MOST Made Simple: How to Avoid Common Errors when Publishing your Preparation Phase Research

Danielle M. Ostendorf, PhD; OBBI SIG Co-Chair

There is increasing interest among researchers in studying the optimization of biobehavioral and behavioral interventions. For example, in the last 5 years, there have been over 1,000 publications indexed in PubMed that have cited the use of the Multiphase Optimization Strategy (MOST), which is the leading framework to guide the optimization of interventions. This is more than double the number of publications compared to the prior 5 years. MOST is a comprehensive, principled, engineering-inspired framework that consists of three phases: 1) Preparation, 2) Optimization, and 3) Evaluation. With a growing interest in intervention optimization, comes a rising need to have consistent, standardized terminology when publishing results applying the MOST framework to enhance rigor and reproducibility in this field.

 

 

 

 

 

Researchers Drs. Ryan Landoll and Sara Vargas sought out to do just that. In their recent publication, titled, “The preparation phase in the multiphase optimization strategy (MOST): a systematic review and introduction of a reporting checklist,” published in Translational Behavioral Medicine (), they conducted a systematic review of published research applying the MOST framework to describe how researchers are presenting preparation work, including their conceptual models and their optimization objectives. The authors were specifically interested in the Preparation Phase of MOST, which involves laying the foundation for intervention optimization and is focused on development of the conceptual model as well as pilot testing of intervention components prior to conducting efficacy trials.  The journal is freely accessible to Society of Behavioral Medicine (SBM) members.

"The Preparation Phase of MOST is important] because it is so foundational to the next stages – it really sets the stage in terms of the theoretical model that you are going to use, intervention components you are selecting, the optimization objective.” – Dr. Sara Vargas

Recently, Drs. Landoll and Vargas sat down for an interview with Dr. Danielle Ostendorf, Co-Chair of the Optimization of Behavioral and Biobehavioral Interventions (OBBI) Special Interest Group (SIG) within SBM to describe their work and to help researchers avoid some of the common pitfalls when publishing their Preparation Phase work.

Inspiration for the Manuscript

Drs. Landoll and Vargas describe their initial inspiration for the manuscript, stating that when they were writing a grant to apply MOST to guide the development of a mobile application, they were looking for examples in the literature and noticed a gap, particularly in terms of how the Preparation Phase was being described and wanted to help others learn from their experiences. One of their students, Dr. Kristen Samardzic, had conducted a preliminary literature review on the MOST Preparation Phase and the team was struck by how much variability there was in reporting standards. 

"Without being clear in your reporting…it is really difficult for the reader to grasp the rationale.” – Dr. Sara Vargas

3 Main Themes for Common Errors when Publishing the Preparation Phase Work:

1. Use of Vague Descriptions in Preparation Phase Work: There was a lack of clarity in how researchers applied MOST terminology in their work. These issues likely stemmed from not having reporting standards and from some researchers potentially retroactively applying the MOST framework to work that had already been completed.
2. Missing the Link Between Theory and Establishment of the Optimization Objective: The term optimization objective was not used in most of the published studies. Fewer than half provided a clear description of the optimization objective articles, thus making it difficult to understand how researchers selected the optimization objective based on their preparation work.
3. Missing Rationale for Selection of Intervention Components, their Identified Mediators, and the Theoretical Model: While many published studies clearly identified the intervention components, there were very few articles that clearly described the rationale for selection of the intervention components, their proposed mediators, and the theoretical model itself.

"Don’t be afraid of going back and labeling something different later. Science is iterative…This is not a bug, but a feature of MOST.” – Dr. Sara Vargas

Advice for Helping Researchers Avoid Common Errors when Publishing Preparation Phase Research:

1. “Be Consistent in Using MOST Terminology”: Clearly label the three phases of MOST, using expert-developed resources as a guide (www.cadio.org). Two excellent example articles that met all checklist criteria included: 1) Lachman and colleagues and 2) Wyrick and colleagues.
2. “Don’t Be Afraid of Iteration”: The process isn’t always linear, and that is okay. For example, the Optimization Phase can become preparation work for further optimization, which is a fantastic feature of MOST. Using mixed methods can help researchers have multiple lines of research going on simultaneously and can lead to continuous iteration of interventions.

"This is taking science and bringing it into a space where we can consider what are the operational demands of a system and using that to what will work on the front lines.” – Dr. Ryan Landoll

Their article provides a detailed checklist for researchers to use when reporting results of the Preparation Phase of MOST (“the PREParation REPorting (PREP-REP) Checklist”). Their hope is that this is a practical and useful tool for researchers publishing their Preparation Phase work and will help advance the science. By having more clarity in reporting, researchers can better understand MOST and the interventions being developed, leading to buy-in, and greater adoption of those interventions in real-world settings.

"The ability to have rigor and reproducibility is a hallmark in science…we need to be able to know what other people are doing.” – Dr. Ryan Landoll