Linda Collins at a presentation with three other researchers.
Published on: Jun 5, 2018

Linda Collins, distinguished professor of human development and family studies and director of the Methodology Center, spent two weeks at the National University of Ireland (NUI) Galway this spring to present and collaborate on research on the multiphase optimization strategy (MOST), a framework for building interventions that help people modify unhealthy behavior. 

Behavior is notoriously difficult to change, and MOST enables researchers to more efficiently build interventions — like treatments to help people quit smoking — that are optimized to meet the researcher’s goals. Collins has been developing MOST over the past 15 years. 

Collins’ trip to Ireland was part of the Fulbright Specialist Program, which sends faculty and professionals from the United States to serve as expert consultants on curriculum, faculty development, institutional planning and related subjects at academic institutions abroad for two to six weeks. 

Collins worked with researchers at NUI’s School of Psychology who are planning to use MOST to optimize health interventions they are developing. 

MOST is a comprehensive, principled, engineering-inspired framework for optimizing and evaluating multicomponent behavioral interventions. 

It incorporates ideas from the process that engineers use for designing products into the process researchers use for designing health interventions, like interventions to help people quit smoking, avoid risky sexual behavior or increase physical activity. 

By applying concepts developed in engineering, MOST can enable scientists to manage resources more carefully and advance intervention science. For example, a long-term study with researchers at the University of Wisconsin’s Center for Tobacco Research and Intervention resulted in development of an abstinence-optimized smoking cessation treatment for use in primary care settings.   

The NUI School of Psychology’s interventions focus on a range of illnesses and conditions, from diabetes in adolescents to cardiac rehabilitation, as well as mental health. Collins’ MOST framework can optimize such interventions.  

“This was a great opportunity to showcase MOST,” Collins said. “I’ve been working hard to promote MOST and help people learn about it. Ireland values health interventions that are highly effective, efficient and economical. One of the country’s goals is to achieve a health system that delivers the best possible outcome for taxpayers’ dollars. I also believe this is important.  MOST can help Ireland to achieve this.” 

Collins said working with the researchers in Ireland has further encouraged her to keep developing and perfecting MOST. 

“It was exciting talking with people there,” she said. “Talking with behavioral and biobehavioral researchers always inspires my methodological work.”

Collins said frameworks such as MOST are important and relevant, as health care continues to evolve, not just in Ireland and in the United States, but all over the world. 

“Multicomponent behavioral and biobehavioral interventions are used widely for prevention and treatment of health problems, improvement of academic achievement, and promotion of health,” Collins said. “These interventions are typically developed and evaluated using a treatment package approach, in which the intervention is assembled a priori and evaluated by means of a two-group randomized controlled trial.”

Using MOST, behavioral and biobehavioral interventions can be optimized using criteria chosen by the intervention scientist, she said. 

“The goal with MOST may be to develop a cost-effective intervention; an intervention that achieves a specified level of effectiveness; the briefest intervention that achieves a minimum level of effectiveness; or any other reasonable goal,” Collins said. 

In addition to her work with researchers at NUI, Collins also presented a two-day workshop on MOST for NUI Galway faculty, and gave a presentation on MOST at the Royal College of Surgeons in Ireland at their Dublin headquarters.