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20 - The Multiphase Optimization Strategy for Developing and Evaluating Behavioral Interventions

from Part V - Intervention Approaches

Published online by Cambridge University Press:  23 March 2020

Aidan G. C. Wright
Affiliation:
University of Pittsburgh
Michael N. Hallquist
Affiliation:
Pennsylvania State University
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Summary

This chapter introduces the multiphase optimization strategy (MOST), an engineering-inspired framework for optimizing multicomponent behavioral interventions. The chapter contrasts the typical development of interventions with the MOST framework and discusses the potential to achieve steady, systematic progress in intervention science. In contrast to the typical development of a multicomponent intervention wherein the intervention is tested en bloc via a randomized controlled trial (RCT), MOST introduces a phase of optimization prior to the RCT wherein the effect of individual components and the interaction between components is empirically tested. The objective of MOST is to arrive at an optimized intervention that is highly effective, but also efficient, economical, and scalable. This chapter provides an overview of the MOST framework and demonstrates its application using a hypothetical example of the optimization of a clinical intervention targeting posttraumatic stress disorder symptoms among children who have experienced maltreatment.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

Almirall, D., Nahum-Shani, I., Sherwood, N. E., & Murphy, S. A. (2014). Introduction to SMART Designs for the Development of Adaptive Interventions: With Application to Weight Loss Research. Translational Behavioral Medicine, 4(3), 260274.Google Scholar
Baker, T. B., Collins, L. M., Mermelstein, R., Piper, M. E., Schlam, T. R., Cook, J. W., … Fiore, M. C. (2015). Enhancing the Effectiveness of Smoking Treatment Research: Conceptual Bases and Progress. Addiction, 111, 107116.Google Scholar
Barth, R. P., Lee, B. R., Lindsey, M. A., Collins, K. S., Strieder, F., Chorpita, B. F., … Sparks, J. A. (2012). Evidence-Based Practice at a Crossroads: The Timely Emergence of Common Elements and Common Factors. Research on Social Work Practice, 22(1), 108119.CrossRefGoogle Scholar
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford.Google Scholar
Becker, K. D., Lee, B. R., Daleiden, E. L., Lindsey, M., Brandt, N. E., & Chorpita, B. F. (2015). The Common Elements of Engagement in Children’s Mental Health Services: Which Elements for Which Outcomes? Journal of Clinical Child & Adolescent Psychology, 44(1), 3043.Google Scholar
Berkowitz, S. J., Stover, C. S., & Marans, S. R. (2011). The Child and Family Traumatic Stress Intervention: Secondary Prevention for Youth at Risk of Developing PTSD. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(6), 676685.Google Scholar
Boustani, M. M., Gellatly, R., Westman, J. G., & Chorpita, B. F. (2017). Advances in Cognitive Behavioral Treatment Design: Time for a Glossary. The Behavior Therapist, 40(6), 199208.Google Scholar
Caldwell, L. L., Smith, E. a., Collins, L. M., Graham, J. W., Lai, M., Wegner, L., … Jacobs, J. (2012). Translational Research in South Africa: Evaluating Implementation Quality Using a Factorial Design. Child & Youth Care Forum, 41(2), 119136.Google Scholar
Carrion, V. G., Weems, C. F., Ray, R. D., Glaser, B., Hessl, D., & Reiss, A. L. (2002). Diurnal Salivary Cortisol in Pediatric Posttraumatic Stress Disorder. Biological Psychiatry, 51(7), 575582.Google Scholar
Chorpita, B. F., & Daleiden, E. L. (2009). Mapping Evidence-Based Treatments for Children and Adolescents: Application of the Distillation and Matching Model to 615 Treatments from 322 Randomized Trials. Journal of Consulting and Clinical Psychology, 77(3), 566579.Google Scholar
Chorpita, B. F., Becker, K. D., Daleiden, E. L., & Hamilton, J. D. (2007). Understanding the Common Elements of Evidence-Based Practice. Journal of the American Academy of Child & Adolescent Psychiatry, 46(5), 647652.CrossRefGoogle ScholarPubMed
