Annals of Behavioral Medicine

, Volume 30, Issue 1, pp 65–73

A strategy for optimizing and evaluating behavioral interventions

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

DOI: 10.1207/s15324796abm3001_8

Cite this article as:
Collins, L.M., Murphy, S.A., Nair, V.N. et al. ann. behav. med. (2005) 30: 65. doi:10.1207/s15324796abm3001_8


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.

Copyright information

© The Society of Behavioral Medicine 2005

Authors and Affiliations

  • Linda M. Collins
    • 1
  • Susan A. Murphy
    • 3
  • Vijay N. Nair
    • 4
  • Victor J. Strecher
    • 5
  1. 1.The Methodology Center Department of Human Development and Family StudiesThe Pennsylvania State UniversityUSA
  2. 2.College of Health and Human Development, Penn StateThe Methodology CenterUniversity Park
  3. 3.Institute for Social Research Department of StatisticsUniversity of MichiganUSA
  4. 4.Department of Statistics Department of Industrial and Operations EngineeringUniversity of MichiganUSA
  5. 5.Department of Health Behavior and Health EducationUniversity of MichiganUSA

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