Reviews

Health Intervention Research: Understanding Research Design & Methods

AFTER READING this book my initial thought was that it requires from the reader an understanding of experimental design, quantitative methods and statistics.

On reflection, reading this book to learn and engage with contemporary health intervention research (HIR) practice would enable novice researchers to overcome some of the historic baggage of the randomised controlled trial (RCT) with which HIR is beset.

The author provides researchers with evidence of the need for systematic evaluation of HIR design to ensure external validity for clinical utility rather than relying on historic practices and procedures.

Readers who want to get to the evaluation phase can learn much about the complexities of HIR in chapter 3, which addresses how to conceptualise problems and interventions, model a mechanism, achieving outcomes, and pilot an intervention protocol.

Due to the author’s interest in patient agency, the design and implementation of health intervention methodologies is placed in the context of the patient in a clinical setting.

The context mechanism outcome of realistic evaluation is mentioned in relation to critiques of causality. Researchers interested in this approach should perhaps follow debate about RCTs in Marchal et al (2013).

Chapter 7 of the book under review presents pragmatic and preference trials as alternatives to RCTs by exploring the utility of intervention evaluation designs under real-world conditions, and evaluating the effectiveness of interventions that are generalisable to practice settings. This chapter should appeal to practitioners interested in undertaking clinical research.

The book would benefit from a closing chapter that pulls together its sections on participant selection, assignment and retention, intervention implementation, and outcome measurement.

The book would be improved by a review of ethics on issues arising from the implementation of intervention evaluation designs, such as individual and group consent in cluster randomisation, and fidelity in contexts of every day clinical settings.

Operational ethical dilemmas and concerns could have been given greater prominence if they had been presented in a closing chapter.

Readers of this book should be prepared to be surprised about how far HIR has advanced. As the author says, health intervention research shares some of the space occupied by so-called ‘doing with and by’ methodologies.

This article is for subscribers only