Hill Karl G, Woodward Danielle, Woelfel Tiffany, Hawkins J David, Green Sara
Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Ave. N.E., Suite 401, Seattle, WA, 98115, USA.
Prev Sci. 2016 Oct;17(7):806-18. doi: 10.1007/s11121-015-0610-7.
Preventive interventions are often designed and tested with the immediate program period in mind, and little thought that the intervention sample might be followed up for years or even decades beyond the initial trial. However, depending on the type of intervention and the nature of the outcomes, long-term follow-up may well be appropriate. The advantages of long-term follow-up of preventive interventions are discussed and include the capacity to examine program effects across multiple later life outcomes, the ability to examine the etiological processes involved in the development of the outcomes of interest, and the ability to provide more concrete estimates of the relative benefits and costs of an intervention. In addition, researchers have identified potential methodological risks of long-term follow-up such as inflation of type 1 error through post hoc selection of outcomes, selection bias, and problems stemming from attrition over time. The present paper presents a set of seven recommendations for the design or evaluation of studies for potential long-term follow-up organized under four areas: Intervention Logic Model, Developmental Theory and Measurement Issues; Design for Retention; Dealing with Missing Data; and Unique Considerations for Intervention Studies. These recommendations include conceptual considerations in the design of a study, pragmatic concerns in the design and implementation of the data collection for long-term follow-up, as well as criteria to be considered for the evaluation of an existing intervention for potential for long-term follow-up. Concrete examples from existing intervention studies that have been followed up over the long term are provided.
预防性干预措施的设计和测试通常只考虑项目的直接实施阶段,很少会想到干预样本可能会在初始试验之后的数年甚至数十年里被持续追踪。然而,根据干预措施的类型和结果的性质,长期随访很可能是合适的。本文讨论了预防性干预措施长期随访的优势,包括能够考察项目对多个晚年生活结果的影响、能够研究目标结果发展过程中涉及的病因学过程,以及能够更具体地估计干预措施的相对收益和成本。此外,研究人员还识别出了长期随访潜在的方法学风险,比如通过事后选择结果导致I型错误膨胀、选择偏倚以及随时间推移因失访产生的问题。本文针对潜在长期随访研究的设计或评估提出了七条建议,这些建议分为四个方面:干预逻辑模型、发展理论与测量问题;留存设计;处理缺失数据;以及干预研究的特殊考量。这些建议包括研究设计中的概念性考量、长期随访数据收集设计与实施中的实际问题,以及评估现有干预措施进行长期随访可能性时应考虑的标准。文中还提供了来自长期随访的现有干预研究的具体实例。