一种优化和评估行为干预措施的策略。

A strategy for optimizing and evaluating behavioral interventions.

作者信息

Collins Linda M, Murphy Susan A, Nair Vijay N, Strecher Victor J

机构信息

The Methodology Center, Department of Human Development and Family Studies, The Pennsylvania State University, University Park 16802, USA.

出版信息

Ann Behav Med. 2005 Aug;30(1):65-73. doi: 10.1207/s15324796abm3001_8.

DOI:10.1207/s15324796abm3001_8

PMID:16097907

Abstract

BACKGROUND

Although the optimization of behavioral interventions offers the potential of both public health and research benefits, currently there is no widely agreed-upon principled procedure for accomplishing this.

PURPOSE

This article suggests a multiphase optimization strategy (MOST) for achieving the dual goals of program optimization and program evaluation in the behavioral intervention field.

METHODS

MOST consists of the following three phases: (a) screening, in which randomized experimentation closely guided by theory is used to assess an array of program and/or delivery components and select the components that merit further investigation; (b) refining, in which interactions among the identified set of components and their interrelationships with covariates are investigated in detail, again via randomized experiments, and optimal dosage levels and combinations of components are identified; and (c) confirming, in which the resulting optimized intervention is evaluated by means of a standard randomized intervention trial. To make the best use of available resources, MOST relies on design and analysis tools that help maximize efficiency, such as fractional factorials.

RESULTS

A slightly modified version of an actual application of MOST to develop a smoking cessation intervention is used to develop and present the ideas.

CONCLUSIONS

MOST has the potential to husband program development resources while increasing our understanding of the individual program and delivery components that make up interventions. Considerations, challenges, open questions, and other potential benefits are discussed.

摘要

背景

尽管行为干预的优化具有公共卫生和研究效益的潜力，但目前尚无广泛认可的原则性程序来实现这一目标。

目的

本文提出一种多阶段优化策略（MOST），以实现行为干预领域中项目优化和项目评估的双重目标。

方法

MOST由以下三个阶段组成：（a）筛选，即使用由理论紧密指导的随机试验来评估一系列项目和/或实施组件，并选择值得进一步研究的组件；（b）细化，即再次通过随机试验详细研究已确定的组件集之间的相互作用及其与协变量的相互关系，并确定组件的最佳剂量水平和组合；（c）确认，即通过标准的随机干预试验对最终优化的干预措施进行评估。为了充分利用现有资源，MOST依赖于有助于提高效率的设计和分析工具，如分数析因设计。