Optimization of behavioral and biobehavioral interventions: Building investigator capacity nationwide

项目摘要/摘要 多组分的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。到目前为止 干预措施的开发和评估主要依赖于经典的一揽子治疗方法， 其中先验地识别一组干预组件，将其组装成治疗包，以及 在随机对照试验(RCT)中评估有效性。尽管RCT是一种很好的方式来 将干预措施作为一揽子方案与适当的对照组或对照组进行比较，仅使用随机对照试验 不能解决对提高干预效果、效率、 经济性和可扩展性。最近出现了一种创新的方案，称为多阶段优化 战略(MOST)。MOST是一个广泛的方法论框架，其灵感来自于工业工程等领域的基本和成熟的思想。大多数包括对随机对照试验中干预措施的评估， 但它增加了旨在优化干预的额外前期研究阶段。到目前为止，至少有30人 使用MOST的项目得到了10个NIH IC的资助，其中6个参与了这次RFA。的确有 新的和现有的干预科学家都有相当大的培训需求，他们希望开发出 学识扎实，有一技之长。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的能力 专注于大多数人。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MOST，并免费提供。具体目标2是 为完成短期课程的干预科学家提供机会以获得更多 获得NIH资金并最成功地应用于其 研究。这些机会将是：(A)在美国各地进行三次为期两天的面对面培训， 由小组练习、开放讨论、自我指导的数据分析练习和个人组成 咨询，以及(B)后续个别磋商会议。具体目标3是培养一种自我维持的 努力建设社会变革管理计划的研究人员能力，方法是：(A)为6名见习教员提供机会 参加为期两天的面对面培训，(B)研究生课程材料，和(C)个人 就课程发展进行谘询。具体目标4是开发一系列带有辅助材料的视频 涵盖干预优化方面的高级、专业和新兴主题，并免费 可在网上获得。拟议的工作将增加精通和资助研究的科学家的数量 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、更高效、更经济、更可扩展的干预措施，从而改善 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.