Evaluating Structural Interventions

Evaluating structural interventions to understand whether they are effective, for whom, and in what context is critical to determining whether, where, and how to deliver structural interventions at scale. This chapter provides a comprehensive evaluation framework comprising three main components: impact of the intervention, process evaluation, and an economic evaluation. Featured within this chapter is the point that structural-level interventions are amenable to evaluation using adaptation of the gold-standard randomized controlled trial design. Where randomization is not feasible, however, the chapter provides alternative designs to evaluate effectiveness, including those that use the stepped-wedge cluster randomized trial, interrupted time series, and nonequivalent comparison group. Four types of economic evaluation techniques are also described.