Abstract
This chapter describes some aspects of an application of the multiphase optimization strategy (MOST) to optimize and evaluate itMatters, an online intervention that targets the intersection of alcohol use and sexual behaviors to reduce sexually transmitted infections (STIs) among college students. The chapter emphasizes two aspects of this application. First, we describe the development of a detailed conceptual model during the preparation phase of MOST. This conceptual model guided decisions such as the choice of outcome variables. Second, we describe an iterative approach to experimentation during the optimization phase of MOST. The objective of the iterative approach is to build a highly effective intervention by using repeated optimization trials to evaluate which intervention components meet a given criterion for effectiveness and which do not. Revisions are undertaken to improve the components that do not meet the criterion, and then a subsequent optimization trial is used to reevaluate the components. This iterative approach has the potential to enable the investigator to develop more effective, efficient, economical, and scalable interventions.
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Abbey, A., Saenz, C., & Buck, P. O. (2005). The cumulative effects of acute alcohol consumption, individual differences and situational perceptions on sexual decision making. Journal of Studies on Alcohol and Drugs, 66(1), 82.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.
American College Health Association. (2016). American College Health Association-National College Health Assessment II: Undergraduate Students Reference Group Data Report Fall 2015. Retrieved from Hanover, MD.
Bailey, J. A., Fleming, C. B., Catalano, R. F., Haggerty, K. P., & Manhart, L. E. (2012). Romantic relationship characteristics and alcohol use: Longitudinal associations with dual method contraception use. Journal of Adolescent Health, 50(5), 450–455.
Baker, T. B., Collins, L. M., Mermelstein, R., Piper, M. E., Schlam, T. R., Cook, J. W., … Fiore, M. C. (2016). Enhancing the effectiveness of smoking treatment research: Conceptual bases and progress. Addiction, 111(1), 107–116. https://doi.org/10.1111/add.13154
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.
Berkowitz, A. (2004). Applications of social norms theory to other health and social justice issues. In H. W. Perkins (Ed.), The social norms approach to preventing school and college age substance abuse: A handbook for educators, counselors, and clinicians (pp. 259–279). San Francisco, CA: Jossey-Bass.
Brown, J. L., & Vanable, P. A. (2007). Alcohol use, partner type, and risky sexual behavior among college students: Findings from an event-level study. Addictive Behaviors, 32(12), 2940–2952.
Caldwell, L. L., Smith, E. A., Collins, L. M., Graham, J. W., Lai, M., Wegner, L., … Jacobs, J. (2012). Translational research in South Africa: Evaluating implementation quality using a factorial design. Paper presented at the Child & Youth Care Forum, 41, 119. https://doi.org/10.1007/s10566-011-9164-4
Carey, K. B., Scott-Sheldon, L. A. J., Elliot, A. J., Bolles, J. R., & Carey, M. P. (2009). Computer-delivered interventions to reduce college student drinking: A meta-analysis. Addiction, 104(11), 1807–1819.
Centers for Disease Control and Prevention. (2013). CDC fact sheet: Incidence, prevalence, and cost of sexually transmitted infections in the United States. CDC.
Chandra, A., Copen, C. E., & Mosher, W. D. (2013). Sexual behavior, sexual attraction, and sexual identity in the United States: Data from the 2006–2010 National Survey of Family Growth. In International handbook on the demography of sexuality (pp. 45–66). Dordrecht: Springer. https://doi.org/10.1007/978-94-007-5512-3_4
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: LEA.
Collins, L. M. (2018). Optimization of behavioral, biobehavioral, and biomedical interventions: The Multiphase Optimization Strategy (MOST). New York, NY: Springer.
Collins, L. M., Dziak, J. J., & Li, R. (2009). Design of experiments with multiple independent variables: A resource management perspective on complete and reduced factorial designs. Psychological Methods, 14(3), 202–224. https://doi.org/10.1037/a0015826
Davis, K. C., Masters, N. T., Eakins, D., Danube, C. L., George, W. H., Norris, J., & Heiman, J. R. (2014). Alcohol intoxication and condom use self-efficacy effects on women’s condom use intentions. Addictive Behaviors, 39(1), 153–158.
