Predictors of Effective Scaling: A Meta-Epidemiological Study of Bias in Early-Stage Studies to Prevent Chronic Disease

项目概要/摘要 开发既有效又可扩展的行为干预措施是一项重大任务 行为科学领域的挑战。许多行为干预措施在其方面表现出了早期的希望 测试，但在更大规模、更有力的评估中却无法发挥作用。这种常见模式（即初始 承诺然后失败）浪费宝贵的资源和时间。该提案的目的是调查 公共卫生行为发展的初步、早期研究（例如试点、可行性研究） 干预措施关注早期测试期间引入的内部和外部偏差。这项研究将 利用已制定的搜索策略和现有资源进行一系列元流行病学研究 针对成人身体活动和饮食行为的行为干预措施的审查。在这些评论中， 通过已发表的早期研究和已发表的更有力的试验进行行为干预 相同/相似的干预措施将针对外部和内部有效性偏差的存在进行系统编码。 将运行元回归模型来了解早期研究中每种偏差的存在/不存在， 影响更大的干预迭代的效果大小和意义。该项目的目标是告知 未来的身体活动和饮食/营养行为干预研究，提高其效率，并最终， 行为干预研究对解决慢性非传染性疾病的有效性。目标 1 是 确定成人身体活动和饮食样本中外部有效性偏差的普遍程度和影响 干预措施。目标 2 是对目标 1 的主要/资深作者进行定性访谈，以更好地理解 早期研究和更强有力的研究之间已确定的差异/相似之处的原因。通过 该项目的执行将获得以下成果： 系统审查、荟萃分析方面的广泛技能 技术、元流行病学方法、定性研究过程和科学传播 包括同行评审的出版物、科学演示、导师同行评审以及起草的博士后 拨款申请。拟议的 F31 研究意义重大，因为拟议研究的结果将确定 导致有效试验成功和不成功扩展的特征，可能会增加 行为干预发展的速度。这项研究具有创新性，因为它将是第一个 确定成人身体活动和饮食中外部和内部偏差的普遍性和影响 行为干预。

PROJECT SUMMARY/ABSTRACT Developing behavioral interventions that are both effective/efficacious and that can be scaled is a major challenge in the field of behavioral science. Many behavioral interventions demonstrate early promise in their testing, only to fail to be effective during a larger, more well-powered evaluation. This common pattern (i.e. initial promise then fail) wastes valuable resources and time. The objective of this proposal is to investigate the role of preliminary, early-stage studies (e.g. pilot, feasibility studies) in the development of public health behavioral interventions with attention to internal and external biases introduced during early stage testing. This study will capitalize on developed search strategies and established resources to conduct a series of meta-epidemiological reviews of behavioral interventions targeting adult physical activity and dietary behaviors. In these reviews, behavioral interventions with a published early-stage study and a published, more well-powered trial of the same/similar intervention will be systematically coded for the presence of external and internal validity biases. Meta-regression models will be run to understand how the presence/absence of each bias in early-stage studies, influences the effect size and significance of larger iterations of the intervention. This project’s goal is to inform future physical activity and diet/nutrition behavioral intervention studies, increasing their efficiency and ultimately, the effectiveness of behavioral intervention research to address chronic, non-communicable disease. Aim 1 is to identify the prevalence and impact of external validity biases in a sample of adult physical activity and diet interventions. Aim 2 is to conduct qualitative interviews with lead/senior authors from Aim 1 to better understand the reasons for identified differences/similarities between early-stage and more well-powered studies. Through the execution of this project the following will be gained: extensive skills in systematic-review, meta-analytic techniques, meta-epidemiological methods, qualitative research processes, and scientific communication including peer-reviewed publication, scientific presentation, mentor peer-reviewed, and a drafted post-doctoral grant application. The proposed F31 study is significant because findings from the proposed study will identify characteristics that lead to successful and unsuccessful scaling of well-powered trials, potentially increasing the speed of behavioral intervention development. This study is innovative because it will be among the first to establish the prevalence and impact of external and internal biases in adult physical activity and dietary behavioral interventions.