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2 results

  • 22 - Evaluation of Behavior Change Interventions

  • from Part II - Methods and Processes of Behavior Change: Intervention Development, Application, and Translation
  • Edited by Martin S. Hagger, Linda D. Cameron, Kyra Hamilton, Griffith University, Nelli Hankonen, University of Helsinki, Taru Lintunen, University of Jyväskylä
  • Book:
    The Handbook of Behavior Change
    Published online:
    04 July 2020
    Print publication:
    23 July 2020, pp 318-332

  • Summary

    Rigorous evaluation of interventions is vital to advance the science of behavior change and identify effective interventions. Although randomized controlled trials (RCTs) are often considered the “gold standard”, other designs are also useful. Considerations when choosing intervention design are the research questions, the stage of evaluation, and different evaluation perspectives. Approaches to explore the utility of an intervention, include a focus on (1) efficacy; (2) “real-world” effectiveness; (3) how an intervention works to produce change; or (4) how the intervention interacts with context. Many evaluation designs are available: experimental, quasi-experimental, and nonexperimental. Each has strengths and limitations and choice of design should be driven by the research question. Choosing relevant outcomes is an important step in planning an evaluation. A typical approach is to identify one primary outcome and a narrow range of secondary outcomes. However, focus on one primary outcome means other important changes may be missed. A well-developed program theory helps identify a relevant outcomes. High-quality evaluation requires (1) involvement of relevant stakeholders; (2) evaluating and updating program theory; (3) consideration of the wider context; (4) addressing implementation issues; and (5) appropriate economics input. Addressing these can increase the quality, usefulness, and impact of behavior change interventions.

  • How much do we know about schizophrenia and how well do we know it? Evidence from the Schizophrenia Library

  • S. L. Matheson, A. M. Shepherd, V. J. Carr
  • Journal:
    Psychological Medicine / Volume 44 / Issue 16 / December 2014
    Published online by Cambridge University Press:
    20 February 2014, pp. 3387-3405
  • Background.

    True findings about schizophrenia remain elusive; many findings are not replicated and conflicting results are common. Well-conducted systematic reviews have the ability to make robust, generalizable conclusions, with good meta-analyses potentially providing the closest estimate of the true effect size. In this paper, we undertake a systematic approach to synthesising the available evidence from well-conducted systematic reviews on schizophrenia.

    Method.

    Reviews were identified by searching Medline, EMBASE, CINAHL, Current Contents and PsycINFO. The decision to include or exclude reviews, data extraction and quality assessments were conducted in duplicate. Evidence was graded as high quality if reviews contained large samples and robust results; and as moderate quality if reviews contained imprecision, inconsistency, smaller samples or study designs that may be prone to bias.

    Results.

    High- and moderate-quality evidence shows that numerous psychosocial and biomedical treatments are effective. Patients have relatively poor cognitive functioning, and subtle, but diverse, structural brain alterations, altered electrophysiological functioning and sleep patterns, minor physical anomalies, neurological soft signs, and sensory alterations. There are markers of infection, inflammation or altered immunological parameters; and there is increased mortality from a range of causes. Risk for schizophrenia is increased with cannabis use, pregnancy and birth complications, prenatal exposure to Toxoplasma gondii, childhood central nervous system viral infections, childhood adversities, urbanicity and immigration (first and second generation), particularly in certain ethnic groups. Developmental motor delays and lower intelligence quotient in childhood and adolescence are apparent.

    Conclusions.

    We conclude that while our knowledge of schizophrenia is very substantial, our understanding of it remains limited.