Chorpita, B. F., Daleiden, E. L., Ebesutani, C. K., Young, J., Becker, K. D., Nakamura, B. J., … Starace, N. (2011). Evidence-Based Treatments for Children and Adolescents: An Updated Review of Indicators of Efficacy and Effectiveness. Clinical Psychology: Science and Practice, 18(2), 154172.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd edn.). London: Routledge.Google Scholar
Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating Trauma and Traumatic Grief in Children and Adolescents. New York: Guilford Press.Google Scholar
Collins, L. M. (2014). Optimizing Family Intervention Programs: The Multiphase Optimization Strategy (MOST). In McHale, S. M., Amato, P., & Booth, A. (Eds.), Emerging Methods in Family Research (pp. 1937). Basel: Springer International.Google Scholar
Collins, L. M. (2018). Optimization of Behavioral, Biobehavioral, and Biomedical Interventions: The Multiphase Optimization Strategy (MOST). New York: Springer.Google Scholar
Collins, L. M., & Kugler, K. C. (Eds.). (2018). Optimization of Multicomponent Behavioral, Biobehavioral, and Biomedical Interventions: Advanced Topics. New York: Springer.Google Scholar
Collins, L. M., Dziak, J. J., & Li, R. (2009). Design of Experiments with Multiple Independent Variables: A Resource Management Perspective on Complete and Reduced Factorial Designs. Psychological Methods, 14(3), 202224.Google Scholar
Collins, L. M., Baker, T. B., Mermelstein, R. J., Piper, M. E., Jorenby, D. E., Smith, S. S., … Fiore, M. C. (2011). The Multiphase Optimization Strategy for Engineering Effective Tobacco Use Interventions. Annals of Behavioral Medicine, 41(2), 208226.Google Scholar
Collins, L. M., MacKinnon, D. P., & Reeve, B. B. (2013). Some Methodological Considerations in Theory-Based Health Behavior Research. Health Psychology, 32(5), 586591.Google Scholar
Collins, L. M., Dziak, J. J., Kugler, K. C., & Trail, J. B. (2014a). Factorial Experiments: Efficient Tools for Evaluation of Intervention Components. American Journal of Preventive Medicine, 47(4), 498504.Google Scholar
Collins, L. M., Nahum-Shani, I., & Almirall, D. (2014b). Optimization of Behavioral Dynamic Treatment Regimens Based on the Sequential, Multiple Assignment, Randomized Trial (SMART). Clinical Trials, 11(4), 426434.Google Scholar
Collins, L. M., Trail, J. B., Kugler, K. C., Baker, T. B., Piper, M. E., & Mermelstein, R. J. (2014c). Evaluating Individual Intervention Components: Making Decisions Based on the Results of a Factorial Screening Experiment. Translational Behavioral Medicine, 4(3), 238251.CrossRefGoogle ScholarPubMed
Cook, J. W., Collins, L. M., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., … Mermelstein, R. (2016). Comparative Effectiveness of Motivation Phase Intervention Components for Use with Smokers Unwilling to Quit: A Factorial Screening Experiment. Addiction, 111(1), 117128.Google Scholar
Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic Events and Posttraumatic Stress in Childhood. Archives of General Psychiatry, 64(5), 577584.CrossRefGoogle ScholarPubMed
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma-Focused Cognitive Behavioral Therapy for Children: Impact of the Trauma Narrative and Treatment Length. Depression & Anxiety, 28(1), 6775.CrossRefGoogle ScholarPubMed
Dimidjian, S., Hollon, S., Dobson, K., Schmaling, K., Kohlenberg, R., Addis, M., … Jacobson, N. (2006). Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Acute Treatment of Adults with Major Depression. Journal of Consulting and Clinical Psychology, 74(4), 658670.CrossRefGoogle ScholarPubMed
Dorsey, S., Mclaughlin, K. A., Kerns, S. E. U., Harrison, J. P., Lambert, H. K., Briggs, E. C., … Amaya-Jackson, L. (2017). Evidence Base Update for Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events. Journal of Clinical Child & Adolescent Psychology, 46(3), 303330.Google Scholar
Dziak, J. J., Nahum-Shani, I., & Collins, L. M. (2012). Multilevel Factorial Experiments for Developing Behavioral Interventions: Power, Sample Size, and Resource Considerations. Psychological Methods, 17(2), 153175.Google Scholar
