title: Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs.
abstract: Occupational health researchers regularly conduct evaluative intervention research for which a randomized controlled trial (RCT) may not be the most appropriate design (eg, effects of policy measures, organizational interventions on work schedules). This article demonstrates the appropriateness of alternative designs for the evaluation of occupational health interventions, which permit causal inferences, formulated along two study design approaches: experimental (stepped-wedge) and observational (propensity scores, instrumental variables, multiple baseline design, interrupted time series, difference-in-difference, and regression discontinuity). For each design, the unique characteristics are presented including the advantages and disadvantages compared to the RCT, illustrated by empirical examples in occupational health. This overview shows that several appropriate alternatives for the RCT design are feasible and available, which may provide sufficiently strong evidence to guide decisions on implementation of interventions in workplaces. Researchers are encouraged to continue exploring these designs and thus contribute to evidence-based occupational health.
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL Leiden, The Netherlands. karen.oudehengel@tno.nl.
authors.forename: Roosmarijn M C
authors.initials: RM
authors.lastname: Schelvis
authors.forename: Karen M
authors.initials: KM
authors.lastname: Oude Hengel
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
authors.forename: Birgitte M
authors.initials: BM
authors.lastname: Blatter
authors.forename: Jorien E
authors.initials: JE
authors.lastname: Strijk
authors.forename: Allard J
authors.initials: AJ
authors.lastname: van der Beek
mesh_terms: D056810:Acaricides; D006801:Humans; D065186:Interrupted Time Series Analysis / Q000379:methods; D064887:Observational Studies as Topic / Q000379:methods; D016272:Occupational Health; D011897:Random Allocation; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012107:Research Design
chemical_list: D056810:Acaricides