Train the Trainer Course book - Cochrane Public Health Group

2. Visit each group to make sure they understand the exercise.
3. Ask a sample of the pairs/groups to report back to the larger group.
4. Look for the following differences (clinical vs. health promotion interventions):
a) Patients vs. populations/communities/groups
b) Single, specific interventions (surgery, drugs, medical treatment) vs. complex
multidisciplinary interventions
c) Immediate outcomes vs. changes in attitude, behaviour or long term (eg. BMI)
d) Patients not involved vs. community participation in development and evaluation
e) Little impact of context vs. potentially large impact of context, population factors and
training
Example:
Clinical
Example: Epidural versus non-epidural analgesia for pain relief in labour:
1) Participants: women patients giving birth
2) Types of interventions: Epidural or non-epidural analgesia
3) Types of outcomes: Pain relief in labour
4) Participants involved in design on intervention: Generally not involved
5) Potential influences on intervention success: Training of person administering epidural
Health promotion or public health
Example: Community interventions for reducing smoking among adults
1) Participants: Any adults, male of female
2) Types of interventions: Co-ordinated multidimensional program – through schools, workplaces,
health professionals, health departments, restaurants, hospitals, retailers. Types of interventions –
mass media, policy, counselling, education, etc.
3) Types of outcomes:
Long term: Morbidity and mortality.
Intermediate measures: Biochemical measure of smoking, self-reported smoking status, self-reported
cigarette consumption.
Proxy measures and mediating variables: knowledge of harms of smoking, attitudes to smoking,
intentions to quit. Process outcomes: Evaluation of the implementation of interventions.
4) Participants involved in design on intervention: Community members usually involved in
planning and implementation
5) Potential influences on intervention success: literacy levels of community, training of those
implementing the intervention, characteristics of the community – urban/rural, context in which
policy was implemented, strength of the organisation implementing the intervention, norms of
smoking, etc.
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