PT  - JOURNAL ARTICLE
AU  - Penelope Hawe
AU  - Alan Shiell
AU  - Therese Riley
AU  - Lisa Gold
TI  - Methods for exploring implementation variation and local context within a cluster randomised community intervention trial
AID  - 10.1136/jech.2003.014415
DP  - 2004 Sep 01
TA  - Journal of Epidemiology and Community Health
PG  - 788--793
VI  - 58
IP  - 9
4099  - http://jech.bmj.com/content/58/9/788.short
4100  - http://jech.bmj.com/content/58/9/788.full
SO  - J Epidemiol Community Health2004 Sep 01; 58
AB  - Insignificant or modest findings in intervention trials may be attributable to poorly designed or theorised interventions, poorly implemented interventions, or inadequate evaluation methods. The pre-existing context may also account for the effects observed. A combination of qualitative and quantitative methods is outlined that will permit the determination of how context level factors might modify intervention effectiveness, within a cluster randomised community intervention trial to promote the health of mothers with new babies. The methods include written and oral narratives, key informant interviews, impact logs, and inter-organisational network analyses. Context level factors, which may affect intervention uptake, success, and sustainability are the density of inter-organisational ties within communities at the start of the intervention, the centrality of the primary care agencies expected to take a lead with the intervention, the extent of context-level adaptation of the intervention, and the amount of local resources contributed by the participating agencies. Investigation of how intervention effects are modified by context is a new methodological frontier in community intervention trial research.