The multiphase optimization strategy for developing and evaluating behavioral interventions

This chapter introduces the multiphase optimization strategy (MOST), an engineering-inspired framework for optimizing multicomponent behavioral interventions. The chapter contrasts the typical development of interventions with the MOST framework and discusses the potential to achieve steady, systematic progress in intervention science. In contrast to the typical development of a multicomponent intervention wherein the intervention is tested en bloc via a randomized controlled trial (RCT), MOST introduces a phase of optimization prior to the RCT wherein the effect of individual components and the interaction between components is empirically tested. The objective of MOST is to arrive at an optimized intervention that is highly effective, but also efficient, economical, and scalable. This chapter provides an overview of the MOST framework and demonstrates its application using a hypothetical example of the optimization of a clinical intervention targeting posttraumatic stress disorder symptoms among children who have experienced maltreatment.