A researcher recently approached me for advice on a cluster-randomized trial he is developing. He is interested in testing the effectiveness of two interventions and wondered whether a 2×2 factorial design might be the best approach.
As we discussed the interventions (I’ll call them and ), it became clear that was the primary focus. Intervention might enhance the effectiveness of , but on its own, was not expected to have much impact. (It’s also possible that alone doesn’t work, but once is in place, the combination may reap benefits.) Given this, it didn’t seem worthwhile to randomize clinics or providers to receive B alone. We agreed that a three-arm cluster-randomized trial—with (1) control, (2) alone, and (3) —would be a more efficient and relevant design.
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