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首页> 外文期刊>Health education & behavior: the official publication of the Society for Public Health Education >Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial
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Challenges and Innovations in a Community-Based Participatory Randomized Controlled Trial

机译：以社区为基础的挑战和创新参与的随机对照试验

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Randomized controlled trials (RCTs) are a long-standing and important design for conducting rigorous tests of the effectiveness of health interventions. However, many questions have been raised about the external validity of RCTs, their utility in explicating mechanisms of intervention and participants' intervention experiences, and their feasibility and acceptability. In the current mixed-methods study, academic and community partners developed and implemented an RCT to test the effectiveness of a collaboratively developed community-based advocacy, learning, and social support intervention. The goals of the intervention were to address social determinants of health and build trust and connections with other mental health services in order to reduce mental health disparities among Afghan, Great Lakes Region African, and Iraqi refugee adults and to engage and retain refugees in trauma-focused treatment, if needed. Two cohorts completed the intervention between 2013 and 2015. Ninety-three adult refugees were randomly assigned to intervention or control group and completed four research interviews (pre-, mid-, and postintervention, and follow-up). Several challenges to conducting a community-based RCT emerged, including issues related to interviewer intervention to assist participants in the control group, diffusion of intervention resources throughout the small refugee communities, and staff and community concerns about the RCT design and what evidence is meaningful to demonstrate intervention effectiveness. These findings highlight important epistemological, methodological, and ethical challenges that should be considered when conducting community-based RCTs and interpreting results from them. In addition, several innovations were developed to address these challenges, which may be useful for other community-academic partnerships engaged in RCTs.
机译：随机对照试验(相关的)长期以来,重要的设计进行严格的测试的有效性的健康干预措施。他们提出了相关的外部效度在进一步阐述的干预机制和参与者的干预的经验,他们的可行性和可接受性。目前的混合方法研究,学术和社区开发和实现了一个合作伙伴个随机对照试验来测试的有效性协同发展以社区为基础的宣传、学习、和社会支持干预。解决健康问题社会决定因素建立信任与其他心理和关系卫生服务以减少心理健康差距在阿富汗,大湖地区非洲、和伊拉克难民成年人和参与和保留的难民创伤治疗,如果需要的话。在2013年和2015年之间。难民被随机分配到干预对照组和四个研究完成面试(前、中期和postintervention,后续)。社区出现了个随机对照试验,包括问题协助相关官干预参与者在对照组,扩散的整个小干预资源难民社区和员工和社区担心个随机对照试验设计和什么证据有意义的演示干预有效性。认识论、方法论和道德挑战时应该考虑的开展以社区为基础的相关和解释从他们的结果。创新是解决这些对于其他的挑战,这可能是有用的从事相关community-academic伙伴关系。

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