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Annals of Behavioral Medicine
Erschienen in: Annals of Behavioral Medicine 3/2008

01.06.2008 | Original Article

Exploring Refinements in Targeted Behavioral Medicine Intervention to Advance Public Health

verfasst von: Abby C. King, Ph.D., David F. Ahn, Ph.D., Audie A. Atienza, Ph.D., Helena C. Kraemer, Ph.D.

Erschienen in: Annals of Behavioral Medicine | Ausgabe 3/2008

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Abstract

Background

Similar to other fields, a targeted behavioral medicine perspective can aid decision-making related to participant–intervention matching.

Purpose

To present one potentially useful definition of intervention targeting activity; describe potential targeting domains of particular relevance to behavioral medicine; discuss different statistical approaches to aid the targeted intervention development process; and discuss the challenges and opportunities accompanying the incorporation of targeted intervention development methods into behavioral randomized clinical trial (RCT) research.

Methods

Drawing from recent conceptual work by the MacArthur group and other scientists in the field, methods and approaches to undertaking moderator analysis are discussed.

Results

Examples of moderator analyses are provided which reflect the different statistical methods and variable domains that may serve as moderators of intervention success.

Conclusions

The recommended exploratory work can help to make the most efficient use of RCTs to identify the best paths for subsequent RCT development in a resource-constrained era.
Literatur
1.
Office of Behavioral and Social Sciences Research. Healthier Lives through Behavioral and Social Sciences Research. Bethesda, MD: OBSSR, National Institutes of Health; 2006.
2.
Ockene JK, Emmons KM, Mermelstein RJ, et al. Relapse and maintenance issues for smoking cessation. Health Psychol. 2000; 19: 17–31.PubMedCrossRef
3.
Haskell WL, Alderman EL, Fair JM, et al. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease: The Stanford Coronary Risk Intervention Project (SCRIP). Circulation. 1994; 89: 975–990.PubMed
4.
Lorig KR, Mazonson PD, Holman HR. Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health costs. Arthritis Rheum. 1993; 36: 439–446.PubMedCrossRef
5.
Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New Engl J Med. 2002; 346: 393–403.CrossRef
6.
Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344: 1343–1350.PubMedCrossRef
7.
Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997; 20: 537–544.PubMedCrossRef
8.
Durantini MR, Albarracin D, Mitchell AL, Earl AN, Gillette JC. Conceptualizing the influence of social agents of behavior change: A meta-analysis of the effectiveness of HIV-prevention interventionists for different groups. Psychol Bull. 2006; 132: 212–248.PubMedCrossRef
9.
Christensen AJ. Patient-by-treatment context interaction in chronic disease: A conceptual framework for the study of patient adherence. Psychosom Med. 2000; 62: 435–443.PubMed
10.
Evans WE, Relling MV. Moving towards individualized medicine with pharmacogenomics. Nature. 2004; 429: 464–468.PubMedCrossRef
11.
Owens EB, Hinshaw SP, Kraemer HC, Arnold LE, Abikoff HB, Cantwell DP, et al. Which treatment for whom for ADHD? Moderators of treatment response in the MTA. J Consult Clin Psychol. 2003; 71: 540–552.PubMedCrossRef
12.
Orleans TC, Gruman J, Ulmer C, Emont SL, Hollendonner JK. Rating our progress in population health promotion: Report card on six behaviors. Am J Health Promot. 1999; 14: 75–82.PubMed
13.
Campbell MK, Tessar O, DeVellis B, et al. Effects of a tailored health promotion program for female blue-collar workers: Health works for women. Prev Med. 2002; 34: 313–323.PubMedCrossRef
14.
King AC, Bauman A, Calfas K. Innovative approaches to understanding and influencing physical activity. Am J Prev Med. 2002; 232 Suppl: 56–63.