Davis, K. C., Norris, J., Hessler, D. M., Zawacki, T., Morrison, D. M., & George, W. H. (2010). College women’s sexual decision making: Cognitive mediation of alcohol expectancy effects. Journal of American College Health, 58(5), 481–489. https://doi.org/10.1080/07448481003599112
Dermen, K. H., & Thomas, S. N. (2011). Randomized controlled trial of brief interventions to reduce college students’ drinking and risky sex. Psychology of Addictive Behaviors, 25, 583–594.
Dry, M. J., Burns, N. R., Nettelbeck, T., Farquharson, A. L., & White, J. M. (2012). Dose-related effects of alcohol on cognitive functioning. PLoS One, 7(11), e50977.
Ebel-Lam, A. P., MacDonald, T. K., Zanna, M. P., & Fong, G. T. (2009). An experimental investigation of the interactive effects of alcohol and sexual arousal on intentions to have unprotected sex. Basic and Applied Social Psychology, 31, 226–233.
Ehret, P. J., Ghaidarov, T. M., & LaBrie, J. W. (2013). Can you say no? Examining the relationship between drinking refusal self-efficacy and protective behavioral strategy use on alcohol outcomes. Addictive Behaviors, 38(4), 1898–1904.
Ferguson, Y. O., Quinn, S. C., Eng, E., & Sandelowski, M. (2006). The gender ratio imbalance and its relationship to risk of HIV/AIDS among African American women at historically black colleges and universities. AIDS Care, 18(4), 323–331. https://doi.org/10.1080/09540120500162122
Fielder, R. L., & Carey, M. P. (2010). Predictors and consequences of sexual “hookups” among college students: A short-term prospective study. Archives of Sexual Behavior, 39(5), 1105–1119.
Fisher, T. D. (2009). The impact of socially conveyed norms on the reporting of sexual behavior and attitudes by men and women. Journal of Experimental Social Psychology, 45(3), 567–572.
Ford, K., Sohn, W., & Lepkowski, J. (2001). Characteristics of adolescents’ sexual partners and their association with use of condoms and other contraceptive methods. Family Planning Perspectives, 33(3), 100–132.
Garcia, J. R., Reiber, C., Massey, S. G., & Merriwether, A. M. (2012). Sexual hookup culture: A review. Review of General Psychology, 16(2), 161.
George, W. H., Davis, K. C., Norris, J., Heiman, J. R., Stoner, S. A., Schacht, R. L., … Kajumulo, K. F. (2009). Indirect effects of acute alcohol intoxication on sexual risk-taking: The roles of subjective and physiological sexual arousal. Archives of Sexual Behavior, 38(4), 498–513.
Grazioli, V. S., Lewis, M. A., Garberson, L. A., Fossos-Wong, N., Lee, C. M., & Larimer, M. E. (2015). Alcohol expectancies and alcohol outcomes: Effects of the use of protective behavioral strategies. Journal of Studies on Alcohol and Drugs, 76(3), 452.
Hendershot, C. S., Stoner, S. A., George, W. H., & Norris, J. (2007). Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults. Psychology of Addictive Behaviors, 21(3), 365–372. https://doi.org/10.1037/0893-164x.21.3.365
Huffman, J. C., Albanese, A. M., Campbell, K. A., Celano, C. M., Millstein, R. A., Mastromauro, C. A., … Collins, L. M. (2017). The positive emotions after acute coronary events behavioral health intervention: Design, rationale, and preliminary feasibility of a factorial design study. Clinical Trials, 14(2), 128–139.
Jennings, J. M., Taylor, R., Iannacchione, V. G., Rogers, S. M., Chung, S.-E., Huettner, S., & Ellen, J. M. (2010). The available pool of sex partners and risk for a current bacterial sexually transmitted infection. Annals of Epidemiology, 20(7), 532–538.
