Optimization of Behavioral, Biobehavioral, and Biomedical Interventions - Advanced Topics

Abstract

This book presents a framework for development, optimization, and evaluation of behavioral, biobehavioral, and biomedical interventions. Behavioral, biobehavioral, and biomedical interventions are programs with the objective of improving and maintaining human health and well-being, broadly defined, in individuals, families, schools, organizations, or communities. These interventions may be aimed at, for example, preventing or treating disease, promoting physical and mental health, preventing violence, or improving academic achievement. This volume introduces the Multiphase Optimization Strategy (MOST), pioneered at The Methodology Center at the Pennsylvania State University, as an alternative to the classical approach of relying solely on the randomized controlled trial (RCT). MOST borrows heavily from perspectives taken and approaches used in engineering, and also integrates concepts from statistics and behavioral science, including the RCT. As described in detail in this book, MOST consists of three phases: preparation, in which the conceptual model underlying the intervention is articulated; optimization, in which experimentation is used to gather the information necessary to identify the optimized intervention; and evaluation, in which the optimized intervention is evaluated in a standard RCT. Through numerous examples, the book demonstrates that MOST can be used to develop interventions that are more effective, efficient, economical, and scalable. Optimization of Behavioral, Biobehavioral, and Biomedical Interventions: The Multiphase Optimization Strategy is the first book to present a comprehensive introduction to MOST. It will be an essential resource for behavioral, biobehavioral, and biomedical scientists; statisticians, biostatisticians, and analysts working in epidemiology and public health; and graduate-level courses in development and evaluation of interventions. Intro; Preface; A Vision for the Future; A Brief Comparison of the Classical Approach and MOST; How MOST Has Been Developed So Far; Some Examples of Implementations of MOST; Objective and Chapters; Intended Audiences and How to Use This Book; Interventions in Different Domains; Additional Resources; Acknowledgments; Concluding Remarks; References; Contents; Chapter 1: Conceptual Introduction to the Multiphase Optimization Strategy (MOST); 1.1 Introduction; 1.1.1 An Approach Inspired by Ideas From Engineering; 1.1.2 The Objective: Optimized Rather Than Best. 1.1.3 The Kind of Information Needed for Optimization1.1.4 Using Research Resources Strategically to Obtain the Needed Information; 1.2 Optimizing an Intervention: A Brief Hypothetical Example; 1.2.1 The MOST Perspective; 1.2.2 Gathering the Information Needed to Optimize the Intervention; 1.2.3 From Experimental Results to Optimized Intervention; 1.3 Definition of Optimization of an Intervention; 1.3.1 Optimization Is a Process: The Continual Optimization Principle; 1.3.2 Four Desiderata: Effectiveness, Efficiency, Economy, and Scalability; 1.3.3 Trade-Offs Among the Desiderata. 1.4 The Resource Management Principle1.5 Some Differences Between the Classical and MOST Perspectives; 1.6 Definitions of Some Important Terms; 1.6.1 Design; 1.6.2 Component; 1.6.3 Multicomponent Interventions; 1.7 The MOST Framework: The Three Phases; 1.7.1 The Preparation Phase; 1.7.2 The Optimization Phase; 1.7.3 The Evaluation Phase; 1.8 Reasons for Returning to the Preparation Phase; 1.8.1 Returning to the Preparation Phase Immediately After the Optimization Phase; 1.8.2 Returning to the Preparation Phase After the Evaluation Phase; 1.9 The Distinction Between Optimization and Evaluation. 1.10 A Different Way of Thinking About Intervention Research: MOST-Induced Dilemmas1.11 WhatÂś Next; References; Chapter 2: The Preparation Phase of MOST; 2.1 The Conceptual Model: The ``EngineÂÁ̂ ́that Drives the Intervention; 2.1.1 Specifying the Conceptual Model; 2.1.2 Targeted Populations and Participant Heterogeneity; 2.2 Using a Figure to Represent a Conceptual Model; 2.2.1 A Hypothetical Example; 2.2.2 Tracing the Causal Chain; 2.3 Using the Conceptual Model to Select Outcome Variables for the Optimization and Evaluation Phases of MOST. 2.3.1 When the Outcome of Primary Interest Is Far in the Future2.4 The Living Conceptual Model; 2.5 Correspondence Between Components and Target Mediators; 2.5.1 The Granularity of Components; 2.6 Meta-Analysis and the Conceptual Model; 2.7 Including Moderation (Effect Modification) in a Figure Representing a Conceptual Model; 2.8 Why Bother With a Conceptual Model?; 2.9 The Role of Pilot Testing in MOST; 2.10 The Optimization Criterion; 2.10.1 Reasons for Identifying the Optimization Criterion in the Preparation Phase Rather Than the Optimization Phase.