CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India.

CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Research Abstract Details 

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CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Abstract Text:

M Kent Ranson,Tara Sinha,Saul S Morris,Anne J Mills,

This paper addresses the logistical challenges of implementing public health interventions in the setting of cluster randomized trials (CRTs), drawing on the experience of carrying out a CRT within a community-based health insurance (CBHI) scheme in rural India. Our CRT is seeking to improve the equity impact--i.e., reduce the differential in claims submission for hospitalization between poor and less poor--of this CBHI in rural areas. Five main challenges are identified and discussed: 1) assigning control clusters, 2) blinding, 3) implementing interventions simultaneously, 4) minimizing leakage, and 5) piggy-backing on a changing scheme. These challenges are not likely to be unique to low-income settings, although the fifth challenge is particularly likely when working with relatively small and resource-constrained programs. While compromises to methodological best-practice may reduce internal validity, they make the intervention more 'real', and potentially more applicable, to other programs and settings. Further, careful documentation of compromises allows them to be considered in the final analysis.

CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Publishing Authors By Initials

MK Ranson,T Sinha,SS Morris,AJ Mills,

For similar health care facilities, manpower, and services: health services: rural health services research abstracts see: health care facilities, manpower, and services: health services: rural health services research

PUBMED ID PMID:

MEDLINE DATE: 2006 Jan-Feb

CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: Canadian journal of public health. Revue canadienn

VOLUME: 97

Page Numbers: 72-5

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ISSN: 0008-4263

DAY: 13

MONTH: 02

YEAR: 2008

CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Information

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LANGUAGE: eng

NlmUniqueID: 372714

CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India. Keywords Mesh Terms:

KEYWORDS: Rural Health Services

MESH TERMS: economics

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Grant and Affiliation Information for CRTs--cluster randomized trials or "courting real troubles": challenges of running a CRT in rural Gujarat, India.

AFFILIATION: Health Policy Unit, London School of Hygiene and Tropical Medicine, UK. kent.ranson@lshtm.ac.uk

Country: Canada

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MEDLINETA: Can J Public Health

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