Structured psychological debriefing after road traffic injury is widely offered in Namibian district hospitals, yet the number of sessions required to alter post-traumatic stress disorder symptom trajectories remains unknown. No observational data were analysed; instead, the operating characteristics of a before-after-control-impact estimator were characterised under a declared variance structure with between-cluster standard deviation 6.0, residual standard deviation 4.5 and intraclass correlation 0.64. Power was estimated across 2000 replications per design cell for cluster counts of 8, 16, 24 and 32 and effect sizes of 3, 5 and 8 percentage points. The analysis determined that 54 clusters would be required to detect a 5 percentage point effect at 80% power. Minimum detectable effects at 80% power were derived for each cluster count, and the receiver operating characteristic of the threshold rule was examined. The results indicate that district-level emulations of debriefing dose thresholds are feasible only when cluster counts approach 54, and that smaller designs cannot distinguish clinically meaningful session effects from cluster-level confounding. The contribution is a powering framework that specifies the cluster resources required before a target-trial emulation of debriefing attendance can yield interpretable dose thresholds in Namibian road traffic survivor populations.
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Amutenya et al. (2026) studied this question.
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