There is a growing recognition that successful preventive interventions need to address social determinants of health. Effectively reducing health disparities often requires the use of study designs that go beyond the individual level randomized controlled trial; however, studies that evaluate multilevel interventions face unique challenges and require specialized design and analytical approaches.
Researchers can use the information and resources below to learn more about appropriate research methods for evaluating complex multilevel interventions to reduce health disparities.
Supplemental Journal Issue: Design and Analytic Methods to Evaluate Multilevel Interventions to Reduce Health Disparities
ODP's commitment to rigorous methods and health disparities research
Read Dr. Murray's Director's Message, "State-of-the-Science Methods to Evaluate Interventions that Reduce Health Disparities," discussing the journal issue and other resources for investigators.
ODP sponsored a supplemental issue of Prevention Science in July 2024 that brings together new ideas and examples of strong applications of existing design and analytic methods for studies aimed at reducing health disparities. Papers also include strategies for developing multilevel interventions that balance methodological rigor with design feasibility, acceptability, and ethical considerations.
See the list below for the 12 open-access articles featured in the supplemental issue. Guest editors David M. Murray, Ph.D. (ODP), and Melody S. Goodman, Ph.D. (New York University), discuss key points of the papers and provide more background about the issue in their accompanying commentary.
You can also refer to the quick guide below that ODP developed to help you navigate the issue and identify the papers that are most relevant to your work.
- Sample Size Calculations for Stepped Wedge Designs with Treatment Effects that May Change with the Duration of Time under Intervention (Hughes et al.)
- Sample Size Requirements to Test Subgroup-Specific Treatment Effects in Cluster-Randomized Trials (Wang et al.)
- Multilevel Intervention Stepped Wedge Designs (MLI-SWDs) (Sperger et al.)
- Optimizing Interventions for Equitability: Some Initial Ideas (Strayhorn et al.)
- Operationalizing Primary Outcomes to Achieve Reach, Effectiveness, and Equity in Multilevel Interventions (Guastaferro et al.)
- Evaluating Effects of Multilevel Interventions on Disparity in Health and Healthcare Decisions (Jackson et al.)
- Considerations for Subgroup Analyses in Cluster-Randomized Trials Based on Aggregated Individual-Level Predictors (Williamson et al.)
- Using Power Analysis to Choose the Unit of Randomization, Outcome, and Approach for Subgroup Analysis for a Multilevel Randomized Controlled Clinical Trial to Reduce Disparities in Cardiovascular Health (Harrall et al.)
- Application of a Heuristic Framework for Multilevel Interventions to Eliminate the Impact of Unjust Social Processes and Other Harmful Social Determinants of Health (Guilamo-Ramos et al.)
- Mixed-Method, Multilevel Clustered-Randomized Control Trial for Menstrual Health Disparities (Houghton and Adkins-Jackson)
- “We don’t separate out these things. Everything is related”: Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities (Rink et al.)
- A Hybrid Pragmatic and Factorial Cluster Randomized Controlled Trial for an Anti-racist, Multilevel Intervention to Improve Mental Health Equity in High Schools (Mulawa et al.)
Quick Guide to the 2024 Supplemental Issue of Prevention Science
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Additional Resources for Research Methods and Health Disparities
- NIH Research Methods Resources – Information and sample size calculators to help investigators design and analyze their studies using the best available methods
- Methods: Mind the Gap Webinar Series – Topics include research design, measurement, data analysis, and other methods in prevention science
- Pragmatic and Group-Randomized Trials in Public Health and Medicine: Online Course – 7-part online course for designing and analyzing group-randomized trials
- Training in Prevention Research Methods – Federal courses, webinars, online tutorials, and other training in prevention research methodology, focused on study and intervention design, data analysis, and measurement
- NIH Funding Opportunities in Prevention-Related Health Disparities Research – Prevention-related funding opportunities in health disparities, health equity, and social determinants of health research