A Theory-Driven Approach to Evaluating a Communication Intervention

Abstract

Evaluating interventions in the practice setting calls for an alternative approach to the traditional randomized controlled trial (RCT), as its feasibility and generalizability, and clinical utility of its results are being questioned. The theory-driven approach (TDA) to evaluation, as an alternative to the RCT, attempts to account for the realities of practice. The TDA specifies the causal processes underlying the intervention effects, and identifies its expected outcomes as well as factors that affect treatment processes, such as patient, intervener, and setting characteristics. In this article, the TDA to intervention evaluation is presented as a means of designing and conducting evaluation. The TDA is discussed at the conceptual level and illustrated with examples from a pilot study that examined the effectiveness of a communication enhancement intervention designed to improve the communication skills of nursing staff in a complex continuing care (CCC) facility.