community intervention trials
CIET conducts community intervention trials—such as the Safe Birth in Cultural Safety initiative—to demonstrate the extent to which a given solution to a problem will be effective. At its simplest, this is a comparison of outcomes in one group of communities with those in a similar community or group of communities where the solution has not yet been tried.
We first do a baseline study in all communities likely to be involved in the study. Wherever possible we then randomly allocate communities to “intervention” and “control” status, using the baseline to help ensure balance between the groups. When they are randomized, community intervention trials are known as cluster randomized controlled trials (CRCTs). Whether randomization is used or not, if the solution is shown to be beneficial, our commitment is to extend it to all communities in the sample.
In late 2009 CIET began a large CRCT in both Mexico’s Guerrero State and Managua, Nicaragua, where we are testing a green and sustainable alternative to dengue prevention and control –we call this project Camino Verde or Green Path, which relies on community participation rather than potentially harmful chemicals.
In Pakistan we conducted a CRCT to test a communication solution to improve household cost-benefit decisions about childhood immunization. Five articles describing the results and various aspects of this trial have been published in BMC International Health and Human Rights and are available at: http://www.biomedcentral.com/1472-698X/9?issue=S1
In Pakistan, we piloted an evidence-based education intervention based on locally designed communication aids used by Lady Health Workers.
In the Eastern Cape and Limpopo provinces in South Africa, CIET tested the impact of “HIV literacy” among female elders. In the Free State province of South Africa, we looked at the impact of an awareness intervention to increase acceptability of antiretroviral therapy among rural populations.
In late 2008 CIET began a CRCT to test the impact of focusing local AIDS prevention on the choice-disabled, especially the victims of gender-based violence, in Botswana, Namibia and Swaziland.