Why is the Intervention Inventory being created?
The Intervention Inventory was developed by the group of national and international experts in 2013. To be included in the inventory, the intervention must be evidence-based with the evidence at a level determined by the group of international experts. The purpose of the inventory is to summarize best practices of effective bio-behavioral and structural interventions implemented in Ukraine that take into consideration the local context and Ukrainian HIV epidemic. Inventory includes interventions with public apprehension status and fulfills three key co-related tasks:
Managerial – provides managers justification for decisions regarding use of certain interventions to receive expected results/effects in a target group;
Research – building of research capacity and implementation of standards for experimental research to confirm the effectiveness of implemented interventions;
Reference – provides an search mechanism for convenient and quick access to information regarding interventions, retrospective review of interventions, results and studies on effectiveness.
Additional information and the criteria and requirements for inclusion in the Intervention Inventory are defined in the Procedure of maintenance.
What is an “intervention with defined level of evidence”?
Intervention – is an engagement with a certain person or small group (up to 20 people) focused on achieving changes in their behavior and/or health.
In recent years increasing attention has been paid to the issue of defining the level of scientific evidence for interventions (evidence-based interventions). In other words, evidence base refers to research based confirmation that a particular intervention with target group representatives achieves the intended change (e.g., change of knowledge level or medical parameters). Research provides the data to demonstrate whether the intervention is effective and reaches expected effect in regularly and not just under ideal circumstances.
Interventions with a defined level of evidence should be documented with details on activities and standard processes to ensure the fidelity of each intervention.
Term “evidence-based interventions” is widely used in international practice. A collection of interventions with a defined level of scientific evidence is available here:
Classification of interventions by categories of expected implementation consequences and results
Interventions can be classified as: behavioral, biomedical, bio-behavioral and structural interventions. Interventions with defined evidence can be selected based on the expected and anticipated changes. Considering the peculiarities of HIV/AIDS response activities typical expected consequences, results or changes from intervention implementation were defined:
- Improvement of Knowledge / attitudes
- Reduction of stigma and discrimination
- Improvement of skills
- Change of behavior
- Increase of service use
- Improvement of adherence
- Improvement of quality of life
- Prevention of infecting
- Reduction of mortality rate
Classification of interventions is done by reviewing expected changes in 2 stages: 1) defining types of consequences; 2) defining specific results.
The full list of anticipated changes, results or consequences of intervention implementation is available here.
Classification of interventions by level of scientific evidence
Evidence for an intervention is defined by the scientific assessment of changes, results or consequences of intervention implementation. The type of evidence to support an intervention depends on the design of the study, analysis conducted and the statistical significance of the changes. The intervention can have a confirmed level of evidence by implementation in the context of Ukraine (national evidence) or other countries in the world (international evidence).
To categorize the evidence which determines the significance of changes in target group after intervention implementation, the following groups are used:
- Group 1: Interventions with evidence confirmed by the results of randomized or non-randomized studies:
- Subgroup 1A: randomized experimental studies;
- Subgroup 1B: non-randomized experimental or quazi-experimental studies where control group is observed simultaneously with intervention group;
- Subgroup 1C: non-randomized studies where implementation effects are compared with previous state or historic information.
- Group 2: Interventions where results/consequences were assessed according to data of program monitoring;
- Group 3: Promising interventions with insufficient level of evaluation of the results/consequences of their implementation:
- Subgroup 3А: results of assessments conducted are not available;
- Subgroup 3В: assessment conducted does not allow to confirm positive and significant changes in correspondent expected results.
The criteria for designating an intervention to certain group according to the type of evidence is available here.
Interventio Inventory development perspectives
The Inventory of Interventions is constantly updated and improved.
Interventions with specific level of evidence are the certain type of strategic information for making managerial decisions in HIV/AIDS response area and implementation of effective interventions according to needs and peculiarities of target groups. For example, different combinations of interventions with an identified level of evidence constitute complex service packages of the new National AIDS Program.
Concurrently, while the program is developing and updating the Intervention Inventory, an agenda on tneeds in special implementation sudies is being formed to evaluate promising interventions. This exercise will also help build national research capacity.
In the future it is envisaged to integrate the Intervention Inventory as component of unified platform of strategic information and co-relation with other databases in HIV/AIDS area in Ukraine (research databases, in particular).