title: Context by treatment interactions as the primary object of study in cluster randomized controlled trials of population health interventions.
abstract: Cluster randomized controlled trials are increasingly used in population health intervention research. Through randomization, researchers attempt to isolate the treatment effect and remove all other effects, including any effects of social context. In many cases, the constant effect assumption cannot be satisfied in cluster randomized controlled trials. We argue that when studying population health interventions, the effective mechanism of intervention lies in the interaction between the treatment and social context. Researchers should be cognizant that attempts to remove the effect of social context using CRTC may fail. The interaction between the treatment and social context should be the primary object of study in population health intervention research.
authors.affiliation: Département de médecine sociale et préventive, Université de Montréal, C.P. 6128, succursale Centre-ville, H3C 3J7, Montréal, QC, Canada. daniel.lavergne.fuller@umontreal.ca
authors.forename: Daniel
authors.initials: D
authors.lastname: Fuller
authors.forename: Louise
authors.initials: L
authors.lastname: Potvin
mesh_terms: D016000:Cluster Analysis; D006293:Health Promotion; D006801:Humans; D011634:Public Health; D016032:Randomized Controlled Trials as Topic