title: Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS.
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.
authors.affiliation: Department of Human Development and Family Studies and The Methodology Center, The Pennsylvania State University, 404 Health & Human Development Building, University Park, PA, 16802, USA. lmcollins@psu.edu.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Collins
authors.affiliation: The Methodology Center, The Pennsylvania State University, University Park, PA, USA.
authors.forename: Kari C
authors.initials: KC
authors.lastname: Kugler
authors.affiliation: Center for Drug Use and HIV Research (CDUHR), College of Nursing, New York University, New York, NY, USA.
authors.forename: Marya Viorst
authors.initials: MV
authors.lastname: Gwadz
mesh_terms: D001521:Behavior Therapy / Q000379:methods*; D003362:Cost-Benefit Analysis; D004738:Engineering / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008962:Models, Theoretical; D017063:Outcome Assessment, Health Care; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods; D040242:Risk Reduction Behavior
keywords: Behavioral intervention; Biobehavioral intervention; Factorial design; Fractional factorial design; Multiphase optimization strategy