ArticleJournal of clinical epidemiology2017
Proposed variations of the stepped-wedge design can be used to accommodate multiple interventions.
Article in Journal of clinical epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
- Nudging implementation of low tidal volume ventilation: a stepped wedge, cluster randomized trial.Implementation science : IS · 2026Trial
- Evaluating the impact of multilevel evidence-based implementation strategies to enhance provider recommendation on human papillomavirus vaccination rates among an empaneled primary care patient population: a study protocol for a stepped-wedge cluster randomized trial.Implementation science : IS · 2018Trial
- Impact of Interventions to Improve Human Papillomavirus Vaccine Uptake on Other Vaccines Due: A Secondary Analysis of a Randomized Trial.Academic pediatricsTrial
- Design and analysis of individually randomized multiple baseline factorial trials.Behavior research methods · 2026Article
- Article
- Analysis of Stepped-Wedge Cluster Randomized Trials When Treatment Effects Vary by Exposure Time or Calendar Time.Statistics in medicine · 2025Article
- Power analysis for concurrent balanced or imbalanced multiple-intervention stepped wedge design: a simulation-based approach.BMC medical research methodology · 2025Article
- Implementing evidence-based practices to improve primary care for high-risk patients: study protocol for the VA high-RIsk VETerans (RIVET) type III effectiveness-implementation trial.Implementation science communications · 2024Article
- Multilevel Implementation Strategies for Adolescent Human Papillomavirus Vaccine Uptake: A Cluster Randomized Clinical Trial.JAMA pediatrics · 2024Article
- A multi-dimensional incomplete stepped-wedge trial design to estimate the impact of standards-based audit.PloS one · 2023Article
- Prognosticating Outcomes and Nudging Decisions with Electronic Records in the Intensive Care Unit Trial Protocol.Annals of the American Thoracic Society · 2021Article
- Mixed-effects models for the design and analysis of stepped wedge cluster randomized trials: An overview.Statistical methods in medical research · 2021Review
- Article
- Admissible multiarm stepped-wedge cluster randomized trial designs.Statistics in medicine · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectivesStepped-wedge design (SWD) cluster-randomized trials have traditionally been used for evaluating a single intervention. We aimed to explore design variants suitable for evaluating multiple interventions in an SWD trial. STUDY DESIGN AND
settingWe identified four specific variants of the traditional SWD that would allow two interventions to be conducted within a single cluster-randomized trial: concurrent, replacement, supplementation, and factorial SWDs. These variants were chosen to flexibly accommodate study characteristics that limit a one-size-fits-all approach for multiple interventions.
resultsIn the concurrent SWD, each cluster receives only one intervention, unlike the other variants. The replacement SWD supports two interventions that will not or cannot be used at the same time. The supplementation SWD is appropriate when the second intervention requires the presence of the first intervention, and the factorial SWD supports the evaluation of intervention interactions. The precision for estimating intervention effects varies across the four variants.
conclusionSelection of the appropriate design variant should be driven by the research question while considering the trade-off between the number of steps, number of clusters, restrictions for concurrent implementation of the interventions, lingering effects of each intervention, and precision of the intervention effect estimates.
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