Challenges in the design, planning and implementation of trials evaluating group interventions

We reviewed participant recruitment and attrition, facilitator training and attrition, attendance at the group sessions, group size and fidelity aspects across five Randomised controlled trials

Katie Biggs

2020

Scholarcy highlights

  • Group interventions are interventions delivered to groups of people rather than to individuals and are used in healthcare for mental health recovery, behaviour change, peer support, self-management and/or health education
  • Advocates of group interventions have proposed mechanisms of action that are important for behaviour change that arise from being in a group that are not present in individual therapies, such as inter-personal change processes, universalisation, social comparison, social learning and modelling
  • Lifestyle Matters, Putting Life IN Years and STEPWISE were prevention trials rather than treatment trials, which have shown to be harder to recruit to previous research. The proportion of those screened providing consent is higher for trials using initial general practitioners mass mail-outs than for other trials; it is lowest in STEPWISE, which recruited participants with schizophrenia which can be a difficult population to recruit to trials
  • Recruitment to our group intervention trials was higher than has been reported in individually randomised trials, suggesting that recruitment to group intervention trials may be easier than recruitment to individual intervention trials, though comparing recruitment rates across a range of interventions, disease areas and settings is problematic as there are a multitude of factors involved
  • This paper provides a rational basis for planning group intervention trials, especially how to match the demand of research participants to the supply of trained group facilitators
  • Further research is needed on expedited set-up of sites in cluster randomised Randomised controlled trials involving group therapies as well as appropriate baseline group composition and participant replenishment following attrition

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