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Web End = Optimization of Multicomponent Behavioral and Biobehavioral Interventions for the Prevention and Treatment of HIV/AIDS
Linda M. Collins1 Kari C. Kugler2 Marya Viorst Gwadz3
Published online: 4 August 2015 Springer Science+Business Media New York 2015
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, efcient, 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 specic optimization criterion, dened 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.
Keywords Behavioral intervention Biobehavioral
intervention Multiphase optimization strategy Factorial
design Fractional factorial design
Introduction
Overview
The purpose of this article is to introduce the multiphase optimization strategy (MOST) to the HIV/AIDS research community, rst by describing the approach and then by providing an illustration of its application to intervention development [14]. Inspired by engineering principles, MOST provides a framework for developing, optimizing, and evaluating behavioral and biobehavioral interventions for the prevention and treatment of HIV/AIDS. The objective of MOST is to produce behavioral interventions that are effective, economical, efcient, and scalable critical factors in an era of both serious public health concerns and constrained resources. MOST can be used to build new interventions, as we describe in the hypothetical example below, or to improve upon existing evidence-based programs. In this article, we will use the term behavioral intervention to refer broadly to...