15.
Mattson ME, Allen JP. Research on matching alcoholic patients to treatments: Findings, issues, and implications. J Addict Dis. 1991; 11: 33–49.PubMedCrossRef
16.
Kent D, Hayward R. When averages hide individual differences in clinical trials. Am Sci. 2007; 95: 60–68.
17.
Kraemer HC, Wilson GT, Fairburn CG, Agras WS. Mediators and moderators of treatment effects in randomized clinical trials. Arch Gen Psychiatry. 2002; 59: 887–883.CrossRef
18.
Zerhouni EA. NIH in the postdoubling era: Realities and strategies for the future. In: NIMH Council Meeting; September; Bethesda, MD; 2006.
19.
Murphy GM Jr., Hollander SB, Rodrigues C, Krema C, Schatzberg AF. Effects of the serotonic transporter gene promoter polymorphism on mirtazapine and paroxetine efficacy and adverse events in geriatric major depression. Arch Gen Psychiatry. 2004; 61: 1163–1169.PubMedCrossRef
20.
Rothwell PM. Treating individuals 1: External validity of randomised controlled trials: “To whom do the results of this trial apply?”. The Lancet. 2005; 365: 82–93.CrossRef
21.
Kraemer HC, Frank E, Kupfer DJ. Moderators of treatment outcomes: Clinical, research, and policy importance. JAMA. 2006; 296: 1286–1289.PubMedCrossRef
22.
Napolitano MA, Marcus BH. Targeting and tailoring physical activity information using print and information technologies. Exerc Sport Sci Rev. 2002; 30: 122–128.PubMedCrossRef
23.
Moyer A, Finney JW, Elworth JT, Kraemer HC. Can methodological features account for patient–treatment matching findings in the alcohol field? J Stud Alcohol. 2001; 62: 62–73.PubMed
24.
Skinner HA. Different strokes for different folks: Differential treatment for alcohol abuse. In: Meyer RE, Babor TF, Glueck BC, Jaffe JH, O’Brien JE, Stabenau JR, eds. Evaluation of the Alcoholic: Implications for Research, Theory, and Treatment. Washington, DC: Government Printing Office; 1981: 349–367.
25.
Marcus BH, Bock BC, Pinto BM, Forsyth LH, Roberts MB, Traficante RM. Efficacy of an individualized, motivationally-tailored physical activity intervention. Ann Behav Med. 1998; 20: 174–180.PubMedCrossRef
26.
Strecher VJ, Marcus A, Bishop K, et al. A randomized controlled trial of multiple tailored messages for smoking cessation among callers to the Cancer Information Service. J Health Commun. 2005; 10: 105–118.PubMedCrossRef
27.
Killen JD, Fortmann SP, Kraemer HC, Varady A, Newman B. Who will relapse? Symptoms of nicotine dependence predict long-term relapse after smoking cessation. J Consult Clin Psychol. 1992; 60: 797–801.PubMedCrossRef
28.
Winkleby MA, Flora JA, Kraemer HC. A community-based heart disease intervention: Predictors of change. Am J Publ Health. 1994; 84: 767–772.
29.
King AC, Satariano W, Marti J, Zhu W. Multi-level modeling of walking behavior: Advances in understanding the interactions of people, place, and time. Med Sci Sports Exerc, 2008;in press.
30.
Wilcox S, Dowda M, Griffin SF, et al. Results of the first year of Active for Life: Translation of two evidence-based physical activity programs for older adults into community settings. Am J Publ Health. 2006; 96: 1201–1209.CrossRef
31.
King AC, Castro C, Wilcox S. From science to practice and back again: Predictors of successful physical activity participation in a telephone-based dissemination research program. Int J Behav Nutr Phys Act. 2008;5(abstract).
32.
Castro FG, Barrera M Jr, Martinez CR Jr. The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prev Sci. 2004; 5: 41–45.PubMedCrossRef
33.
Munoz RF, Mendelson T. Toward evidence-base interventions for diverse populations: The San Francisco General Hospital Prevention and Treatment Manuals. J Consult Clin Psychol. 2005; 73: 790–799.PubMedCrossRef
34.
Behrens JT. Principles and procedures of exploratory data analysis. Psychol Methods. 1997; 2: 131–160.CrossRef
35.
