多层次干预阶段形设计 (MLI-SWDs)
John Sperger1, Michael R Kosorok2, Laura Linnan3
1Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, USA. jsperger@live.unc.edu.
概括
本研究介绍了一种新的多层次干预阶段设计 (MLI-SWD),以解决健康公平研究中的方法挑战. MLI-SWD结合了集群和个人随机化,以进行可靠的干预效应估计.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 多层次干预 (MLI) 通过针对健康的社会决定因素,显示出减少健康不平等的潜力.
- 方法上的挑战和缺少样本大小计算工具阻碍了MLI的发展.
研究的目的:
- 提出和描述多层干预阶段设计 (MLI-SWD),一种混合实验设计.
- 为MLI-SWD提供样本大小和功率计算工具.
- 将MLI-SWD的适用性扩展到动态群体.
主要方法:
- MLI-SWD结合了集群级 (CL) 随机化 (步骤设计) 和独立的个人级 (IL) 随机化.
- 该设计适用于各种研究类型 (截面,队列) 和观察模式 (完整,不完整).
- 一般化估计方程和R包适用于样本大小计算.
主要成果:
- MLI-SWD允许估计个人层面,集群层面和联合干预效应,包括相互作用.
- 拟议的方法和R套件有助于MLI-SWD的样本大小和功率计算.
- 该研究将MLI-SWD扩展到个人动态加入集群的环境.
结论:
- MLI-SWD为评估MLIs提供了一个强大的框架,解决了关键的方法差距.
- 开发的工具支持高效设计和分析复杂的多层次卫生干预措施.
- 扩展到动态种群扩大了MLI-SWD在现实环境中的应用.
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