The goal of intervention optimization is to develop and advance interventions that are not only effective, but also ready to be implemented because they are affordable, scalable, and efficient. The methodology is being proposed as a systematic empirical process.
Describing DAIVE as “a major methodological innovation in intervention optimization,” Dr. Gwadz highlighted the new possibilities that it opens up for optimizing interventions for effectiveness on multiple valued outcomes. “In the past, optimization trials could use information from only one outcome variable for decision-making about the optimized intervention. Sometimes interventions are actually meant to intervene on multiple outcomes simultaneously--and in those cases using only one outcome for decision-making can mean that useful information is lost."
Titled, “Using decision analysis for intervention value efficiency to select optimized interventions in the multiphase optimization strategy,” the paper describes how the authors applied DAIVE to select optimized interventions based on data from an optimization trial funded by the National Institute on Drug Abuse called Heart to Heart 2 (HTH2).
HTH2 was led by Dr. Gwadz and additional co-author Dr. Linda M. Collins, Professor at GPH. It sought to optimize a multi-component HIV care continuum intervention that would successfully improve important health outcomes for Black and Latino individuals living with HIV who experience serious barriers to engaging along the HIV care continuum, and who do not therefore evidence HIV viral suppression, all while remaining affordable and efficient.
Dr. Collins, who serves as Director of the Center for Advancement and Dissemination of Intervention Optimization (cadio) at GPH, highlighted the study’s additional innovation in methods for strategically balancing effectiveness and cost. “It’s the first article to introduce the concept of ‘value efficiency’ in selecting optimized interventions, offering a huge step forward toward arriving at interventions that are both effective and efficient in their use of the available resources.”
Applying DAIVE to data from the HTH2 study identified value-efficient versions of the HIV care continuum intervention, a major contribution to continued optimization and eventual implementation of an optimized HIV care continuum intervention in clinical settings. Lead author Dr. Strayhorn notes that DAIVE can be applied in optimization trials widely to accommodate a variety of objectives. “We are excited about DAIVE’s versatility and—we hope—ease of use.”
In addition to Drs. Strayhorn, Gwadz, and Collins, co-authors are Dr. Charles M. Cleland, Associate Professor, NYU Grossman School of Medicine; Dr. David J. Vanness, Professor, Pennsylvania State University College of Health and Human Development; and Dr. Leo Wilton, Professor, Department of Human Development, Binghamton University.