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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

1
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
2
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
3
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
4
The Methodology Center and Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA.

Abstract

BACKGROUND:

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.

PURPOSE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
31586194
DOI:
10.1093/abm/kaz035

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