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. 2016 Jan;20 Suppl 1(0 1):S197-214.
doi: 10.1007/s10461-015-1145-4.

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS

Linda M Collins  1 , Kari C Kugler  2 , Marya Viorst Gwadz  3
Affiliations

Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS

Linda M Collins et al. AIDS Behav. 2016 Jan.

Abstract

To move society toward an AIDS-free generation, behavioral interventions for prevention and treatment of HIV/AIDS must be not only effective, but also cost-effective, efficient, and readily scalable. The purpose of this article is to introduce to the HIV/AIDS research community the multiphase optimization strategy (MOST), a new methodological framework inspired by engineering principles and designed to develop behavioral interventions that have these important characteristics. Many behavioral interventions comprise multiple components. In MOST, randomized experimentation is conducted to assess the individual performance of each intervention component, and whether its presence/absence/setting has an impact on the performance of other components. This information is used to engineer an intervention that meets a specific optimization criterion, defined a priori in terms of effectiveness, cost, cost-effectiveness, and/or scalability. MOST will enable intervention science to develop a coherent knowledge base about what works and does not work. Ultimately this will improve behavioral interventions systematically and incrementally.

Keywords: Behavioral intervention; Biobehavioral intervention; Factorial design; Fractional factorial design; Multiphase optimization strategy.

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Figures

Fig. 1
Fig. 1
Conceptual model of alcohol use and ART adherence among persons living with HIV/AIDS
Fig. 2
Fig. 2
Comparison of treatment package approach and multiphase optimization strategy (MOST) Differences are in bold
See this image and copyright information in PMC

References

    1. Collins LM, Murphy SA, Nair VN, Strecher VJ. A strategy for optimizing and evaluating behavioral interventions. Annals of Behavioral Medicine. 2005;30(1):65–73. - PubMed
    1. Collins LM, Murphy SA, Strecher V. The multiphase optimization strategy (MOST) and the sequential multiple assignment randomized trial (SMART): New methods for more potent e-health interventions. American Journal of Preventive Medicine. 2007;32:S112–S8. - PMC - PubMed
    1. Collins LM, Baker TB, Mermelstein RJ, Piper ME, Jorenby DE, Smith SS, et al. The multiphase optimization strategy for engineering effective tobacco use interventions. Annals of Behavioral Medicine. 2011;41(2):208–26. - PMC - PubMed
    1. Collins LM, Nahum-Shani I, Almirall D. Optimization of behavioral dynamic treatment regimens based on the sequential, multiple assignment, randomized trial (SMART) Clinical Trials. 2014:1740774514536795. - PMC - PubMed
    1. Seeley J, Watts CH, Kippax S, Russell S, Heise L, Whiteside A. Addressing the structural drivers of HIV: a luxury or necessity for programmes? Journal of the International AIDS Society. 2012;15(Suppl 1) - PMC - PubMed

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