![]() ![]() Ramifications of interventions are not always apparent until they are fully evaluated. As the examples above point out, assessing risk factors may not be adequate. Many behavioral intervention trials document the capacity of interventions to modify risk factors (NHLBI, 1998), but relatively few Level I studies measured outcomes of life expectancy and quality of life. Only when primary health outcomes were considered was it established that the drug was dangerous (Cardiac Arrhythmia Suppression Trial (CAST) Investigators, 1989). If investigators had measured only heart rhythm changes, they would have concluded that the drug was beneficial. However, a randomized drug trial in 1455 post-infarction patients demonstrated that those who were randomly assigned to take an anti-arrhythmia drug showed reduced arrhythmia, but were significantly more likely to die from arrhythmia and from all causes than those assigned to take a placebo. Among adults who previously suffered a myocardial infarction, symptomatic cardiac arrhythmia is a risk factor for sudden death (Bigger, 1984). Another example can be found in the treatment of cardiac arrhythmia. (1999) demonstrated that intake of dietary sodium in overweight people was not related to the incidence of coronary heart disease but was associated with mortality form coronary heart disease. Inclusion of the full range of phases from hypothesis generation to demonstration research should facilitate development of a more balanced perspective on the value of behavioral and psychosocial interventions.Įt al, 1990). A range of research and evaluation methods are required to address diverse needs for scientific rigor, appropriateness and benefit to the communities involved, relevance to research questions, and flexibility in cost and setting. Those phases reflect the importance of methods development in providing a basis for large-scale trials and the need for studies of the dissemination and diffusion process as a means of identifying effective application strategies. The challenge of bridging research and practice is discussed with respect to clinical interventions, communities, public agencies, systems of health care delivery, and patients.ĭuring the early 1980s, the National Heart, Lung, and Blood Institute (NHLBI) and the National Cancer Institute (NCI) suggested a sequence of research phases for the development of programs that were effective in modifying behavior (Greenwald, 1984 Greenwald and Cullen, 1984 NHLBI, 1983): hypothesis generation (phase I), intervention methods development (phase II), controlled intervention trials (phase III), studies in defined populations (phase IV), and demonstration research (phase V). ![]() This chapter addresses the complex relationship between research and application. Use, however, existing knowledge must be evaluated and disseminated. Enough research evidence has accumulated to warrant wider application of this information. A recurrent theme is that continued multidisciplinary and interdisciplinary efforts are needed. The preceding chapters review contemporary research on health and behavior from the broad perspectives of the biological, behavioral, and social sciences. Information from physicians, community leaders, public health officials, and patients are all-important for determining the overall effectiveness of interventions. Furthermore, feedback is needed from practitioners to determine the overall effectiveness of interventions in real-life settings. Information about efficacious interventions needs to be disseminated to practitioners. Randomized clinical trials provide the most convincing evidence, but may not be suitable for examining all of the factors and interactions addressed in this report. The efficacy of interventions can only be determined by appropriately designed empirical studies. Medical practices and community-based programs are often based on professional consensus rather than evidence. The principles of science-based interventions cannot be overemphasized. However, this has proved surprisingly complex and is the source of considerable debate. Evaluating and Disseminating Intervention ResearchĮfforts to change health behaviors should be guided by clear criteria of efficacy and effectiveness of the interventions. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |