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Review
. 2018 Apr 1:39:5-25.
doi: 10.1146/annurev-publhealth-040617-014128. Epub 2018 Jan 12.

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research

Margaret A Handley  1   2   3 , Courtney R Lyles  2   3 , Charles McCulloch  1 , Adithya Cattamanchi  3   4
Affiliations
Review

Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research

Margaret A Handley et al. Annu Rev Public Health. .

Abstract

Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

Keywords: external validity; implementation science; interrupted time series; prepost; quasi-experimental design; stepped wedge.

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Figures

Figure 1.
Figure 1.
Illustration of the Pre-Post Non-Equivalent Control Group Design
Figure 2.
Figure 2.
Interrupted Time Series Design
Figure 3.
Figure 3.
Illustration of the stepped wedge study design-Intervention Roll-Out Over Time* * Adapted from Turner et al 2017
Figure 4.
Figure 4.
Illustration of the stepped wedge study design- Summary of Exposed and Unexposed Cluster Time* Adapted from Hemming 2015
Fig 5.
Fig 5.
Quasi-Experimental Design Decision-Making Map
See this image and copyright information in PMC

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