The paper's purpose is to participate in a debate about the role of randomised controlled trials in evaluation of preventive interventions for children.
The paper is a response to critiques on Stewart‐Brown et al. published in the Journal of Children's Services, Vol. 6 No. 4, pp. 228–35.
Randomised controlled trials are likely to be at their best in the evaluation of interventions that do not require the active engagement and personal development of participants. The latter may depend on a series of interventions and events that potentiate each other over time. Randomised controlled trials are likely to be least valuable in evaluating universal level interventions that aim to change population norms. Because of the challenges involved in conducting RCTs in this setting they cannot be relied upon to give accurate estimates of programme effect and therefore do not deserve the privileged position that has been accorded them in the hierarchy of evidence.
This paper develops the argument that the privileged position of RCTs in the evidence hierarchy of preventive services for children is undeserved.