Jones, B. T., Corbin, W., & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction, 96(1), 57–72.
Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., Hawkins, J., … Zaza, S. (2016). Youth risk behavior surveillance—United States, 2015. MMWR Surveillance Summaries, 65(6), 1–174. https://doi.org/10.15585/mmwr.ss6506a1
Kirmani, M. N., & Suman, L. N. (2010). Gender differences in alcohol related attitudes and expectancies among college students. Journal of the Indian Academy of Applied Psychology, 36(1), 19–24.
Lewis, J. E., Miguez-Burban, M.-J., & Malow, R. M. (2009). HIV risk behavior among college students in the United States. College Student Journal, 43(2), 475–491.
Lewis, M. A., Patrick, M. E., Litt, D. M., Atkins, D. C., Kim, T., Blayney, J. A., … Larimer, M. E. (2014). Randomized controlled trial of a web-delivered personalized normative feedback intervention to reduce alcohol-related risky sexual behavior among college students. Journal of Consulting and Clinical Psychology, 82(3), 429.
Lewis, M. A., Rees, M., Logan, D. E., Kaysen, D. L., & Kilmer, J. R. (2010). Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption. Psychology of Addictive Behaviors, 24(2), 229.
Logan, D. E., Koo, K. H., Kilmer, J. R., Blayney, J. A., & Lewis, M. A. (2015). Use of drinking protective behavioral strategies and sexual perceptions and behaviors in US college students. Journal of Sex Research, 52(5), 558–569.
Nesoff, E. D., Dunkle, K., & Lang, D. (2016). The impact of condom use negotiation self-efficacy and partnership patterns on consistent condom use among college-educated women. Health Education & Behavior, 43(1), 61–67.
Olmstead, S. B., Pasley, K., & Fincham, F. D. (2013). Hooking up and penetrative hookups: Correlates that differentiate college men. Archives of Sexual Behavior, 42(4), 573–583.
Paul, E. L., McManus, B., & Hayes, A. (2000). “Hookups”: Characteristics and correlates of college students’ spontaneous and anonymous sexual experiences. Journal of Sex Research, 37(1), 76–88.
Paves, A. P., Pedersen, E. R., Hummer, J. F., & Labrie, J. W. (2012). Prevalence, social contexts, and risks for prepartying among ethnically diverse college students. Addictive Behaviors, 37(7), 803–810. https://doi.org/10.1016/j.addbeh.2012.03.003
Pearson, M. R. (2013). Use of alcohol protective behavioral strategies among college students: A critical review. Clinical Psychology Review, 33(8), 1025–1040.
Pearson, M. R., Prince, M. A., & Bravo, A. J. (2017). Moderators of the effects of alcohol protective behavioral strategies: Three attempts of replication and extension. Substance Use & Misuse, 52(7), 939–949.
Pellegrini, C. A., Hoffman, S. A., Collins, L. M., & Spring, B. (2014). Optimization of remotely delivered intensive lifestyle treatment for obesity using the Multiphase Optimization Strategy: Opt-IN study protocol. Contemporary Clinical Trials, 38, 251–259.
Pellegrini, C. A., Hoffman, S. A., Collins, L. M., & Spring, B. (2015). Corrigendum to “Optimization of remotely delivered intensive lifestyle treatment for obesity using the Multiphase Optimization Strategy: Opt-IN study protocol”. Contemporary Clinical Trials, 38(2014), 251–259. Contemp Clin Trials, 45(Pt B), 468–469. https://doi.org/10.1016/j.cct.2015.09.001
Piper, M. E., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., Collins, L. M., … Jorenby, D. E. (2016). Identifying effective intervention components for smoking cessation: A factorial screening experiment. Addiction, 111(1), 129–141.
