Should we give up on RCTs?
This is a guest post by Andrew Smith, a Research Associate at the Policy Evaluation and Research Unit where he runs www.reducing-reoffending.uk
Finding new solutions
The need to find solutions to new and enduring challenges has been at the forefront of scientific progress and the improvement of living conditions. This quest has often accelerated during times of unprecedented change, danger or novel problems. Writing during one of the greatest public health challenges in generations, it is clear that the scale of the pandemic is being met by an overwhelming scientific effort to find a vaccine that works. And this effort is largely underpinned by one research method: the randomized controlled trial (RCT).
Whilst medical trials are a familiar example of the use of experimental methods, RCTs are also used in many non-medical fields, including criminal justice, to help policy makers to understand what works. For example, the US National Institute of Justice provides details of nearly 100 programmes that have been deemed ‘effective’ as a result of evidence from trials. This evidence is based on mathematical logic and statistical methods and many policymakers and researchers see trials as being a method par excellence when it comes to being certain about whether or not a programme or intervention works.
Randomised Controlled Trials
But as my colleagues and I point out in a recently published paper, the quantitative basis of RCTs (the very thing that makes them so effective in the quest to understand what works) is also a significant limitation. RCTs tell us ‘what worked’, and not necessarily how it worked. Neither do they tell us how well the programme was implemented, nor whether it will work elsewhere or in the future. To answer these sorts of questions different forms of evidence can be really helpful. That doesn’t mean giving up on RCTs. In other sectors researchers are starting to combine different kinds of evidence much more effectively as part of a ‘multi-method’ approach. So, alongside the RCT they may use qualitative methods such as interviews and focus groups to better understand the mechanisms within an intervention that cause an outcome or the importance of different contextual factors. They might also develop a program theory about how exactly the intervention is expected to work. But when we reviewed recent criminological RCTs we struggled to find the kinds of methodological innovations that are becoming commonplace in sectors such healthcare, education and international development.
The idea behind a RCT or ‘trial’ is quite simple: test some sort of intervention (perhaps a new pharmaceutical drug or a new programme of cognitive behavioural therapy) by administering it to one group of people and comparing the outcome with another group who don’t get the intervention. As long as the groups are large enough, the trial is well conducted, and (importantly!) individuals are randomly assigned to the groups, the difference in outcomes between the groups (e.g. health, educational attainment, reoffending) is wholly and directly attributable to the intervention. Using trials in this way helps researchers, evaluators and policy makers to systematically test interventions in order to understand what works in any given field. This approach has gained considerable traction in government and policymaking circles around the world. In the UK, the government’s nine independent What Works centres and affiliates largely base their approach on commissioning and summarising evidence from RCTs and experimental methods. They cover policy areas such as crime reduction, local economic growth and education, which account for more than £250 billion of public spending.
RCTs and criminology
Despite the support for RCTs across a range of social policy areas in the UK, most criminology trials to date have taken place in the US, with some examples in Europe and relatively few in the UK. Nevertheless, in our recent review we were encouraged by the growth in the use of trials outside the US, including in the UK, helped in part by the What Works Centres and the wider evidence-based policy movement.
But while we found evidence of more criminological RCTs taking place in the UK, they, like their counterparts in the US don’t seem to be routinely adopting multi-method approaches. To test this we searched for RCTs published in four high quality criminology journals between 2013 and 2018. We found 46 which met our search criteria, only four of which described the planned use of qualitative methods in this way.
The development of RCTs in criminology seems, to us, to be going down a different route to some other fields such as healthcare, international development and education where multi-method approaches are becoming the norm. An example from international development illustrates the value of ‘multi-method RCTs’. When a trial found that a HIV prevention programme in Uganda actually led to an unexpected increase in risky sexual behaviour, qualitative work established that the intervention was not consistently implemented and identified reasons for this behavioural change in villages which received the intervention. These kinds of findings are vital to any future rollout of an intervention and give important clues as to how the intervention should be further developed.
The value of qualitative research
We therefore make a strong case for paying more attention to developing programme theory and to using qualitative methods in multi-method RCTs. Programme theories (for example, theories of change) are an aid to understanding how a programme or intervention is expected to work thereby signposting areas where qualitative research is needed and helping researchers interpret the findings of the RCT.
So, given the advantages afforded by multi-method RCTs, why aren’t there more examples in criminology? We suggest several reasons. Perhaps those who conduct and commission trials tend to favour quantitative evidence whilst being agnostic or sceptical about the value of qualitative research. Criminology is also an area which spans and is informed by a number of different disciplines and therefore may be methodologically fragmented. Like many academic subjects it has seen its fair share of ‘paradigm wars’ – disputes about the seemingly irreconcilable differences between quantitative and qualitative perspectives and the philosophies that underpin them. Some leading (US) criminological journals also tend to favour quantitative research.
We also offered a number of ideas to move criminology towards greater use of multi-method RCTs. These include the academic training of criminologists as mixed-method researchers, the staffing of research and evaluation teams with specialists representing a range of methodological perspectives, and that criminologists take more notice of the development of multi-method RCTs in other fields.
Now is time for the criminal justice sector to rethink how it evaluates programmes designed to reduce crime, not by giving up on RCTs, but by doing them differently.
Thanks to Science in HD for kind permission to use the images in this blog which were originally published on Unsplash.