A randomized, controlled trial. Also, intramural support through pilot study mechanisms and foundation support are feasible funding alternatives. An opportunity for occupational therapy. Because efficacy trials are typically dependent on study volunteers and focus on internal versus external validity, inclusion criteria usually delimit a homogeneous population. Integrating cost analyses early on and using hybrid models also hold promise for closing the research—practice gap. CitePeer Related Articles http:

Oxford University Press; Critical to this phase is ensuring that the active ingredients that make the intervention work, or its immutable components e. Combining elements of clinical effectiveness and implementation research to enhance public health impact. Determining ways to monitor quality of and fidelity in delivery, receipt, and enactment of the intervention remains the primary focus of these three latter phases. Knowledge generated from activities in this phase can advance a working intervention prototype and treatment manual.

Introducing a New Intervention: An Overview of Research Phases and Common Challenges

An essential question in this phase is, Why would the intervention work? This article examines the challenges in and progress of behavioral intervention research, the trajectory followed for introducing new interventions, and key considerations in protocol development.

In addition to these considerations, conducting a task analysis of an intervention is a useful exercise. Crossing the quality chasm: Regardless of the pipeline followed, intervention development must begin with discovery preclinical phase.

Tailored biobehavioral interventions: a literature review and synthesis.

Speculations about making it real and going to scale. American Journal of Health Behavior. Effect of multicomponent interventions on caregiver burden and depression: Dissemination and implementation research in health: Phase 4 can be either an effectiveness or a replication trial in which the intervention is evaluated within the practice or service context and with a broader group of study participants.


Figure 1 presents an adaptation of the traditional four-phase sequence for developing an intervention: New hybrid models that blend test phases and involve a team approach consisting of stakeholders and end users up front in developing and testing interventions may shorten the timeframe and enhance adoption.

Behavior, lifestyle, and the social and physical environment are the primary contributors to longevity, health, well-being, and quality of life Buetner, Before conducting failored efficacy trial, formal registration is required at ClinicalTrials.

ITT may require that interpolation methodologies be applied because behavioral trials always experience attrition.

Table 1 outlines domains and specific elements to consider in constructing an intervention. A biobehavioral home-based intervention and the well-being of patients with dementia and their caregivers: Each of these considerations should be informed by theory, best evidence, practice guidelines, and clinical know-how and knowledge of the implementation goal and site.

New England Journal of Medicine.

Either your web browser doesn’t support Javascript or it is currently turned off. Journal of General Internal Medicine. Annals of Internal Medicine. Domain Elements Target of intervention Individual Family and social network Physical environment Community Agency personnel Provider System of care Policy Area targeted Behavior Affect Knowledge Skills Social environment Physical environment Delivery technique Tailoring Risk assessment driven Prescriptive one size fits all Stage of intervening Prevention Stage of disease Disease management Delivery mode Face to face Group Telephone Mail Technology-assisted devices computer, smart phone, Wii Dose and intensity Frequency of contact Length of time Immediate and potential delivery setting Home Community Agency Clinic or medical office Legislative office Web-based computer technology Characteristics of interventionists Who can deliver the intervention Level of education, years of practice, or skill Previous training requirements Potential funding streams to support the intervention if proven effective Consideration of cost associated with training in using intervention and its delivery.


Thus, length of time from discovery to integration in a practice setting, complexity of developing evidence for diverse populations, and insufficient funding for developing and introducing behavioral interventions in real-world contexts continue to fuel the knowledge-to-application gap.

tailored biobehavioral interventions a literature review and synthesis

Geriatric care management for low-income seniors: Introducing a new behavioral intervention has typically followed interventioms traditional medical and pharmacological linear pipeline. Knowledge Transfer Study Group. If this stage is combined with Phase 1, an NIH planning grant R34 sponsored by some institutions is a potential funding source. Additionally, the most important public health challenges of today—obesity, caregiving, chronic illness, dementia care, autism—are not amenable to pharmacological and medical solutions, approaches that have mostly been ineffective in addressing the behavioral, cognitive, and environmental components of these health conditions.

Defining the components of the research pipeline.

tailored biobehavioral interventions a literature review and synthesis

Health behavior and health education: National Academies Press; It is helpful to become familiar with the CONSORT checklist before designing an efficacy trial and writing a grant application because it reflects a comprehensive list of necessary considerations.

Developing and testing health-related behavioral interventions involve an incremental and iterative process to build a robust body of evidence that initially supports feasibility and safety, then proves efficacy and effectiveness, and subsequently involves translation, implementation, and sustainability in a real-world context.

American Journal of Occupational Therapy.

tailored biobehavioral interventions a literature review and synthesis

Another consideration in this phase is monitoring fidelity in both the intervention and control groups.