Intervention dose estimation in health promotion programmes: a framework and a tool. Application to the diet and physical activity promotion PRALIMAP trial

BMC Medical Research Methodology

Serge Briançon¹  Nathalie Thilly⁴  Evelyne Aptel⁶  Edith Lecomte⁵  Jean François Collin³  Fabienne Empereur²  Clotilde Latarche²  Emilie Bonsergent³  Karine Legrand² 

[1] Clinical epidemiology and evaluation department, University Hospital of Nancy, Allée du morvan, 54505, Vandoeuvre-lès-Nancy Cedex, France;CHU Nancy, Epidémiologie et Evaluation Cliniques, Nancy, France;Université de Lorraine, Faculté de Médecine, Ecole de Santé Publique, Nancy, France;Université de Lorraine, Université Paris Descartes, EA 4360 Apemac, Nancy, France;National conservatory of arts and crafts (CNAM), Nancy, France;Local school office of the Nancy-Metz academy, Nancy, France

关键词: Evaluation;    Process;    Dose;    Implementation;    Programme;    Health promotion;   

Others  :  1126700
DOI  :  10.1186/1471-2288-12-146

 received in 2012-03-16, accepted in 2012-07-28,  发布年份 2012

【 摘 要 】

Background

Although the outcomes of health promotion and prevention programmes may depend on the level of intervention, studies and trials often fail to take it into account. The objective of this work was to develop a framework within which to consider the implementation of interventions, and to propose a tool with which to measure the quantity and the quality of activities, whether planned or not, relevant to the intervention under investigation. The framework and the tool were applied to data from the diet and physical activity promotion PRALIMAP trial.

Methods

A framework allowing for calculation of an intervention dose in any health promotion programme was developed. A literature reviews revealed several relevant concepts that were considered in greater detail by a multidisciplinary working group. A method was devised with which to calculate the dose of intervention planned and that is actually received (programme-driven activities dose), as well as the amount of non-planned intervention (non-programme-driven activities dose).

Results

Indicators cover the roles of all those involved (supervisors, anchor personnel as receivers and providers, targets), in each intervention-related groups (IRG: basic setting in which a given intervention is planned by the programme and may differ in implementation level) and for every intervention period. All indicators are described according to two domains (delivery, participation) in two declensions (quantity and quality). Application to PRALIMAP data revealed important inter- and intra-IRG variability in intervention dose.

Conclusions

A literature analysis shows that the terminology in this area is not yet consolidated and that research is ongoing. The present work provides a methodological framework by specifying concepts, by defining new constructs and by developing multiple information synthesis methods which must be introduced from the programme's conception. Application to PRALIMAP underlined the feasibility of measuring the implementation level. The framework and the tool can be used in any complex programme evaluation. The intervention doses obtained could be particularly useful in comparative trials.

Trial registration

PRALIMAP is registered at ClinicalTrials.gov under NCT00814554

【 授权许可】

   
2012 Legrand et al.; licensee BioMed Central Ltd.

【 图 表 】

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