Home Research Areas The Multiphase Optimization Strategy How MOST Differs from the Standard Approach

Here we compare and contrast the standard approach to intervention development/evaluation and MOST.

Standard approach. The sequence of events may begin with a series of pilot tests (e.g. Sussman, Dent, Burton, Stacy, & Flay, 1995). (Here we use Vogt's (1993) definition of a pilot study as "a preliminary test or study to try out procedures and discover problems before the main study begins. It is a research project's 'dress rehearsal.'" (p. 172). Note that according to this definition, pilot studies are aimed at feasibility and implementation issues rather than optimization, and may or may not be randomized experiments.) Next, the intervention is subjected to a confirmatory trial. Further refinement of the intervention takes place after the confirmatory trial, based on analyses of data collected in the course of the trial, in the form of intermediate outcomes, covariates, and the like. Any conclusions drawn from these data are for the most part based on secondary analyses rather than randomized experimentation. The newly refined intervention may be tested in an additional confirmatory trial, setting up a cycle of confirmatory intervention trial/exploratory analysis/program revision/confirmatory intervention trial.

MOST. Any pilot testing takes place prior to the screening step (step c) of MOST. Pilot testing is important in order to arrive at the exact versions of intervention components and dosages that are to be tested in the screening and refining phases. However, pilot testing in no way replaces the experiments conducted in the screening and refining steps of MOST. These experiments have an objective that is fundamentally different from pilot testing. The screening and refining steps consist of randomized, controlled tests aimed squarely at optimization of intervention components and dosages. Only once an optimized intervention has been identified based on the screening and refining steps, and even then only if the optimized intervention is sufficiently promising, is a confirmatory trial undertaken. The aim is to optimize the intervention before the RCT.

References

Sussman, S., Dent, C.W., Burton, D., Stacy, A.W., & Flay, B.R. (1995). Developing school-based tobacco use prevention and cessation programs. Thousand Oaks, CA: SAGE.

Vogt, P. (1993). Dictionary of statistics and methodology. Newbury Park, CA: SAGE.