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Table 3 Examples of intervention testing and how this testing influenced the final intervention and trial.

From: How much does pre-trial testing influence complex intervention trials and would more testing make any difference? An email survey

Ways in which the intervention was tested Ways in which testing influenced the intervention or its delivery
A component of the intervention, the guideline flowchart, was piloted in a single hospital. The sequence and flow of questions and recommendations was altered. Some minor changes to the wording and format of the guidelines were made.
Individual components of the study (eg. data collection, intervention, retention strategies) were tested, followed by a small feasibility trial of the whole intervention package with, finally, a pilot study involving the target population. The data collection instruments and the intervention were modified. Recruitment and retention protocols were also modified.
The computer-based decision support system was user-tested prior to the trial. Improvements to navigation and the user interface were made.
A one-year before-after pilot of the full intervention. Confirmed that the intervention was promising. Highlighted communication problems between different health professionals, which were addressed before the trial. An extra member of staff (a care coordinator) was added to the support team that formed part of the intervention.
Three educational videos were shown to people to get comments on their potential as an educational intervention. Using videos as an intervention was abandoned and a completely new intervention was designed.
Educational outreach and the reminder system were piloted in one geographical area. Feasibility of this form of intervention was confirmed.
A one-year randomised controlled feasibility study of the full intervention. One comparison arm of the trial was dropped. Training manuals were modified slightly.