Selecting and Improving Quasi-Experimental Designs in Effectiveness and Implementation Research

Annu Rev Public Health. 2018 Apr 1:39:5-25. doi: 10.1146/annurev-publhealth-040617-014128. Epub 2018 Jan 12.


Interventional researchers face many design challenges when assessing intervention implementation in real-world settings. Intervention implementation requires holding fast on internal validity needs while incorporating external validity considerations (such as uptake by diverse subpopulations, acceptability, cost, and sustainability). Quasi-experimental designs (QEDs) are increasingly employed to achieve a balance between internal and external validity. Although these designs are often referred to and summarized in terms of logistical benefits, there is still uncertainty about (a) selecting from among various QEDs and (b) developing strategies to strengthen the internal and external validity of QEDs. We focus here on commonly used QEDs (prepost designs with nonequivalent control groups, interrupted time series, and stepped-wedge designs) and discuss several variants that maximize internal and external validity at the design, execution and implementation, and analysis stages.

Keywords: external validity; implementation science; interrupted time series; prepost; quasi-experimental design; stepped wedge.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Humans
  • Implementation Science*
  • Reproducibility of Results
  • Research Design*