Prause, N., Staley, C., & Finn, P. (2011). The effects of acute ethanol consumption on sexual response and sexual risk-taking intent. Archives of Sexual Behavior, 40(2), 1–12. https://doi.org/10.1007/s10508-010-9718-9
Purdie, M. P., Norris, J., Davis, K. C., Zawacki, T., Morrison, D. M., George, W. H., & Kiekel, P. A. (2011). The effects of acute alcohol intoxication, partner risk level, and general intention to have unprotected sex on women’s sexual decision making with a new partner. Experimental and Clinical Psychopharmacology, 19(5), 378.
Randolph, M. E., Torres, H., Gore-Felton, C., Lloyd, B., & McGarvey, E. L. (2009). Alcohol use and sexual risk behavior among college students: Understanding gender and ethnic differences. The American Journal of Drug and Alcohol Abuse, 35(2), 80–84. https://doi.org/10.1080/00952990802585422
Reeves, B., Ickes, M. J., & Mark, K. P. (2016). Gender differences and condom-associated embarrassment in the acquisition of purchased versus free condoms among college students. American Journal of Sexuality Education, 11(1), 61–75.
Reid, A. E., & Carey, K. B. (2015). Interventions to reduce college student drinking: State of the evidence for mechanisms of behavior change. Clinical Psychology Review, 40, 213–224.
Rosenstock, I. M. (1990). The health belief model: Explaining health behavior through expectancies. In K. Glanz, F. Lewis, & B. Rimer (Eds.), Health behavior and health education. San Francisco, CA: Jossey-Bass.
Scott-Sheldon, L. A., Carey, K. B., Cunningham, K., Johnson, B. T., Carey, M. P., & Team, M. R. (2016). Alcohol use predicts sexual decision-making: A systematic review and meta-analysis of the experimental literature. AIDS and Behavior, 20(1), 19–39.
Scott-Sheldon, L. A. J., Huedo-Medina, T. B., Warren, M. R., Johnson, B. T., & Carey, M. P. (2011). Efficacy of behavioral interventions to increase condom use and reduce sexually transmitted infections: A meta-analysis, 1991 to 2010. JAIDS: Journal of Acquired Immune Deficiency Syndromes, 58, 489.
Sevincer, A. T., & Oettingen, G. (2014). Alcohol myopia and goal commitment. Frontiers in Psychology, 5, 169.
Shuper, P. A., Neuman, M., Kanteres, F., Baliunas, D., Joharchi, N., & Rehm, J. (2010). Causal considerations on alcohol and HIV/AIDS—a systematic review. Alcohol and Alcoholism, 45(2), 159–166. https://doi.org/10.1093/alcalc/agp091
Tanner-Smith, E. E., & Lipsey, M. W. (2015). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of Substance Abuse Treatment, 51, 1–18.
Treloar, H., Martens, M. P., & McCarthy, D. M. (2015). The protective behavioral strategies scale-20: Improved content validity of the serious harm reduction subscale. Psychological Assessment, 27(1), 340.
Trepka, M. J., Kim, S., Pekovic, V., Zamor, P., Velez, E., & Gabaroni, M. V. (2008). High-risk sexual behavior among students of a minority-serving university in a community with a high HIV/AIDS prevalence. Journal of American College Health, 57(1), 77–84.
Wyrick, D. L., Rulison, K. L., Fearnow-Kenney, M., Milroy, J. J., & Collins, L. M. (2014). Moving beyond the treatment package approach to developing behavioral interventions: Addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST). Translational Behavioral Medicine, 4(3), 252–259.
Acknowledgments
Preparation of this chapter was supported by Award Number R01 AA022931 from the National Institute on Alcohol Abuse and Alcoholism and Award Number P50 DA039838 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors thank Amanda Applegate for editorial assistance.
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Kugler, K.C. et al. (2018). Using the Multiphase Optimization Strategy (MOST) to Develop an Optimized Online STI Preventive Intervention Aimed at College Students: Description of Conceptual Model and Iterative Approach to Optimization. In: Collins, L., Kugler, K. (eds) Optimization of Behavioral, Biobehavioral, and Biomedical Interventions. Statistics for Social and Behavioral Sciences. Springer, Cham. https://doi.org/10.1007/978-3-319-91776-4_1
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