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Table 1 Function QUERI STRIDE SW-CRT design decisions and their impact on the study

From: Implementation of a stepped wedge cluster randomized trial to evaluate a hospital mobility program

Design decision Function QUERI SW-CRT Advantages Disadvantages
Time period length 3 months Shorter length and larger number of time periods increased power Longer time period length would have given sites longer window to launch program
Number of sites per sequence 2 Allowed study team to provide significant implementation support to each site; study conducted faster than if only 1 site/time period Power implications; maximum power with one cluster per sequence
Recruitment and randomization strategy Recruited and randomized clusters to sequences in 2 separate blocks Reduced maximum possible time from enrollment to program launch time; ability to start study before all sites recruited; potentially fewer dropouts; ability for earlier sites to serve as mentors for later sites Not able to collect patient-reported data from block 2 sites in time periods before enrollment
Potential confounding of treatment with block
Full statistical implications of blocked randomization for SW-CRT have not been studied.
Calendar time versus time since randomization may be an issue for blocks
Complete vs. incomplete design and type Incomplete design—outcome data during implementation interval not used for evaluation Avoided including data when program is partially implemented Power implications; loss of data from time periods not included in evaluation