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Published in: Trials 1/2019

Open Access 01-12-2019 | Study protocol

Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol

Authors: Sarabeth Broder-Fingert, Jocelyn Kuhn, Radley Christopher Sheldrick, Andrea Chu, Lisa Fortuna, Megan Jordan, Dana Rubin, Emily Feinberg

Published in: Trials | Issue 1/2019

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Abstract

Background

Delivery of behavioral interventions is complex, as the majority of interventions consist of multiple components used either simultaneously, sequentially, or both. The importance of clearly delineating delivery strategies within these complex interventions—and furthermore understanding the impact of each strategy on effectiveness—has recently emerged as an important facet of intervention research. Yet, few methodologies exist to prospectively test the effectiveness of delivery strategies and how they impact implementation. In the current paper, we describe a study protocol for a large randomized controlled trial in which we will use the Multiphase Optimization Strategy (MOST), a novel framework developed to optimize interventions, i.e., to test the effectiveness of intervention delivery strategies using a factorial design. We apply this framework to delivery of Family Navigation (FN), an evidence-based care management strategy designed to reduce disparities and improve access to behavioral health services, and test four components related to its implementation.

Methods/design

The MOST framework contains three distinct phases: Preparation, Optimization, and Evaluation. The Preparation phase for this study occurred previously. The current study consists of the Optimization and Evaluation phases. Children aged 3-to-12 years old who are detected as “at-risk” for behavioral health disorders (n = 304) at a large, urban federally qualified community health center will be referred to a Family Partner—a bicultural, bilingual member of the community with training in behavioral health and systems navigation—who will perform FN. Families will then be randomized to one of 16 possible combinations of FN delivery strategies (2 × 2 × 2× 2 factorial design). The primary outcome measure will be achieving a family-centered goal related to behavioral health services within 90 days of randomization. Implementation data on the fidelity, acceptability, feasibility, and cost of each strategy will also be collected. Results from the primary and secondary outcomes will be reviewed by our team of stakeholders to optimize FN delivery for implementation and dissemination based on effectiveness, efficiency, and cost.

Discussion

In this protocol paper, we describe how the MOST framework can be used to improve intervention delivery. These methods will be useful for future studies testing intervention delivery strategies and their impact on implementation.

Trial registration

ClinicalTrials.gov, NCT03569449. Registered on 26 June 2018.
Appendix
Available only for authorised users
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Metadata
Title
Using the Multiphase Optimization Strategy (MOST) framework to test intervention delivery strategies: a study protocol
Authors
Sarabeth Broder-Fingert
Jocelyn Kuhn
Radley Christopher Sheldrick
Andrea Chu
Lisa Fortuna
Megan Jordan
Dana Rubin
Emily Feinberg
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3853-y

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