Send to

Choose Destination
Ann Behav Med. 2019 Oct 5. pii: kaz035. doi: 10.1093/abm/kaz035. [Epub ahead of print]

Developing a Psychological-Behavioral Intervention in Cardiac Patients Using the Multiphase Optimization Strategy: Lessons Learned From the Field.

Author information

Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
The Methodology Center and Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA.



The Multiphase Optimization Strategy (MOST) is an approach to systematically and efficiently developing a behavioral intervention using a sequence of experiments to prepare and optimize the intervention.


Using a 6 year MOST-based behavioral intervention development project as an example, we outline the results-and resulting decision-making process-related to experiments at each step to display the practical challenges present at each stage.


To develop a positive psychology (PP) based intervention to promote physical activity after an acute coronary syndrome (N = 255 across four phases), we utilized qualitative, proof-of-concept, factorial design, and randomized pilot experiments, with iterative modification of intervention content and delivery.


Through this multiphase approach, we ultimately developed a 12 week, phone-delivered, combined PP-motivational interviewing intervention to promote physical activity. Across stages, we learned several important lessons: (a) participant and interventionist feedback is important, even in later optimization stages; (b) a thoughtful and systematic approach using all information sources is required when conflicting results in experiments make next steps unclear; and (3) new approaches in the field over a multiyear project should be integrated into the development process.


A MOST-based behavioral intervention development program can be efficient and effective in developing optimized new interventions, and it may require complex and nuanced decision-making at each phase.


Intervention development; Motivational interviewing; Multiphase optimization strategy; Optimization; Physical activity; Positive psychology


Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center