Train the Trainer Course book - Cochrane Public Health Group

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Randomised controlled trial – critical appraisal exercise Sahota P, Rudolf CJ, Dixey R, Hill AJ, Barth JH, Cade J. Randomised controlled trial of primary school based intervention to reduce risk factors for obesity. BMJ 2001;323:1029-32. Selection bias (Q1) Are the individuals selected to participate in the study likely to be representative of the target population? Not likely Somewhat likely Not likely (Q2) What percentage of selected individuals agreed to participate? 80-100% agreement 60-79% agreement less than 60% agreement Not reported Not Applicable RATE THIS SECTION Strong Moderate Weak Study design Indicate the study design Is the method of random allocation stated? No Yes If the method of random allocation is stated is it appropriate? No Yes Was the method of random allocation reported as concealed? No Yes RATE THIS SECTION Strong Moderate Weak Confounders (Q1) Prior to the intervention were there between group differences for important confounders reported in the paper? Yes No Can’t tell (Q2) If there were differences between groups for important confounders, were they adequately managed in the analysis? Yes No Not applicable (Q3) Were there important confounders not reported in the paper? Yes Somewhat likely All of the schools were state primary schools sited outside the inner city area. Slight bias towards more advantaged children – 1-42% of children from ethnic minorities, 7-29% entitled to free school meals. Not reported We are only told that 10 schools took part in the intervention; we do not know how many schools were approached. Weak Randomised controlled trial Yes Group randomised controlled trial Yes Schools were first paired (size, ethnicity, level of social disadvantaged) and then randomised using the toss of a coin. No (no information reported) Strong No The groups were similar in terms of age, school year, BMI, etc. There were no significant differences found between any of the intervention and comparison pupils for any of the measures. No differences, but still adjusted results. Calculations adjusted for sex, age, initial BMI SD score, and type of school. No 94
No RATE THIS SECTION Strong Moderate Weak Blinding (Q1) Was (were) the outcome assessor(s) aware of the intervention or exposure status of participants? Yes No Not reported Not applicable RATE THIS SECTION Strong Moderate Weak Data collection methods (Q1) Were the data collection tools shown to be valid? Yes No (Q2) Were data collection tools shown to be reliable? Yes No RATE THIS SECTION Strong Moderate Weak Withdrawals and drop-outs (Q1) Indicate the percentage of participants completing the study. 80-100% 60-79% Less than 60% Not reported Not applicable RATE THIS SECTION Strong Moderate Weak Analyses (Q1) Is there a sample size calculation or power Strong Yes The measures could not be obtained blind to the schools’ intervention status. Measurement of BMI by the same auxologist. (Would you expect BMI to change in such a short time?) Diet – 24-hour recall, 3-day diary Physical activity – measured by questionnaire, activity during the past week, frequency of sedentary behaviour in last 24 hours. Psychological measures- 3 validated tools – selfperception profile, measure of dietary restraint, adapted body shape perception scale. Knowledge and attitudes towards healthy eating – focus groups. Weak No Standard measurements for height and weight. No information on validity of 24-hour recall and 3-day food diaries. No information provided on validity of physical activity questionnaire. Three validated tools were used for measuring psychological status. No No information provided. Weak 80-100% The figure presented shows the progress of the schools throughout the trial. 21 children declined to participate in the data collection, 613 children were measured at baseline and 595 at one-year follow-up. All persons were accounted for. However, 42 children left the study and 40 new children joined. We are not told which groups these children dropped-out of. Strong Yes 95
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TRAIN-THE-TRAINER HANDBOOOK Two-day
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Contents Introduction .............
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Additional reading: Textbooks: Oliv
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2) ONCE REGISTRATIONS HAVE BEEN REC
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OUTLINE OF TWO-DAY WORKSHOP 9:00am
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Unit One: Background to Systematic
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Reviews of clinical interventions v
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FACILITATOR’S GUIDE Time required
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Unit Two: International Systematic
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Unit Three: Resources Required Lear
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Formulate review question Establish
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Unit Four: Developing a Protocol Le
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Establish an Advisory Group whose m
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Unit Five: Asking an Answerable Que
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To investigate both the implementat
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Process evaluations: these studies
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REFERENCES 1. Oliver S. 1997. Explo
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FACILATOR’S GUIDE Time required:
Page 47 and 48: Unit Six: Finding The Evidence Lear
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Page 51 and 52: Where to locate studies a) Electron
Page 53 and 54: ADDITIONAL READING Harden A, Peersm
Page 55 and 56: 45. "Diet-Fat-Restricted"/ all subh
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Page 116 and 117: A Checklist for Evaluating Evidence
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Page 132 and 133: 9. Swerrissen H, Crisp BR. The sust
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Page 142 and 143: 2 points out of the possible 4 poin
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