From pills to programs: lessons from medicine for developing effective lifestyle interventions.

OBJECTIVE: To propose a scheme for comprehensive development and evaluation of lifestyle interventions. METHODS: We adapted the four-phase system used in drug development, the engine of progress in medicine for decades, to construct a system for developing lifestyle intervention programs. RESULTS: P...

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Publicado en:Preventive Medicine Vol. 49; no. 1; pp. 12 - 19
Autores principales: Rosen LJ, Manor O, Brody DL, Engelhard D, Shtarkshall RA, Zucker D
Formato: clinical trial research tables/charts Journal Article
Publicado: Academic Press Inc. Aug2009
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Academic Press Inc.
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        atl: From pills to programs: lessons from medicine for developing effective lifestyle interventions.
      aug:
        au:
          Rosen LJ
          Manor O
          Brody DL
          Engelhard D
          Shtarkshall RA
          Zucker D
        affil: Department of Health Promotion, School of Public Health, Tel Aviv University, Ramat Aviv, Israel. rosenl@post.tau.ac.il
      sug:
        subj:
          Life Style Changes In Infancy and Childhood
          Program Development
          Program Evaluation
          School Health Education Evaluation
          Adolescence
          Child
          Clinical Trials
          Descriptive Statistics
          Funding Source
          Handwashing
          Israel
          P-Value
          Human
          Adolescent: 13-18 years
          Child: 6-12 years
      ab: OBJECTIVE: To propose a scheme for comprehensive development and evaluation of lifestyle interventions. METHODS: We adapted the four-phase system used in drug development, the engine of progress in medicine for decades, to construct a system for developing lifestyle intervention programs. RESULTS: Phase I: The intervention is constructed and tested with a small number of individuals. Acceptability and feasibility are assessed. Evaluation is primarily qualitative. Phase II: Effectiveness on intermediate endpoints (e.g. behavior) is tested in a real field setting, with a limited number of individuals, using a before-and-after design. An iterative process of testing and refinement may be necessary. Phase III: The effectiveness of the intervention on health-related outcomes is tested, using, where possible, a randomized design. Phase IV: Large-scale implementation and penetration are assessed in other populations. Process variables and local and national health indicators are studied. The development and evaluation of our hygiene intervention, which took place in Jerusalem from 1999 to 2001, is presented as a case study. CONCLUSIONS: Adaptation of the phased system of drug development to lifestyle interventions is a conceptually simple approach to building effective, sustainable programs for community-based public health. Copyright © 2009 by Elsevier Inc.
      pubtype: Academic Journal
      doctype:
        clinical trial
        research
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        Journal Article
      ougenre: Article
    language: English
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