Implementing multi-level intervention components for patients and providers in a large health-system: The MOST:PrEP study
Elizabeth Lockhart

Intervening at more than one level of the health system may have synergistic effects on health outcomes. This talk will highlight the optimization phase of one of the first known studies to implement multi-level intervention components during the optimization phase of MOST. We developed two intervention components for patients and two for providers that are being delivered in a randomized, clustered trial among primary care clinics at a large health system. Emphasis will be given to determining sample size for primary and secondary outcomes, facilitators and barriers to implementing multi-level components in a health system, data on preliminary engagement with intervention components, and lessons learned/additional considerations for future multi-level interventions using the MOST framework.

Evaluating an Optimized Intervention and Informing Policy Decisions
Angela Pfammatter

Using the Multiphase Optimization Strategy, the EVO study was designed to evaluate the non-inferiority of an optimized weight management intervention as compared to an individually delivered Diabetes Prevention Program. In light of the ongoing pandemic, the trial was launched to be decentralized and implemented in an entirely virtual format. Some benefits were realized, such as the ability to recruit from a wider geographical area. We will present the rationale and design of the EVO study and some preliminary findings, and discuss the parallel economic evaluation to inform policy. We will discuss opportunities for further optimization and explore the potential benefits of leveraging novel approaches in a decentralized context.

From Conceptual Model to Components: Preparation Phase Insights from LaunchPad
Kelly Rulison

The transition out of high school provides a critical opportunity to prevent and reduce substance use, yet few scalable interventions target this period. Using the Multiphase Optimization Strategy (MOST) framework, our team is developing LaunchPad, an online intervention for high school seniors. This presentation highlights our Preparation Phase activities, integrating Human-Centered Design to translate our conceptual model into candidate intervention components.

We synthesize findings from qualitative interviews with school staff and youth and quantitative surveys from a national sample of young adults (N=400) to inform component development. Quantitative data are guiding the development of personalized normative feedback targeting key mechanisms in our conceptual model, while stakeholder insights are shaping implementation and delivery decisions.

Together, these data illustrate how combining Human-Centered Design within MOST can accelerate development of efficient and scalable interventions. We end by discussing how this work lays the foundation for two upcoming iterative optimization trials.