Greenhouse JB, Greenhouse JBW. Exploratory statistical methods, with applications to psychiatric research. Psychoneuroendocrinology. 1992; 17: 423–441.PubMedCrossRef
36.
Tukey J. Exploratory Data Analysis. Reading, MA: Addison-Wesley; 1977.
37.
Wilkinson L, The Task Force on Statistical Inference of the APA Board of Scientific Affairs. Statistical methods in psychology journals: Guidelines and explanations. Am Psychol. 1999; 54: 594–604.CrossRef
38.
Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM. Statistics in medicine—Reporting of subgroup analyses in clinical trials. N Engl J Med. 2007; 357: 2189–2194.PubMedCrossRef
39.
King AC, Kiernan M, Oman RF, Kraemer HC, Hull M, Ahn D. Can we identify who will adhere to long-term physical activity? Application of signal detection methodology as a potential aid to clinical decision-making. Health Psychol. 1997; 16: 380–389.PubMedCrossRef
40.
Schneiderman N, Saab PG, Catellier DJ, et al. Psychosocial treatment within sex by ethnicity subgroups in the Enhancing Recovery in Coronary Heart Disease clinical trial. Psychosom Med. 2004; 66: 475–483.PubMedCrossRef
41.
King AC, Stokols D, Talen E, Brassington GS, Killingsworth R. Theoretical approaches to the promotion of physical activity: Forging a transdisciplinary paradigm. Am J Prev Med. 2002; 232S: 15–25.PubMedCrossRef
42.
Kraemer HC, Stice E, Kazdin A, Offord D, Kupfer D. How do risk factors work together? Mediators, moderators, and independent, overlapping, and proxy risk factors. Am J Psychiatr. 2001; 158: 848–856.PubMed
43.
King AC, Marcus BH, Dunn AL, et al. Identifying subgroups who succeed or fail with three physical activity interventions: The Activity Counseling Trial. Health Psychol. 2006; 25: 336–347.PubMedCrossRef
44.
Kiernan M, King AC, Stefanick M, Kraemer HC. Characteristics of successful and unsuccessful dieters: An application of signal detection methodology. Ann Behav Med. 1998; 20: 1–6.PubMedCrossRef
45.
Berry DA, Cirrincione C, Henderson IC, et al. Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer. JAMA. 2006; 295: 1658–1667.PubMedCrossRef
46.
Killen JD, Fortmann SP, Davis L, Strausberg L, Varady A. Do heavy smokers benefit from higher dose nicotine patch therapy? Exp Clin Psychopharmacol. 1999; 7: 226–233.PubMedCrossRef
47.
Pittas AG, Das SK, Hajduk CL, et al. A low-glycemic load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. Diabetes Care. 2005; 28: 2939–2941.PubMedCrossRef
48.
Ebbeling CB, Leidig MM, Feldman HA, Lovesky MM, Ludwig DS. Effects of a low-glycemic load vs low-fat diet in obese young adults: A randomized trial. JAMA. 2007; 297: 2092–2102.PubMedCrossRef
49.
Cornier MA, Donahoo WT, Pereira R, et al. Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women. Obes Res. 2005; 13: 703–709.PubMedCrossRef
50.
Sallis JF, Owen N. In: Glanz K, Rimer BK, Lewis FM, eds. Health Behavior and Health Education: Theory, Research, and Practice. Ecological models of health behavior. 3rd ed. San Francisco: Jossey-Bass; 2002: 462–484.
51.
Murphy SA. An experimental design for the development of adaptive treatment strategies. Stat Med. 2005; 24: 1455–1481.PubMedCrossRef
52.
Collins LM, Murphy SA, Nair VN, Strecher VJ. A strategy for optimizing and evaluating behavioral interventions. Ann Behav Med. 2005; 30: 65–73.PubMedCrossRef
53.
54.
Rush AJ, Trivedi M, Fava M. Depression, IV: STAR*D treatment trial for depression. Am J Psychiatry. 2003; 160: 237–245.PubMedCrossRef
55.
Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression. N Engl J Med. 2006; 354: 1243–1252.PubMedCrossRef
56.
Killen JD, Fortmann SP, Kraemer HC, Varady AN, Davis L, Newman B. Interactive effects of depression symptoms, nicotine dependence, and weight change on late smoking relapse. J Consult Clin Psychol. 1996; 64: 1060–1067.PubMedCrossRef
57.
Biddle SJH, Nigg CR. Theories of exercise behavior. Int J Sport Psychol. 2000; 31: 290–304.
