Optimization of behavioral and biobehavioral interventions: Building investigator capacity nationwide

项目总结/摘要 多成分行为和生物行为干预措施，如旨在预防和 治疗药物滥用、艾滋病毒和尼古丁依赖，在公共卫生中发挥着核心作用。迄今 干预措施的制定和评价主要依赖于传统的一揽子治疗方法， 其中，一组干预组件被先验地识别，被组装到治疗包中，并且 在随机对照试验（RCT）中评估其有效性。虽然RCT是一种很好的方法， 将干预措施作为一个整体与适当的对照组或比较组进行比较，单独使用RCT 无法解决对提高干预有效性、效率 经济性和可扩展性。最近出现了一种创新的替代方案，称为多相优化 战略（MOST）。社会变革管理计划是一个广泛的方法框架，其灵感来自工业工程等领域的基本和成熟的思想。社会变革管理计划包括对随机对照试验中的干预措施进行评价， 但它增加了一个额外的前期研究阶段，旨在优化干预。迄今为止，至少有30个 使用MOST的项目得到了10个NIH IC的资助，其中6个参与了RFA。有 新的和建立的干预科学家谁希望发展的培训需求相当大， 知识基础和MOST的技能。拟议工作的目的是建立调查员 通过开展广泛和可持续的培训工作，在全国范围内优化干预措施 专注于MOST。具体目标1是开发一个在线短期课程，提供全面的 通过视频和辅助材料介绍社会变革管理计划，并免费提供。具体目标二是 为完成短期课程的干预科学家提供机会， 获得国家卫生研究院资助和成功地将社会变革管理计划应用于其 research.这些机会将是（a）在美国各地举办三次为期2天的面对面培训， 包括小组练习，公开讨论，自我指导的数据分析实习，和个人 （B）跟进个别谘询会议。具体目标3是培养自我维持的 努力建设社会变革管理计划的调查能力，方法是：（a）为6名见习教员提供机会， 参加为期2天的面对面培训，（B）研究生课程的课程材料，以及（c）个人 就课程发展进行咨询。具体目标4是制作一系列视频和辅助材料 涵盖干预优化中的高级，专业和新兴主题，并使其免费 可在线获取。这项拟议中的工作将增加精通并获得资助的科学家人数。 优化行为和生物行为干预。这些科学家的工作将反过来产生 更有效、高效、经济和可扩展的干预措施，从而改善国家的健康状况， 药物滥用、艾滋病毒、癌症和无数其他重要的公共卫生领域。

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.