Evaluating complex interventions Flashcards
What is an intervention?
a set of planned actions that are designed to bring about desired changes in defined beneficiaries in order to address a health or social problem
What is a complex intervention?
made up of many components that act both on their own and in conjunction with each other
What are the aspects of the MRC framework?
feasibility/ piloting
evaluation
implementation
development
What are the parts of feasibility / piloting?
testing procedures
estimating recruitment / retention
determining sample size
What are the parts of evaluation?
Assessing effectiveness
understanding change process
assessing cost- effectiveness
What are the parts of implementation?
dissemination
surveillance and monitoring
long term follow up
What are the parts of development?
identifying evidence base
developing theory
modelling process and outcomes
what is the theory of change?
a comprehensive description and illustration of how and why the desired change is expected to happen in a particular context
What is a logic model?
a diagrammatic representation of an intervention
describing anticipated delivery mechanisms
what is process evaluation?
a study which aims to understand the functioning of an intervention, by examining implementation , mechanisms of impact and contextual factors
complimentary to but not a substitute for high quality outcomes evaluation
Why is process evaluation necessary?
to know whether the study succeeded due to its context and wouldn’t work elsewhere or whether it failed due to its context and could succeed elsewhere
checks that it could be reproduced
that it will produce same outcomes in different context
how it was implemented
whether the intervention could benefit any of the target population
What is health economics?
the study of how scarce resources are allocated among alternative uses for the care of the sick and health promotion, maintenance and improvement of health
What is cost-effectiveness analysis?
CEA
measures outcomes as natural units
cost per unit effective - e.g. lives saved, symptom free days etc
What is cost-utility analysis?
CUA
measures health outcomes in terms of QALYs
can be used to directly compare different interventions