Dziak, J. J., Collins, L. M., & Wagner, A. T. (2013). FactorialPowerPlan SAS Macro Suite Users’ Guide (No. 1.0). University Park: Methodology Center, Pennsylvania State University.Google Scholar
Foa, E. B., McLean, C. P., Capaldi, S., & Rosenfield, D. (2013). Prolonged Exposure vs. Supportive Counseling for Sexual Abuse-Related PTSD in Adolescent Girls: A Randomized Clinical Trial. JAMA, 310(24), 26502657.Google Scholar
Gwadz, M. V., Collins, L. M., Cleland, C. M., Leonard, N. R., Wilton, L., Gandhi, M., … Scott Braithwaite, R. (2017). Using the Multiphase Optimization Strategy (MOST) to Optimize an HIV Care Continuum Intervention for Vulnerable Populations: A Study Protocol. BMC Public Health, 17, 120.Google Scholar
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research Electronic Data Capture (REDCap) – A Metadata-Driven Methodology and Workflow Process for Providing Translational Research Informatics Support. Journal of Biomedical Informatics, 42(2), 377381.CrossRefGoogle ScholarPubMed
Hayes, A. M., Yasinski, C., Grasso, D., Ready, C. B., Alpert, E., McCauley, T., … Deblinger, E. (2017). Constructive and Unproductive Processing of Traumatic Experiences in Trauma-Focused Cognitive-Behavioral Therapy for Youth. Behavior Therapy, 48(2), 166181.Google Scholar
Insel, T. R., & Gogtay, N. (2014). National Institute of Mental Health Clinical Trials: New Opportunities, New Expectations. JAMA Psychiatry, 71(7), 745746.CrossRefGoogle ScholarPubMed
Jacobson, N., Dobson, K., Truax, P., Addis, M., Koerner, K., Gollan, J., … Prince, S. (1996). A Component Analysis of Cognitive-Behavioral Treatment for Depression. Consulting and Clinical Psychology, 64(2), 295304.Google Scholar
Jacobson, N., Martell, C. R., & Dimidjian, S. (2001). Behavioral Activation Treatment for Depression: Returning to Contextual Roots. Clinical Psychology: Science and Practice, 8(3), 255270.Google Scholar
Kahana, S. Y., Feeny, N. C., Youngstrom, E., & Drotar, D. (2006). Posttraumatic Stress in Youth Experiencing Illnesses and Injuries: An Exploratory Meta-Analysis. Traumatology, 12(2), 148161.Google Scholar
Kugler, K. C., Balantekin, K. N., Birch, L. L., & Savage, J. S. (2016). Application of the Multiphase Optimization Strategy to a Pilot Study: An Empirical Example Targeting Obesity among Children of Low-Income Mothers. BMC Public Health, 16(1), 11811191.CrossRefGoogle ScholarPubMed
Kugler, K. C., Wyrick, D. L., Tanner, A. E., Milroy, J. J., Chambers, B. D., Ma, A., … Collins, L. M. (2018). Using the Multiphase Optimization Strategy (MOST) to Develop an Optimized Online STI Preventive Intervention Aimed at College Students: Description of Conceptual Model and Iterative Approach to Optimization. In Collins, L. M. & Kugler, K. C. (Eds.), Optimization of Multicomponent Behavioral, Biobehavioral, and Biomedical Interventions: Advanced Topics (pp. 121). New York: Springer.Google Scholar
Lindsey, M. A., Brandt, N. E., Becker, K. D., Lee, B. R., Barth, R. P., Daleiden, E. L., & Chorpita, B. F. (2014). Identifying the Common Elements of Treatment Engagement Interventions in Children’s Mental Health Services. Clinical Child and Family Psychology Review, 17, 283298.Google Scholar
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation Analysis. Annual Review of Psychology, 58, 593614.Google Scholar
Nahum-Shani, I., & Dziak, J. J. (2018). Multilevel Factorial Designs in Intervention Development. In Collins, L. M. & Kugler, K. C. (Eds.), Optimization of Multicomponent Behavioral, Biobehavioral, and Biomedical Interventions: Advanced Topics (pp. 4787). New York: Springer.CrossRefGoogle Scholar
Nahum-Shani, I., Dziak, J. J., & Collins, L. M. (2017). Multilevel Factorial Designs with Experiment-Induced Clustering. Psychological Methods, 22(3), 458479.Google Scholar
Nolen-Hoeksema, S., & Watkins, E. R. (2011). A Heuristic for Developing Transdiagnostic Models of Psychopathology: Explaining Multifinality and Divergent Trajectories. Perspectives on Psychological Science, 6(6), 589609.CrossRefGoogle ScholarPubMed