58.
King AC, Friedman R, Marcus B, et al. Harnessing motivational forces in the promotion of physical activity: The Community Health Advice by Telephone (CHAT) Project. Health Educ Res. 2002; 17: 627–636.PubMedCrossRef
59.
Williams GG, Gagne M, Ryan RM, Deci EL. Facilitating autonomous motivation for smoking cessation. Health Psychol. 2002; 21: 40–50.PubMedCrossRef
60.
Efron B. The efficiency of logistic regression compared to normal discriminant. J Am Stat Assoc. 1975; 70: 892–898.CrossRef
61.
Kiernan M, Kraemer HC, Winkleby MA, King AC, Taylor CB. Do logistic regression and signal detection identify different subgroups at risk? Implications for the design of tailored interventions. Psychol Methods. 2001; 6: 35–48.PubMedCrossRef
62.
Kraemer HC. Evaluating Medical Tests: Objective and Quantitative Guidelines. Newbury Park, CA: Sage; 1992.
63.
King AC, Toobert D, Ahn D, et al. Perceived environments as physical activity correlates and moderators of interventions in five studies. Am J Health Promot. 2006; 21: 24–35.PubMed
64.
Kraemer HC. Toward non-parametric and clinically meaningful moderators and mediators. Stat Med. 2007; 27(10): 1679–1692.
65.
Cook RJ, Sackett DL. The number needed to treat: A clinically useful measure of treatment effect. Br Med J. 1995; 310: 452–454.
66.
Grissom RJ, Kim JJ. Effect Sizes for Research. Mahwah, NJ: Erlbaum; 2005.
67.
King AC, Haskell WL, Taylor CB, Kraemer HC, DeBusk RF. Group- versus home-based exercise training in healthy older men and women: A community-based clinical trial. JAMA. 1991; 266: 1535–1542.PubMedCrossRef
68.
Gaudard M, Ramsey P, Stephens M. Interactive data mining and design of experiments: The JMP partition and custom design platforms. In: JMP version 5.1.2 (SAS). Cary, NC: SAS; 2006.
69.
Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W. Classification and regression tree analysis in public health: Methodological review and comparison with logistic regression. Ann Behav Med. 2003; 26: 172–181.PubMedCrossRef
70.
Kraemer HC. Assessment of 2 X 2 association: Generalization of signal detection methods. Am Stat. 1988; 42: 37–49.CrossRef
71.
Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Publ Health. 2003; 93: 1261–1267.
72.
Davidson KW, Goldstein M, Kaplan RM, et al. Evidence-based behavioral medicine: What is it and how do we achieve it? Ann Behav Med. 2003; 26: 161–171.PubMedCrossRef
73.
Rosen L, Manor O, Engelhard D, Zucker D. In defense of the randomized controlled trial for health promotion research. Am J Publ Health. 2006; 96: 1181–1186.CrossRef
74.
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Publ Health. 1999; 89: 1322–1327.CrossRef
75.
Atienza AA, Yaroch AL, Masse LC, Moser RP, Hesse BW, King AC. Identifying sedentary subgroups: The National Cancer Institute’s Health Information National Trends Survey. Am J Prev Med. 2006; 31: 383–390.PubMedCrossRef
76.
Pickering TG, Shimbo D, Haas D. Ambulatory blood pressure monitoring. New Engl J Med. 2006; 354: 2368–2374.PubMedCrossRef
77.
Pence C, McErlane K. Anticoagulation self-monitoring. Am J Nurs. 2005; 105: 62–65.PubMed
78.
Harris ND, Baykouchev SB, Marques JL, et al. A portable system for monitoring physiological responses to hypoglycaemia. J Med Eng Technol. 1996; 20: 196–202.PubMedCrossRef
79.
Patrick K, Intille SS, Zabinsky MF. An ecological framework for cancer communication: Implications for research. J Med Internet Res. 2005; 7: 1–7.CrossRef
Metadaten
Titel
Exploring Refinements in Targeted Behavioral Medicine Intervention to Advance Public Health
verfasst von
Abby C. King, Ph.D.
David F. Ahn, Ph.D.
Audie A. Atienza, Ph.D.
Helena C. Kraemer, Ph.D.
Publikationsdatum
01.06.2008
Verlag
Springer-Verlag
Erschienen in
Annals of Behavioral Medicine / Ausgabe 3/2008
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-008-9032-0

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