Crossing the quality chasm: These developments are positively changing the conduct of behavioral intervention research. Second, theories often lack a strong empirical foundation, and their application to an intervention can be difficult. In addition to the funding sources discussed above, activities for this phase can be supported through the NIH R21 mechanism. A new health system for the 21st century.

Knowledge generated from activities in this phase can advance a working intervention prototype and treatment manual. Journal of Continuing Education in the Health Professions. 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. Retooling for an aging America: Department of Health and Human Services, This article has been cited by other articles in PMC.

Tailored biobehavioral interventions: a literature review and synthesis.

taolored The quality of health care delivered to adults in the United States. Outcomes and bipbehavioral learned. It takes many years, from discovery to efficacy testing and evaluation of implementation, for interventions to be fully developed and subsequently integrated in practice.

Understanding and assessing the barriers to optimal health care. Challenges of and Progress in Behavioral Intervention Research One of the most critical challenges in introducing a new intervention is that development and testing transpire over a long period of time, estimated at 17 yr or more. In this phase, case studies, pre—post study designs, or focus groups, or a combination of these methodologies, can help define and refine intervention delivery characteristics e.

tailored biobehavioral interventions a literature review and synthesis

Determining ways to monitor quality of and fidelity in delivery, receipt, and enactment of the synthesks remains the primary focus of these three latter phases. Because efficacy trials are typically dependent on study volunteers and focus on internal versus external validity, inclusion criteria usually delimit a homogeneous population.


Tailored biobehavioral interventions: a literature review and synthesis.

Similarly, evidence suggests that tailoring an intervention to specific needs or characteristics is more effective than taking a one-size-fits-all approach if the biobehvioral outcome is behavior change Richards et al.

Economic evaluations inform the investment necessary at the individual, agency, and societal levels.

tailored biobehavioral interventions a literature review and synthesis

Yet another approach is involvement of stakeholders and end users as research team members in early phases. An active control group is often favored for comparative purposes because it is designed to control for attention, time, and empathy, factors that are afforded the treatment group and that may account for or confound treatment intervenyions.

A synthesis of the literature. 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.

Journal of General Internal Medicine.

tailored biobehavioral interventions a literature review and synthesis

Intervention Development Phases Figure 1 presents an adaptation of the traditional four-phase sequence for developing an intervention: Also of importance in designing an efficacy trial is attention to potential mediator and moderator factors, again according to the theory guiding the trial.

A competitive application for an efficacy trial must be supported by pilot test results, demonstration of feasibility, expected effect size, treatment manuals detailing treatment and control group protocols, tested recruitment and enrollment procedures, and a strong theory base and hypotheses. Conclusion Introducing a new behavioral intervention is an important and exciting endeavor but is not without challenges. 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.


Knowledge of setting exigencies and implementation challenges may inform intervention protocol development and facilitate more rapid and efficient translation into practice.

Unfortunately, most researchers lack a clear understanding of the contexts in which their interventions may eventually be located. CitePeer Related Articles http: Building the health care workforce. Similarly, an intervention targeting multisystems individual, family, community may require a broad ecological model supplemented with theories specific to the planned intervention activities at each level.

Despite challenges, great strides have been made in introducing new interventions Campbell et al. Open in a separate window.

A literature review and synthesis. A small randomized trial with a sample size, e. Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. A community-integrated home based depression intervention for older African Americans: Rethinking the efficacy-to-effectiveness transition. Built environments and obesity in disadvantaged populations.

How does Europe PMC derive its citations network? Journal of Continuing Education in the Health Professions.