Optimization of behavioral and biobehavioral interventions: Building investigator capacity nationwide

Project Summary This application seeks renewal of funding for an R25 that is building nationwide investigator capacity in optimization of behavioral and biobehavioral interventions. Multicomponent behavioral and biobehavioral interventions play a central role across many areas of public health, including but not limited to substance abuse disorders, HIV, cancer, and diabetes. To date, intervention science has relied primarily on the classical treatment package approach, in which a set of intervention components is identified a priori, assembled into a treatment package, and then immediately evaluated in a randomized clinical trial. Sole reliance on this approach has prevented the field from addressing fundamental research questions—e.g., which components are effective?—that are critical for development of interventions with sustained high public health impact. Recently an innovative alternative has emerged called the multiphase optimization strategy (MOST). MOST, a broad methodological framework for the principled optimization of interventions, is used to arrive at an intervention that strategically balances effectiveness against affordability, scalability, and efficiency to ensure that the intervention is practical to implement and therefore has the potential for sustained high public health impact. Between 2016 and 2022, annual NIH funding awarded for projects involving intervention optimization grew more than 450%, from about $30 million to about $144 million. At this writing, NIH has funded at least 245 projects related to MOST. We believe this growth has been enabled in part by the training efforts of the previous R25. We prepared and placed 2 free comprehensive asynchronous introductory courses on the Coursera platform, accessed by over 700 learners to date, and developed a synchronous virtual training aimed at helping investigators gain the skill set they need to write successful funding applications and conduct high- quality intervention optimization research. By the end of the first R25’s funding we expect more than 150 investigators will have completed our synchronous virtual training. In response to growing demand, we propose to expand our training, outreach, and support efforts. Aim 1: We will continue to offer synchronous virtual trainings, and coordinate with compatible existing NIH-sponsored training endeavors. Aim 2: In addition to updating our existing offerings, we will offer exciting new courses on the Coursera platform. Aim 3: We will enable investigators working with MOST to share the very latest findings, best practices, on-the-ground experiences, and tips with each other by offering 12-16 informal webinars per year. Aim 4: We will provide ongoing consultation, mentorship, support, and outreach for investigators at all career levels. Impact: The proposed work will increase the number of investigators proficient in and funded for optimization of behavioral and biobehavioral interventions. These investigators will, in turn, produce interventions that are effective, readily implementable, and sustainable, i.e., have high public health impact, and thereby improve the nation’s health in substance abuse, HIV, cancer, diabetes, and countless other important areas.