Pellegrini, C. A., Hoffman, S. A., Collins, L. M., & Spring, B. (2014). Optimization of Remotely Delivered Intensive Lifestyle Treatment for Obesity Using the Multiphase Optimization Strategy: Opt-IN Study Protocol. Contemporary Clinical Trials, 38(2), 251259.Google Scholar
Piper, M. E., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., Collins, L. M., … Baker, T. B. (2016). Identifying Effective Intervention Components for Smoking Cessation: A Factorial Screening Experiment. Addiction, 111(1), 129141.Google Scholar
Piper, M. E., Schlam, T. R., Fraser, D., Oguss, M., & Cook, J. W. (2018). Implementing Factorial Experiments in Real-World Settings: Lessons Learned While Engineering an Optimized Smoking Cessation Treatment. In Collins, L. M. & Kugler, K. C. (Eds.), Optimization of Multicomponent Behavioral, Biobehavioral, and Biomedical Interventions: Advanced Topics (pp. 2345). New York: Springer.CrossRefGoogle Scholar
Sanislow, C. A., Pine, D. S., Quinn, K. J., Kozak, M. J., Garvey, M. A., Heinssen, R. K., … Cuthbert, B. N. (2010). Developing Constructs for Psychopathology Research: Research Domain Criteria. Journal of Abnormal Psychology, 119(4), 631639.Google Scholar
Schlam, T. R., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., Collins, L. M., … Baker, T. B. (2016). Comparative Effectiveness of Intervention Components for Producing Long-Term Abstinence from Smoking: A Factorial Screening Experiment. Addiction, 111(1), 142155.Google Scholar
Shenk, C. E., Putnam, F. W., Rausch, J. R., Peugh, J. L., & Noll, J. G. (2014). A Longitudinal Study of Several Potential Mediators of the Relationship between Child Maltreatment and Posttraumatic Stress Disorder Symptoms. Development and Psychopathology, 26(1), 8191.Google Scholar
Shenk, C. E., Griffin, A. M., & O’Donnell, K. J. (2015). Symptoms of Major Depressive Disorder Subsequent to Child Maltreatment: Examining Change across Multiple Levels of Analysis to Identify Transdiagnostic Risk Pathways. Development and Psychopathology, 27(4 pt 2), 15031514.CrossRefGoogle ScholarPubMed
Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-Based Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events. Journal of Clinical Child & Adolescent Psychology, 37(1), 156183.Google Scholar
Steinberg, A. M., Brymer, M. J., Decker, K. B., & Pynoos, R. S. (2004). The University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index. Current Psychiatry Reports, 6(2), 96100.Google Scholar
Steinberg, A. M., Brymer, M. J., Kim, S., Briggs, E. C., Ippen, C. G., Ostrowski, S. A., … Pynoos, R. S. (2013). Psychometric Properties of the UCLA PTSD Reaction Index: Part I. Journal of Traumatic Stress, 26, 19.Google Scholar
Strecher, V. J., Mcclure, J. B., Alexander, G. L., Nair, V. N., Konkel, J. M., Greene, S. M., … Pomerleau, O. F. (2009). Web-Based Smoking-Cessation Program: Results of a Randomized Trial. American Journal of Preventive Medicine, 34(5), 373381.CrossRefGoogle Scholar
Trickett, P. K., Noll, J. G., Susman, E. J., Shenk, C. E., & Putnam, F. W. (2010). Attenuation of Cortisol across Development for Victims of Sexual Abuse. Development and Psychopathology, 22(1), 165175.Google Scholar
US Department of Health & Human Services, Administration for Children and Families, Administration on Children Youth and Families, & Children’s Bureau. (2017). Child Maltreatment 2015. Retrieved from www.acf.hhs.gov/programs/cb/research-data-technology/statistics-research/child-maltreatmentGoogle Scholar
Widom, C. S. (1999). Posttraumatic Stress Disorder in Abused and Neglected Children Grown Up. American Journal of Psychiatry, 156(8), 12231229.Google Scholar
Wyrick, D. L., Rulison, K. L., Fearnow-Kenney, M., Milroy, J. J., & Collins, L. M. (2014). Moving beyond the Treatment Package Approach to Developing Behavioral Interventions: Addressing Questions That Arose during an Application of the Multiphase Optimization Strategy (MOST). Translational Behavioral Medicine, 4(3), 252259.CrossRefGoogle ScholarPubMed

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