PROJECT SUMMARY/ABSTRACT
Multicomponent behavioral and biobehavioral interventions, such as interventions aimed at preventing and
treating substance abuse, HIV, and nicotine dependence, play a central role in public health. To date
development and evaluation of interventions has relied primarily on the classical treatment package approach,
in which a set of intervention components is identified a priori, assembled into a treatment package, and
evaluated for effectiveness in a randomized controlled trial (RCT). Although the RCT is an excellent way to
compare an intervention as a package to a suitable control or comparison group, use of the RCT alone does
not enable addressing research questions that are critical for improving intervention effectiveness, efficiency,
economy, and scalability. Recently an innovative alternative has emerged, called the multiphase optimization
strategy (MOST). MOST is a broad methodological framework inspired by ideas that are fundamental and well-established in fields such as industrial engineering. MOST includes evaluation of an intervention in an RCT,
but it adds an additional prior phase of research aimed at optimization of the intervention. To date, at least 30
projects using MOST have been funded by 10 NIH ICs, 6 of which participate in this RFA. There is
considerable demand for training among both new and established intervention scientists who wish to develop
intellectual grounding and a skill set in MOST. The purpose of the proposed work is to build investigator
capacity in intervention optimization nationwide by developing a wide-reaching and sustainable training effort
focused on MOST. Specific Aim 1 is to develop an online short course that provides a comprehensive
introduction to MOST via videos and supporting materials, and make it freely available. Specific Aim 2 is to
provide opportunities for intervention scientists who have completed the short course to gain additional
conceptual and practical expertise needed to obtain NIH funding and apply MOST successfully in their
research. These opportunities will be (a) three 2-day in-person trainings at various locations around the US,
consisting of small group exercises, open discussion, a self-guided data analysis practicum, and individual
consultation, and (b) follow-up individual consultation sessions. Specific Aim 3 is to foster a self-sustaining
effort to build investigator capacity in MOST by providing (a) opportunities for 6 apprentice instructors to
participate in the 2-day in-person trainings, (b) curriculum materials for a graduate course, and (c) individual
consultation on course development. Specific Aim 4 is to develop a series of videos with supporting materials
covering advanced, specialized, and emerging topics in intervention optimization and make them freely
available online. The proposed work will increase the number of scientists proficient in and funded for
optimization of behavioral and biobehavioral interventions. The work of these scientists will, in turn, produce
more effective, efficient, economical, and scalable interventions, and thereby improve the nation’s health in
substance abuse, HIV, cancer, and countless other important areas of public health.