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

Abstract

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.

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