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Efficacy and Effectiveness Trials

Examples from Smoking Cessation and Bullying Prevention

James O. Prochaska

University of Rhode Island, USA

Kerry E. Evers

Janice M. Prochaska

Deborah Van Marter

Janet L. Johnson

Pro-Change Behavior Systems, Inc., USA

If health psychology is to maximize impacts on health, there will need to be a shift from relying primarily on efficacy trials to increasing reliance on effectiveness trials. Efficacy trials use homogeneous, highly motivated samples with minimal complications from a single setting receiving intensive treatments delivered under highly controlled conditions. Two effectiveness trials on bullying prevention illustrate the use of a heterogeneous population from multiple sites receiving a low intensity tailored treatment delivered under highly variable conditions. In spite of considerable noise the effectiveness trials produced robust results (odds ratios of about four) that bode well for population impacts under real-world dissemination.

Key Words: bullying prevention • effectiveness • efficacy • smoking • stages of change

Journal of Health Psychology, Vol. 12, No. 1, 170-178 (2007)
DOI: 10.1177/1359105307071751
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