21 The Two “E’s” of Research: Efficacy and Effectiveness Trials

In this chapter we review the empirical foundation for Eye Movement Desensitization and Reproessing Therapy (EMDR) for posttraumatic stress disorder. We present a brief description of the therapy, critically review recent primary and meta-analytic investigations concerning its efficacy and effectiveness, offer a summary of recent primary investigations that addressed the mechanism of action for EMDR, and based on this overall review, we suggest limitations with recommendations for future research. Recent empirical investigations of the efficacy of EMDR have improved along a number of important dimensions, and these along with the few completed effectiveness trials, position this therapy among evidence-based frontline interventions for PTSD. What is less thoroughly researched, and thus less well understood, are putative models of its theoretical mechanism of action. In addition to continuing specific improvements in research concerning efficacy and effectiveness, we recommend more and higher quality empirical studies of its mechanism of action.

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Translational Research Principles of an Effectiveness Trial for Diabetes Care in an Urban African American Population

The Diabetes Educator ◽

10.1177/0145721705282254 ◽

2005 ◽

Vol 31 (6) ◽

pp. 880-889 ◽

Cited By ~ 21

Author(s):

Tiffany L. Gary ◽

Felicia Hill-Briggs ◽

Marian Batts-Turner ◽

Frederick L. Brancati

Keyword(s):

African American ◽

African Americans ◽

Diabetes Care ◽

Large Scale ◽

Health Workers ◽

Controlled Trial ◽

Phase 1 ◽

Community Setting ◽

Minority Community ◽

Effectiveness Trials

Purpose Large-scale effectiveness trials designed to translate evidence-based diabetes care to community settings are few. Studies describing these methods among high-risk minority populations are particularly limited. Methods The authors describe Project Sugar, a randomized controlled trial conducted in 2 phases: Project Sugar 1 (1994-1999), which piloted a 4-arm clinic and homebased intervention using nurse case management and community health workers in 186 urban African Americans with type 2 diabetes, and Project Sugar 2 (2000-2005), which examined effectiveness of this intervention among 542 diabetic, urban African Americans. Results and Conclusions Project Sugar had success with regard to recruitment and retention, both in phase 1 (80% rate at 24 months) and phase 2 (>90% at 24 months). Using the RE-AIM framework, planning and research design for Project Sugar 2 is described in detail for elements that contributed to the reach, effectiveness, adoption, implementation, and maintenance of this study within a minority community setting. In addition to successful strategies, challenges to conducting effectiveness trials in an inner-city African American community are identified.

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