One view of the next decade of research on behavioral and biobehavioral approaches to cancer prevention and control: intervention optimization

Abstract

As a new decade begins, we propose that the time is right to reexamine current methods and procedures and look for opportunities to accelerate progress in cancer prevention and control. In this article we offer our view of the next decade of research on behavioral and biobehavioral interventions for cancer prevention and control. We begin by discussing and questioning several implicit conventions. We then briefly introduce an alternative research framework: the multiphase optimization strategy (MOST). MOST, a principled framework for intervention development, optimization, and evaluation, stresses not only intervention effectiveness, but also intervention affordability, scalability, and efficiency. We review some current limitations of MOST along with future directions for methodological work in this area, and suggest some changes in the scientific environment we believe would permit wider adoption of intervention optimization. We propose that wider adoption of intervention optimization would have a positive impact on development and successful implementation of interventions for cancer prevention and control and on intervention science more broadly, including accumulation of a coherent base of knowledge about what works and what does not; establishment of an empirical basis for adaptation of interventions to different settings with different levels and types of resources; and, in the long run, acceleration of progress from Stage 0 to Stage V in the National Institutes of Health Model of Stages of Intervention Development.

mHealth Interventions to Promote a Healthy Diet and Physical Activity among Cancer Survivors: A Systematic Review of Randomized Controlled Trials

“…Our results show that mHealth interventions are a promising approach to improving physical activity and dietary behaviors in cancer survivors. To better establish the optimal types and combination of mHealth interventions for cancer survivors, alternative study designs, as described by the Multiphase Optimization Strategy framework, may be useful [ 59 ]. Additionally, studies with larger sample sizes, longer study periods, and more racially/ethnically and socioeconomically diverse study populations are needed.…”

Refining and optimising a behavioural intervention to support endocrine therapy adherence (ROSETA) in UK women with breast cancer: protocol for a pilot fractional factorial trial

“…The optimised intervention package can be evaluated in a definitive RCT. The process of optimisation aims to yield more effective, affordable, scalable and efficient intervention packages compared with alternative approaches 24 25. Given the complexity of adherence behaviours, the lack of information available about individual intervention component efficacy, and the need to address an important clinical problem efficiently, we used the MOST framework to guide our approach to intervention optimisation.…”

Acceptability, fidelity and trial experience of four intervention components to support medication adherence in women with breast cancer: A process evaluation protocol for a pilot fractional factorial trial

“…Experimental versions of the intervention components are being assessed for feasibility in an external, multi-site exploratory pilot trial. Guided by the Multiphase Optimisation Strategy (MOST), a framework used to optimise multicomponent behavioural interventions [15][16][17] , this pilot trial is using a highly efficient 2 4-1 fractional factorial design. Participants are randomised to one of eight experimental conditions, in which they may receive usual care plus a combination of intervention components.…”