Theory-Driven Process Evaluation of the SHINE Trial Using a Program Impact Pathway Approach

Overview

Journal Clin Infect Dis

Publisher Oxford University Press

Specialty Infectious Diseases

Date 2015 Nov 26

PMID 26602304

Citations 28

Authors

Mduduzi N N Mbuya

Andrew D Jones

Robert Ntozini

Jean H Humphrey

Lawrence H Moulton

Rebecca J Stoltzfus

John A Maluccio

Affiliations

Soon will be listed here.

Abstract

Two reasons for the lack of success of programs or interventions are poor alignment of interventions with the causes of the problem targeted by the intervention, leading to poor efficacy (theory failure), and failure to implement interventions as designed (program failure). These failures are important for both public health programs and randomized trials. In the Sanitation Hygiene and Infant Nutrition Efficacy (SHINE) Trial, we utilize the program impact pathway (PIP) approach to track intervention implementation and behavior uptake. In this article, we present the SHINE PIP including definitions and measurements of key mediating domains, and discuss the implications of this approach for randomized trials. Operationally, the PIP can be used for monitoring and strengthening intervention delivery, facilitating course-correction at various stages of implementation. Analytically, the PIP can facilitate a richer understanding of the mediating and modifying determinants of intervention impact than would be possible from an intention-to-treat analysis alone.

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