Evaluating the Effectiveness of Complex, Multi-component, Dynamic, Community Based Injury Prevention Interventions: A Statistical Framework

Abstract

Dynamic violence and injury prevention interventions located within community settings raise evaluation challenges by virtue of their complex structure, focus, and aims. They try to address many risk factors simulta neously, are often overlapped in their implementation, and their imple mentation may be phased over time. This article proposes a statistical and analytic framework for evaluating the effectiveness of multilevel, multi system, multi-component, community-driven, dynamic interventions. The proposed framework builds on meta regression methodology and recently proposed approaches for pooling results from multi-component interven tion studies. The methodology is applied to the evaluation of the effec tiveness of South African community-centered injury prevention and safety promotion interventions. The proposed framework allows for complex interventions to be disaggregated into their constituent parts in order to extract their specific effects. The potential utility of the framework is suc cessfully illustrated using contact crime data from select police stations in Johannesburg. The proposed framework and statistical guidelines proved to be useful to study the effectiveness of complex, dynamic, community-based interventions as a whole and of their components. The framework may help researchers and policy makers to adopt and study a specific methodology for evaluating the effectiveness of complex intervention programs.