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Related Experiment Videos

Confounding in community interventions

R B Rothenberg1

  • 1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.

American Journal of Preventive Medicine
|November 1, 1993
PubMed
Summary

The case-control method offers a cost-effective way to evaluate community interventions, potentially reducing confounding risks. However, interventions with lower prevented fractions require careful interpretation due to increased susceptibility.

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Area of Science:

  • Epidemiology
  • Public Health Research
  • Intervention Science

Background:

  • Community intervention evaluations often use costly cohort studies.
  • These studies may lack sufficient statistical power for robust analysis.
  • Alternative methodologies are needed for efficient and powerful evaluation.

Purpose of the Study:

  • To explore the case-control approach as an alternative for community intervention evaluation.
  • To assess the potential for confounding in case-control evaluations of intervention effects.
  • To provide guidance on planning and interpreting community-based intervention studies.

Main Methods:

  • Simulation study based on case-control methodology.
  • Calculation of intervention program effect using the "prevented fraction" metric.

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  • Analysis of confounding threats at various levels of prevented fractions.

    • Main Results:

    • The case-control approach is a potentially inexpensive alternative to cohort studies for community interventions.
    • Confounding threats are modest for prevented fractions between 10% and 30%.
    • Community interventions with lower prevented fractions are more susceptible to confounding and require cautious interpretation.

    Conclusions:

    • The case-control method is a viable and potentially cost-effective approach for evaluating community interventions.
    • Investigators should consider the potential for confounding, especially for interventions with low prevented fractions.
    • This methodology can aid in planning and interpreting community-based disease control efforts.