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 has 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.
Mots-clés Pascal : Evaluation, Intervention, Communauté, Lutte sanitaire, Homme, Pays en développement, Résultat
Mots-clés Pascal anglais : Evaluation, Operation, Community, Sanitary control, Human, Developing countries, Result
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0007739
Code Inist : 002B30A01C. Création : 17/04/1998.