An alternative to RCTs in the case of sample heterogeneity

Abstract

As the population living with congenital heart disease ages, health promotion interventions have become more important. The uptake and maintenance of health-promoting behaviours and social support for the congenital heart disease population not only have the potential to extend a person's life expectancy, but also enhance quality of life and overall health and wellbeing. Using a gold-standard approach, such as a randomised controlled trial (RCT), to evaluate the effectiveness of such an intervention does not address heterogeneity among individuals, while the results obtained from RCTs tend to not be generalised to the larger population of interest. The Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework provides an alternative evaluative approach to examining the effectiveness of online gaming interventions, and has the capacity to address the unique needs of the congenital heart disease population.