摘要：Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks such as the Prevention Research Centers. The generally robust methods of multisite randomized controlled trials (RCTs) 1 , 2 purchase high standards of internal validity and statistical power with the currency of external validity. The very discipline applied to such trials that makes them trustworthy engines for the generation of insights about efficacy seriously compromises their utility for the demonstration of real-world effectiveness. 1 What happens in an RCT may, alas, stay in an RCT. 2 Most multisite RCTs add diversity of geography, populations, and settings, but they generally insist on standardization of the interventions being tested, which means that they do not allow for adaptation of intervention to the local circumstances and populations.
