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Reinforcing RCTs of Public Health Interventions: Defining and Linking Form and Function

Lederer, Lisa (2020) Reinforcing RCTs of Public Health Interventions: Defining and Linking Form and Function. Master's Thesis, University of Pittsburgh. (Unpublished)

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According to its stated core values, the American Public Health Association (APHA) is committed to policies and practices based on “evidence that demonstrates effectiveness.” The meaning of this phrase, however, leaves much room for debate, and this paper’s Public Health significance lies in its contribution to such a debate. Elaborating on its assertion about evidence, the APHA warns researchers “not to take statistics at face value.” Accordingly, Public Health researchers have adopted a range of approaches for bolstering the statistical outputs of Randomized Controlled Trials (RCTs) -- though these results are frequently seen as the “gold standard” of medical and policy evidence. Not all of the approaches are equal, however, in their ability to integrate statistical results into actionable conclusions. This paper, after tracing the origins of the outsized prominence of RCT results in Public Health -- despite the APHA’s warning -- and locating the central weakness of these results to their limited portability between settings, evaluates the approaches that have been proposed thus far. Surveying different disciplinary perspectives shows that, while many researchers have attempted to isolate and investigate the context of Public Health interventions, truly bolstering RCT results requires researching the operations of the interventions themselves. The optimal approach, it is concluded, demands creating a multi-level definition in which mechanisms are outlined at each level, including that of the participant.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Lederer, Lisalisaglederer@gmail.comlgl50000-0003-3811-7055
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairHawk, Marymary.hawk@pitt.edumeh960000-0001-9753-4356
Committee MemberYouk, Adaayouk@pitt.eduayouk0000-0001-6912-9759
Committee MemberCoulter,
Date: 30 July 2020
Date Type: Publication
Defense Date: 30 March 2020
Approval Date: 30 July 2020
Submission Date: 31 March 2020
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 39
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: complex interventions, RCT, implementation science, core components
Date Deposited: 30 Jul 2020 17:16
Last Modified: 30 Jul 2020 17:16


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