Chronic Disease Prevention

Near Top Tier Updated: Nov 21, 2017

Healthy Living Partnerships to Prevent Diabetes (HELP PD)

Randomized controlled trial shows effects on weight and other diabetes risk factors over two years.

Suggestive Tier Updated: Jan 12, 2018

Obesity Treatment through Behavioral Coaching

Randomized controlled trial shows meaningful weight loss sustained over a two-year period.

Suggestive Tier Updated: May 25, 2018

Community Health Worker-Led Intervention to Control Blood Pressure

Randomized controlled trial shows sizable, statistically significant increase in the rate of controlled hypertension 18 months after random assignment.

Top Tier

Programs shown in well-conducted RCTs, carried out in typical community settings, to produce sizable, sustained effects on important outcomes. Top Tier evidence includes a requirement for replication – specifically, the demonstration of such effects in two or more RCTs conducted in different implementation sites, or, alternatively, in one large multi-site RCT. Such evidence provides confidence that the program would produce important effects if implemented faithfully in settings and populations similar to those in the original studies.
Near Top Tier

Programs shown to meet almost all elements of the Top Tier standard, and which only need one additional step to qualify. This category primarily includes programs that meet all elements of the Top Tier standard in a single study site, but need a replication RCT to confirm the initial findings and establish that they generalize to other sites. This is best viewed as tentative evidence that the program would produce important effects if implemented faithfully in settings and populations similar to those in the original study.
Suggestive Tier

Programs that have been evaluated in one or more well-conducted RCTs (or studies that closely approximate random assignment) and found to produce sizable positive effects, but whose evidence is limited by only short-term follow-up, effects that fall short of statistical significance, or other factors. Such evidence suggests the program may be an especially strong candidate for further research, but does not yet provide confidence that the program would produce important effects if implemented in new settings.