Developing Sustainable Behavioral Interventions: The Innovative Use of Multiphase Optimization Strategy (MOST) Under Community Based Participatory Research (CBPR) Principles

Billions of dollars have been spent to develop and test evidence-based behavioral interventions (National Institutes of Health, 2016) without community input.  As a consequence, sustainable translation into community settings become a major challenge (Glasgow et. al., 2015) and these interventions fail to fulfil their potential to serve marginalized individuals. Most interventions are multifaceted, multisession, multicomponent and tested for efficacy as a complete bundle. Testing complex interventions as a bundle makes it impossible to evaluate the extent to which each component is needed in order to achieve efficacy.

This team of social work researchers has received federal funding (National Institute on Minority Health and Health Disparities, grant # xxx, PIs: Author) to test Community Wise, an innovative multilevel, 15-session intervention designed to reduce substance use by implementing MOST (Collins et. al., 2009) under CBPR principles (Israel et. al., 2003). We have developed and employed successful CBPR techniques in order to develop grants and conduct community grounded research in New York City, Newark, Chicago, Spain, and Brazil in collaboration with practitioners and community members (author, 2007; author, 2008; author, 2012; author, 2013; author, 2013; author, 2014 a & b; author, 2014; author, 2015). These techniques include group dynamics and iterative processes to integrate life experiences and practice wisdom into health research. We ensure power-sharing and the exchange of diverse knowledge through dialectic processes. We use mutual support to overcome social and professional differences, and we use problem solvingto achieve consensus on distribution of research tasks (author, 2013; author, 2012; author, 2014b).

MOST is a rigorous framework that employs factorial designs to identify which components of an intervention contribute the most to desired outcome changes (Collins et. al., 2009). It relies on quantitative methods to optimize interventions. MOST adds experimental tools that CBPR researchers can use in developing and testing interventions. CBPR enhances MOST by bringing in the perspectives of the community in the early identification of key intervention ingredients and the interpretation of quantitative findings. Harnessing these complementary frameworks will assist social workers to enhance the efficiency, the efficacy, translation and implementation of behavioral interventions at the community level.

By the end of this workshop,  participants will: 1) describe how to integrate MOST and CBPR, including strengths and limitations; 2) identify ways by which  MOST and CBPR are being used to develop a specific intervention, Community Wise, and to develop a successful NIH grant proposal; 3) describe details about how MOST and CBPR can be used together to optimize interventions focused on different diseases and disorders; and 4) identify ways by which CBPR enhances MOST by bringing in the perspectives of the community in the early identification of key intervention ingredients.