title: Time issues in multilevel interventions for cancer treatment and prevention.
abstract: The concept of time introduces important complexities in estimating intervention effects, program and evaluation design, and measurement and analysis of individual change in multilevel interventions (MLIs). Despite growing recognition that time is a critical element for assessing both individual-level outcomes and higher-level changes in organizational, community, and policy contexts, most MLI designs and evaluations have not addressed these issues. In this chapter we discuss 1) conceptualizing disease life-course and treatment theory in MLIs, 2) approaches to incorporating time in research and program design for MLIs in cancer treatment and prevention, 3) analysis of time-varying multilevel data in the context of cancer treatment and prevention, and 4) resource considerations and trade-offs of incorporating time as a dimension of MLIs and analysis. Although analytic techniques for analyzing time-related phenomena are becoming more available and powerful, there has not been corresponding progress made in the development of theory to guide the application of these techniques in program design and implementation.
authors.affiliation: Department of Health Management and Policy, The University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA. jalexand@umich.edu
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Alexander
authors.forename: Irene
authors.initials: I
authors.lastname: Prabhu Das
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Johnson
mesh_terms: D003131:Combined Modality Therapy / Q000592:standards*; D003266:Continuity of Patient Care / Q000592:standards / Q000639:trends; D019033:Delivery of Health Care, Integrated / Q000592:standards / Q000639:trends; D006302:Health Services Research; D006801:Humans; D009369:Neoplasms / Q000517:prevention & control / Q000628:therapy*; D009936:Organizational Innovation; D010348:Patient Care Team / Q000592:standards / Q000639:trends; D018802:Patient-Centered Care / Q000592:standards / Q000639:trends; D011787:Quality of Health Care / Q000592:standards / Q000639:trends; D012107:Research Design; D013995:Time; D013997:Time Factors; D014481:United States