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Context by treatment interactions as the primary object of study in cluster randomized controlled trials of population health interventions

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  • Daniel Fuller
  • Louise Potvin

Abstract

Cluster randomized controlled trials are increasingly used in population health intervention research. Through randomization, researchers attempt to isolate the treatment effect and remove all other effects, including any effects of social context. In many cases, the constant effect assumption cannot be satisfied in cluster randomized controlled trials. We argue that when studying population health interventions, the effective mechanism of intervention lies in the interaction between the treatment and social context. Researchers should be cognizant that attempts to remove the effect of social context using CRTC may fail. The interaction between the treatment and social context should be the primary object of study in population health intervention research. Copyright Swiss School of Public Health 2012

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  • Daniel Fuller & Louise Potvin, 2012. "Context by treatment interactions as the primary object of study in cluster randomized controlled trials of population health interventions," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(3), pages 633-636, June.
    • Handle: RePEc:spr:ijphth:v:57:y:2012:i:3:p:633-636
    DOI: 10.1007/s00038-012-0357-x
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    1. West, S.G. & Duan, N. & Pequegnat, W. & Gaist, P. & Des Jarlais, D.C. & Holtgrave, D. & Szapocznik, J. & Fishbein, M. & Rapkin, B. & Clatts, M. & Mullen, P.D., 2008. "Alternatives to the randomized controlled trial," American Journal of Public Health, American Public Health Association, vol. 98(8), pages 1359-1366.
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    Cited by:

    1. Aarestrup, Anne Kristine & Jørgensen, Thea Suldrup & Due, Pernille & Krølner, Rikke, 2014. "A six-step protocol to systematic process evaluation of multicomponent cluster-randomised health promoting interventions illustrated by the Boost study," Evaluation and Program Planning, Elsevier, vol. 46(C), pages 58-71.
    2. Till Bärnighausen, 2017. "Population health intervention research: three important advancements," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(8), pages 841-843, November.
    3. Andersen, Susan & Rod, Morten Hulvej & Ersbøll, Annette Kjær & Stock, Christiane & Johansen, Christoffer & Holmberg, Teresa & Zinckernagel, Line & Ingholt, Liselotte & Sørensen, Betina Bang & Tolstrup, 2016. "Effects of a settings-based intervention to promote student wellbeing and reduce smoking in vocational schools: A non-randomized controlled study," Social Science & Medicine, Elsevier, vol. 161(C), pages 195-203.
    4. David McQueen, 2014. "Evidence and harm: time for reflection," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(1), pages 1-2, February.

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