scholarly journals Reopening schools safely in the face of COVID-19: Can cluster randomized trials help?

2021 ◽  
pp. 174077452098486
Author(s):  
Charles Weijer ◽  
Karla Hemming ◽  
Spencer Phillips Hey ◽  
Holly Fernandez Lynch
Keyword(s):  
Randomized Trials ◽  
Cluster Randomized Trial ◽  
Evidence Based ◽  
School Closures ◽  
School Aged Children ◽  
The Face ◽  
Community Transmission ◽  
Cluster Randomized ◽  
The Impact ◽  
Health Policymaking

The COVID-19 pandemic has highlighted the challenges of evidence-based health policymaking, as critical precautionary decisions, such as school closures, had to be made urgently on the basis of little evidence. As primary and secondary schools once again close in the face of surging infections, there is an opportunity to rigorously study their reopening. School-aged children appear to be less affected by COVID-19 than adults, yet schools may drive community transmission of the virus. Given the impact of school closures on both education and the economy, schools cannot remain closed indefinitely. But when and how can they be reopened safely? We argue that a cluster randomized trial is a rigorous and ethical way to resolve these uncertainties. We discuss key scientific, ethical, and resource considerations both to inform trial design of school reopenings and to prompt discussion of the merits and feasibility of conducting such a trial.

scholarly journals The impact of providing rapid diagnostic malaria tests on fever management in the private retail sector in Ghana: a cluster randomized trial

BMJ ◽  
2015 ◽  
Vol 350 (mar04 8) ◽  
pp. h1019-h1019 ◽  
Author(s):  
E. K. Ansah ◽  
S. Narh-Bana ◽  
H. Affran-Bonful ◽  
C. Bart-Plange ◽  
B. Cundill ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Retail Sector ◽  
Cluster Randomized ◽  
The Impact ◽  
Fever Management

scholarly journals Assessing the impact of a school-based latrine cleaning and handwashing program on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial

2014 ◽  
Vol 19 (10) ◽  
pp. 1185-1197 ◽  
Author(s):  
Bethany A. Caruso ◽  
Matthew C. Freeman ◽  
Joshua V. Garn ◽  
Robert Dreibelbis ◽  
Shadi Saboori ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Nyanza Province ◽  
School Based ◽  
Cluster Randomized ◽  
The Impact

scholarly journals The evaluation of Suchana, a large-scale development program to prevent chronic undernutrition in north-eastern Bangladesh

2020 ◽  
Author(s):  
Nuzhat Choudhury ◽  
Mohammad Jyoti Raihan ◽  
S M Tanvir Ahmed ◽  
Kazi Eliza Islam ◽  
Vanessa Self ◽  
...  
Keyword(s):  
Large Scale ◽  
Development Program ◽  
Cluster Randomized Trial ◽  
Baseline Survey ◽  
Poor People ◽  
Poor Households ◽  
Service Delivery Systems ◽  
Administrative Unit ◽  
Cluster Randomized ◽  
The Impact

Abstract Evidence of the impact of community-based nutrition programs is uncommon for two main reasons: the lack of untreated controls, and implementation does not account for the evaluation design. Suchana is a large-scale program to prevent malnutrition in children in Sylhet Division, Bangladesh by improving the livelihoods and nutrition knowledge of poor and very poor households. Suchana is being implemented in 157 unions, the smallest administrative unit of government, in two districts of Sylhet. Suchana will deliver a package of interventions to poor people in about 40 randomly selected new unions annually over four years, until all are covered. All beneficiaries will receive the normal government nutrition services. For evaluation purposes the last 40 unions will act as a control for the first 40 intervention unions. The remaining unions will receive the program but will not take part in the evaluation. A baseline survey was conducted in both intervention and control unions; it will be repeated after three years to estimate the impact on the prevalence of stunted children and other indicators.This stepped wedge design has several advantages for both the implementation and evaluation of services, as well as some disadvantages. The units of delivery are randomized, which controls for other influences on outcomes; the program supports government service delivery systems, so it is replicable and scalable; and the program can be improved over time as lessons are learned. The main disadvantages are the difficulty of estimating the impact of each component of the program, and the geographical distribution of unions, which increases program delivery costs. Stepped implementation allows a cluster randomized trial to be achieved within a large-scale poverty alleviation program and phased-in and scaled-up over a period of time. This paper may encourage evaluators to consider how to estimate attributable impact by using stepped implementation, which allows the counterfactual group eventually to be treated.

How to Use This Manual

2021 ◽  
pp. 37-46
Author(s):  
Heather Thompson-Brenner ◽  
Melanie Smith ◽  
Gayle Brooks ◽  
Rebecca Berman ◽  
Angela Kaloudis ◽  
...  
Keyword(s):  
Emotional Dysregulation ◽  
Clinical Population ◽  
Evidence Based ◽  
The Face ◽  
The Impact

The authors have designed this manual to be utilized in many settings and modalities, by therapists from various disciplines, and at any frequency of session scheduling to facilitate use by the broadest range of therapists and clients. Research on implementation suggests that evidence-based interventions need to be adapted to the particular needs of a clinical population and setting to be maximally effective. Clinicians may share the impact that a part of a session has had on them or otherwise disclose their experience in the here and now. In the face of troubled emotions and the impulse to avoid, clients may employ “strategies of disconnection,” which may involve withdrawal, anger, or displays of emotional dysregulation. This treatment focuses on emotions and experiences that are by definition difficult for clients to tolerate, and clinicians may also have strong reactions to this process.

Reducing Physical Aggression in High School Students in KwaZulu-Natal: A Cluster Randomized Trial

2020 ◽  
Vol 35 (6) ◽  
pp. 861-884
Author(s):  
Myra Taylor ◽  
Benn Sartorius ◽  
Saloshni Naidoo ◽  
Hein de Vries
Keyword(s):  
High School Students ◽  
Randomized Trial ◽  
Youth Violence ◽  
Intervention Program ◽  
Physical Violence ◽  
Cluster Randomized Trial ◽  
School Students ◽  
Analytical Technique ◽  
Cluster Randomized ◽  
The Impact

Youth violence is of public health and social concern. A South African cluster randomized trial (434 grade 10 students, 16 schools), used the Integrated Model for Behavior Change conceptual framework to implement a 20 module classroom-based intervention program. The study contributes to the literature and used a strong analytical technique since mixed effects linear regression assessed the impact of the intervention on physical violence endpoints and other socioeconomic confounders/factors. The intervention reduced students' experiencing physical violence compared to controls and social pressure for this, yet no differences were found for hitting others. Our results support findings that school programs against violence can reduce students' experience of physical violence, but translation of these findings to reduce the actual hitting of others may need further approaches and/or more time.

Sign in / Sign up

Export Citation Format

Share Document