An Abductive Theory of Method for Addressing Challenges in Evidence-Based Prevention

Introduction: Systems to establish whether prevention programs are ‘evidence-based’ rely heavily on the logic of deductive reasoning to establish scientific inference. This reliance has fostered implementation of scientifically-based strategies with explicitly stated standards of evidence used to gauge program validity and suitability for dissemination. Frequently, investigators utilize the randomized controlled trial (RCT) as a means to rule out competing hypotheses and control extraneous variation. Across numerous disciplines, including prevention science, this design strategy has achieved success, but is not without its challenges.

Method: In this presentation, we review the principles of the hypothetico-deductive method as applied to evidence-based prevention and outline three challenges that strict allegiance to the method engenders, including issues related to the reproducibility, generalizability, and credibility of program evaluation findings. We then posit that extending current standards of evidence with principles drawn from an abductive theory of method can strengthen our ability to address these challenges.

Results: Abduction involves working from observed phenomena to the generation of alternative explanations for the phenomena and comparing the alternatives to select the best possible explanation. We discuss how its principles can address the challenges of evidence-based prevention by suggesting methods that go beyond the RCT for improving the reproducibility (meta-analysis, big data analytics, grounded theory), generalizability (non-linear analysis, mixed quantitative-qualitative methods), and credibility (inference to the best explanation, without ultimate certainty) of program evaluation findings.

Conclusions: Further gains in prevention science will be contingent on ensuring that findings generated by the field are reliable, valid, and credible. Such gains will only be partially realized with a sole commitment to improving the rigor and transparency of RCTs (e.g., through good clinical practice training and trial registration requirements). Instead, more significant steps forward might be achieved by extending current research practices with those guided by abductive principles, as reflected in recommendations provided herein. Doing so may help the field increase its influence and impact, ultimately for public health benefit.