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Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?

It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges i...

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Autores principales: Bolton, Derek, Khazaezadeh, Nina, Carr, Ewan, Bolton, Matthew, Platsa, Eirini, Moore-Shelley, Imogen, Luderowski, Ana, Demilew, Jill, Brown, June
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177613/
https://www.ncbi.nlm.nih.gov/pubmed/32272680
http://dx.doi.org/10.3390/ijerph17072523
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author Bolton, Derek
Khazaezadeh, Nina
Carr, Ewan
Bolton, Matthew
Platsa, Eirini
Moore-Shelley, Imogen
Luderowski, Ana
Demilew, Jill
Brown, June
author_facet Bolton, Derek
Khazaezadeh, Nina
Carr, Ewan
Bolton, Matthew
Platsa, Eirini
Moore-Shelley, Imogen
Luderowski, Ana
Demilew, Jill
Brown, June
author_sort Bolton, Derek
collection PubMed
description It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, the inconsistency of the intervention across sites and, second, the absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy, and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames, and methodologies. In one, the sampling frame and methodology were under community control, permitting a comparison of change in outcomes before and after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results, however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, the measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis.
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spelling pubmed-71776132020-04-28 Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible? Bolton, Derek Khazaezadeh, Nina Carr, Ewan Bolton, Matthew Platsa, Eirini Moore-Shelley, Imogen Luderowski, Ana Demilew, Jill Brown, June Int J Environ Res Public Health Article It is widely recognized that public health interventions benefit from community engagement and leadership, yet there are challenges to evaluating complex, community-led interventions assuming hierarchies of evidence derived from laboratory experimentation and clinical trials. Particular challenges include, first, the inconsistency of the intervention across sites and, second, the absence of researcher control over the sampling frame and methodology. This report highlights these challenges as they played out in the evaluation of a community-organized health project in South London. The project aimed to benefit maternal mental health, health literacy, and social capital, and especially to engage local populations known to have reduced contact with statutory services. We evaluated the project using two studies with different designs, sampling frames, and methodologies. In one, the sampling frame and methodology were under community control, permitting a comparison of change in outcomes before and after participation in the project. In the other, the sampling frame and methodology were under researcher control, permitting a case-control design. The two evaluations led to different results, however: participants in the community-controlled study showed benefits, while participants in the researcher-controlled study did not. The principal conclusions are that while there are severe challenges to evaluating a community-led health intervention using a controlled design, the measurement of pre-/post-participation changes in well-defined health outcomes should typically be a minimum evaluation requirement, and confidence in attributing causation of any positive changes to participation can be increased by use of interventions in the project and in the engagement process itself that have a credible theoretical and empirical basis. MDPI 2020-04-07 2020-04 /pmc/articles/PMC7177613/ /pubmed/32272680 http://dx.doi.org/10.3390/ijerph17072523 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bolton, Derek
Khazaezadeh, Nina
Carr, Ewan
Bolton, Matthew
Platsa, Eirini
Moore-Shelley, Imogen
Luderowski, Ana
Demilew, Jill
Brown, June
Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title_full Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title_fullStr Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title_full_unstemmed Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title_short Evaluation of a Community-Led Intervention in South London: How Much Standardization Is Possible?
title_sort evaluation of a community-led intervention in south london: how much standardization is possible?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177613/
https://www.ncbi.nlm.nih.gov/pubmed/32272680
http://dx.doi.org/10.3390/ijerph17072523
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