Intensively Adaptive Interventions Using Control Systems Engineering: Two Illustrative Examples

Uncontrolled Eating during Pregnancy Predicts Fetal Growth: The Healthy Mom Zone Trial

“…There are also some limitations of this research. The small sample size, although adequate for an optimization trial within the MOST framework [46], precludes the ability to make assumptions at a population level. The intervention and control groups were unbalanced in terms of the proportion of women with obesity; however, all analyses controlled for prepregnancy BMI.…”

“…Data for this analysis were collected as part of an ancillary study to measure fetal growth in women participating in Healthy Mom Zone, an optimization trial within the multiphase optimization strategy (MOST) framework [46], of an adaptive intervention to manage gestational weight gain among pregnant women with overweight or obesity [18]. This study was approved by the Pennsylvania State University Institutional Review Board (study ID #00003752, initial approval date 12/1/2015), and participants provided written consent for their participation.…”

“…Healthy Mom Zone is an individually tailored, adaptive intervention to optimize gestational weight gain among pregnant women with overweight and obesity. This optimization trial was built within the multiphase optimization strategy (MOST) framework [46] with the aim of developing an intervention to efficiently and effectively manage weight gain over pregnancy. Details of the Healthy Mom Zone intervention are published elsewhere [18], but in short, principles from the theory of planned behavior (TPB) [47] and self-regulation [48] provide the conceptual framework for the intervention.…”

On the Control of Psychological Networks

“…Rivera, Pew, and Collins (2007) likewise described how to apply control theory to model and assess adaptive interventions on single target variables. In perhaps the most comprehensive application, Rivera, Hekler, Savage, and Downs (2018) used a sophisticated form of control called model predictive control (MPC) in two separate interventions with sedentary, overweight adults and pregnant women (for further discussion of the utility of MPC, see our Future Directions section). Finally, there is a related large literature on adaptive interventions (Collins, Murphy, & Bierman, 2004;Collins et al, 2004;Nahum-Shani et al, 2018), which is considerably broader than control theory in intervention design, but addresses key considerations for both study and intervention design.…”

A dynamical systems model of intrauterine fetal growth

“…The implementation of such a framework calls for developing advanced control systems which rely on dynamical models that are able to predict individualized responses to different intervention components and subsequently predict GWG, the intrauterine growth profile, and infant birth weight [15–17]. In particular, one important end use of a dynamical systems model of intrauterine fetal growth is as the internal model in a model-based controller that accomplishes an optimized, adaptive intervention [18–20]. …”