itMatters : Optimization of an online intervention to prevent sexually transmitted infections in college students

Annals of Behavioral Medicine

Rulison

et al. 2021

Self Cite

Background Using the multiphase optimization strategy (MOST), we previously developed and optimized an online behavioral intervention, itMatters, aimed at reducing the risk of sexually transmitted infections (STI) among first-year college students by targeting the intersection of alcohol use and sexual behaviors. Purpose We had two goals: (a) to evaluate the optimized itMatters intervention and (b) to determine whether the candidate sexual violence prevention (SVP) component (included at the request of participating universities) had a detectable effect and therefore should be added to create a new version of itMatters. We also describe the hybrid evaluation-optimization trial we conducted to accomplish these two goals in a single experiment. Methods First year college students (N = 3,098) at four universities in the USA were individually randomized in a hybrid evaluation-optimization 2 × 2 factorial trial. Data were analyzed using regression models, with pre-test outcome variables included as covariates in the models. Analyses were conducted separately with (a) immediate post-test scores and (b) 60-day follow-up scores as outcome variables. Results Experimental results indicated a significant effect of itMatters on targeted proximal outcomes (norms) and on one distal behavioral outcome (binge drinking). There were no significant effects on other behavioral outcomes, including the intersection of alcohol and sexual behaviors. In addition, there were mixed results (positive short-term effect; no effect at 60-day follow-up) of the SVP component on targeted proximal outcomes (students’ self-efficacy to reduce/prevent sexual violence and perceived effectiveness of protective behavioral strategies). Conclusions The hybrid evaluation-optimization trial enabled us to evaluate the individual and combined effectiveness of the optimized itMatters intervention and the SVP component in a single experiment, conserving resources and providing greatly improved efficiency. Trial Registration NCT04095065.

Section: Application Of Most In Itmatters's Development Optimization ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Hybrid Evaluation-Optimization Trial to Evaluate an Intervention Targeting the Intersection of Alcohol and Sex in College Students and Simultaneously Test an Additional Component Aimed at Preventing Sexual Violence

Tanner

Annals of Behavioral Medicine

Rulison

et al. 2021

Self Cite

“…The multiphase optimization strategy (MOST) is a framework for the development, optimization and evaluation of multicomponent behavioural and biobehavioural interventions 2 . MOST has been applied in a number of public health priority areas including smoking cessation, 3 obesity, 4 heart disease, 5 HIV, 6,7 palliative care 8 and the prevention of sexually transmitted infections 9,10 . In this introduction to MOST, our intent is to demonstrate how MOST can be used to increase the public health impact of social and behavioural oral health interventions.…”

Section: Introductionmentioning

confidence: 99%

“…2 MOST has been applied in a number of public health priority areas including smoking cessation, 3 obesity, 4 heart disease, 5 HIV, 6,7 palliative care 8 and the prevention of sexually transmitted infections. 9,10 In this introduction to MOST, our intent is to demonstrate how MOST can be used to increase the public health impact of social and behavioural oral health interventions. Specifically, using a hypothetical example, we seek to demonstrate how MOST permits intervention scientists to identify interventions that offer the best balance of effectiveness and other important considerations, including affordability, scalability and efficiency (i.e., intervention EASE).…”

Section: Introductionmentioning

confidence: 99%

Multiphase optimization strategy: How to build more effective, affordable, scalable and efficient social and behavioural oral health interventions

Strayhorn

2023

Comm Dent Oral Epid

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This commentary introduces the field of social behavioural oral health interventions to the multiphase optimization strategy (MOST). MOST is a principled framework for the development, optimization and evaluation of multicomponent interventions.Drawing from the fields of engineering, behavioural science, economics, decision science and public health, intervention optimization requires a strategic balance of effectiveness with affordability, scalability and efficiency. We argue that interventions developed using MOST are more likely to maximize the public health impact of social behavioural oral health interventions.

“…Over the past 15 years, over 100 projects applying MOST have been funded by the National Institutes of Health across many institutes and centers across a number of public health priority areas including smoking cessation (e.g., Piper et al, 2016), obesity (e.g., Spring et al, 2020), heart disease (e.g., Celano et al, 2018), HIV (e.g., Caldwell et al, 2012;Gwadz et al, 2017), and the prevention of sexually transmitted infections (STI; Tanner et al, 2021;Wyrick et al, 2020). For example, in an online intervention to prevent STI among first year college students five theoretically and empirically supported components were identified and tested following the MOST framework (Wyrick et al, 2020). Experimental data from a highly efficient randomized experimental trial indicated that only two components had a significant effect on the outcome of interest.…”

Section: Introductionmentioning

confidence: 99%

The Multiphase Optimization Strategy (MOST) in Child Maltreatment Prevention Research

Strayhorn

2021

J Child Fam Stud

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Each year hundreds of thousands of children and families receive behavioral interventions designed to prevent child maltreatment; yet rates of maltreatment have not declined in over a decade. To reduce the prevalence and prevent the lifelong negative consequences of child maltreatment, behavioral interventions must not only be effective, but also affordable, scalable, and efficient to meet the demand for these services. An innovative approach to intervention science is needed. The purpose of this article is to introduce the multiphase optimization strategy (MOST) to the field of child maltreatment prevention. MOST is an engineering-inspired framework for developing, optimizing, and evaluating multicomponent behavioral interventions. MOST enables intervention scientists to empirically examine the performance of each intervention component, independently and in combination. Using a hypothetical example of a home visiting intervention and artificial data, this article demonstrates how MOST may be used to optimize the content of a parent-focused in-home intervention and the engagement strategies of an intervention to increase completion rate to identify an intervention that is effective, efficient, economical, and scalable. We suggest that MOST will ultimately improve prevention science and hasten the progress of translational science to prevent child maltreatment. Keywords Home visiting• Multiphase optimization strategy (MOST) • Child maltreatment • Intervention science • Behavioral interventions Highlights •To reduce prevalence rates of child maltreatment an innovative approach to prevention is needed.• Home visiting programs can be developed or refined to not only be more effective but also affordable, scalable, and efficient.• Using the multiphase optimization strategy (MOST) can improve the public health impact.