Gulliford S Chinn JAC Sterne PGJ Burney Department of Public Health Sciences, Guy's, King's and St Thomas' School of Medicine, King's College London, UK Background Health technology assessment often requires the evaluation of interventions which are implemented at the level of geographical area or health service organisational unit. Examples include health promotion interventions implemented in schools, workplaces or neighbourhoods, screening programmes in health authority populations, and healthcare interventions in general practices or hospitals. Interventions like these are implemented for clusters of individuals. Evaluation of cluster-based interventions presents a number of difficulties but some evidence suggests these are not always addressed in an optimal manner. This report describes a systematic review of methods for evaluating cluster-based interventions.
Methods is a bullet.
The review focused on methods for evaluating health and healthcare interventions that are implemented for clusters of patients or healthy individuals. References were obtained by handsearching journals, searching electronic databases, screening cited references, contacting expert informants, and searching the world wide web. Synthesis into a methodological checklist was by means of qualitative judgements concerning validity. A review of seven health science journals in 1996 yielded 56 papers reporting evaluations of cluster-based interventions. Evaluation against the checklist of methodological recommendations identified the main departures from good practice.