
- Developing countries
- Evaluation
- Study design
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Infectious Diseases
- Parasitology
- Immunology