BMJ  2004;328:282-285 (31 January), doi:10.1136/bmj.328.7434.282

Education and debate

Evaluating the health effects of social interventions

¹ MRC Social and Public Health Sciences Unit, Glasgow, G12 8RZ, ² Nursing and Midwifery School, University of Glasgow, Glasgow, ³ Public Health and Health Policy, Division of Community Based Sciences, University of Glasgow, ⁴ Easterhouse Money Advice Centre, Easterhouse, Glasgow, ⁵ School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, Glasgow

Is no evidence better than any evidence when controlled studies are unethical?

The first 150 words of the full text of this article appear below.

Rigorous evidence on the health effects of social interventions is scarce^{1 2} despite calls for more evidence from randomised studies.³ One reason for the lack of such experimental research on social interventions may be the perception among researchers, policymakers, and others that randomised designs belong to the biomedical world and that their application to social interventions is both unethical and simplistic.⁴ Applying experimental designs to social interventions may be problematic but is not always impossible and is a desirable alternative to uncontrolled experimentation.³ However, even when randomised designs have been used to evaluate social interventions, opportunities to incorporate health measures have often been missed.⁵ For example, income supplementation is thought to be a key part of reducing health inequalities,⁶ but rigorous evidence to support this is lacking because most randomised controlled trials of income supplementation have not included health measures.⁵ Current moves to increase uptake of benefits offer new opportunities to . . . [Full text of this article]

-->
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Developing and evaluating complex interventions: the new Medical Research Council guidance

Peter Craig, Paul Dieppe, Sally Macintyre, Susan Michie, Irwin Nazareth, and Mark Petticrew
BMJ 2008 337: a1655. [Full Text]

Effect of insulating existing houses on health inequality: cluster randomised study in the community

Philippa Howden-Chapman, Anna Matheson, Julian Crane, Helen Viggers, Malcolm Cunningham, Tony Blakely, Chris Cunningham, Alistair Woodward, Kay Saville-Smith, Des O'Dea, Martin Kennedy, Michael Baker, Nick Waipara, Ralph Chapman, and Gabrielle Davie
BMJ 2007 334: 460. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Thomson, H (2008). A dose of realism for healthy urban policy: lessons from area-based initiatives in the UK. J. Epidemiol. Community Health 62: 932-936 [Abstract] [Full text]  
• Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., Petticrew, M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ 337: a1655-a1655 [Full text]  
• Howden-Chapman, P., Matheson, A., Crane, J., Viggers, H., Cunningham, M., Blakely, T., Cunningham, C., Woodward, A., Saville-Smith, K., O'Dea, D., Kennedy, M., Baker, M., Waipara, N., Chapman, R., Davie, G. (2007). Effect of insulating existing houses on health inequality: cluster randomised study in the community. BMJ 334: 460-460 [Abstract] [Full text]  
• Thomson, H., Morrison, D., Petticrew, M. (2007). The health impacts of housing-led regeneration: a prospective controlled study. J. Epidemiol. Community Health 61: 211-214 [Abstract] [Full text]  
• Stronks, K., Mackenbach, J. P. (2006). Evaluating the effect of policies and interventions to address inequalities in health: lessons from a Dutch programme. Eur J Public Health 16: 346-353 [Abstract] [Full text]  
• Joffe, M., Mindell, J. (2006). Complex Causal Process Diagrams for Analyzing the Health Impacts of Policy Interventions. AJPH 96: 473-479 [Abstract] [Full text]  
• Ogilvie, D., Egan, M., Hamilton, V., Petticrew, M. (2005). Systematic reviews of health effects of social interventions: 2. Best available evidence: how low should you go?. J. Epidemiol. Community Health 59: 886-892 [Abstract] [Full text]  
• Ogilvie, D., Hamilton, V., Egan, M., Petticrew, M. (2005). Systematic reviews of health effects of social interventions: 1. Finding the evidence: how far should you go?. J. Epidemiol. Community Health 59: 804-808 [Abstract] [Full text]  
• Muir, M. (2005). Hygieia. J. Epidemiol. Community Health 59: 176-176 [Full text]  
• Powell, J. E., Langley, C., Kirwan, J., Gubbay, D., Memel, D., Pollock, J., Means, R., Hewlett, S. (2004). Welfare rights services for people disabled with arthritis integrated in primary care and hospital settings: set-up costs and monetary benefits. Rheumatology (Oxford) 43: 1167-1172 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Improving Access and improving health - social intervention does work. The case for "simplistic" evidence!

Stephen Ferguson
bmj.com, 30 Jan 2004 [Full text]

Attendance Allowance

Robert A Billings
bmj.com, 4 Feb 2004 [Full text]

RCT may not be the 'gold standard'

Trisha Greenhalgh, et al.
bmj.com, 11 Feb 2004 [Full text]

Re: Attendance Allowance

Robert Hoskins, et al.
bmj.com, 12 Feb 2004 [Full text]

Evaluation of social interventions should reflect their complexity

Suzanne Moffatt, et al.
bmj.com, 17 Feb 2004 [Full text]

Re: RCT may not be the 'gold standard'

Vicki J Strange, et al.
bmj.com, 18 Feb 2004 [Full text]

An opportunity to broaden the "Gold Standard" debate?

Aidan P. O'Hora
bmj.com, 19 Feb 2004 [Full text]

Evaluating the health effects of social interventions: studying the Torbay Financial Assessments and Benefits Team

Suzanne Richards, et al.
bmj.com, 5 Mar 2004 [Full text]

Authors Response

Hilary Thomson, et al.
bmj.com, 10 Mar 2004 [Full text]

Re: RCT may not be the 'gold standard'

Robert T Mathie
bmj.com, 6 Apr 2004 [Full text]

Online poll

Find out more >>