Evidence-Based Research in Community Rehabilitation: Design Issues and Strategies

This review highlights a number of methodological issues that arise when a randomised controlled trial (RCT) is conducted on community rehabilitation programmes. These methodological issues are discussed with reference to examples of evidence-based studies conducted with the Hong Kong Society for Rehabilitation. In conducting RCTs of community rehabilitation programmes, we recommend using randomisation, a control or comparison group, at least single-blinding, and objective outcome measures. We also discuss strategies used to control inter-subject differences, the importance of pilot testing, and follow-up assessments. Qualitative evaluation and process evaluation can provide important evidence for enhancing the quality of programmes and examining why and how programmes either work or do not work. In view of the resources available to community rehabilitation settings, we recommend a combination of four strategies in community trials: (a) quantitative evaluation using experimental or quasi-experimental designs, (b) subjective outcome evaluation, (c) qualitative evaluation, and (d) process outcome evaluation.