Multiphase Optimization Strategy (MOST)

A Future Research Agenda for Digital Geriatric Mental Healthcare

“…46,47 MOST involves three phases of research: 1) preparation (selecting components, collecting pilot and feasibility data, identifying criteria for the minimum effectiveness of individual or combined components for inclusion in an evaluation), 2) optimization (typically using a factorial experiment to determine which of the components, or which combination of components, meet the criteria for minimum effectiveness, and then determining the ideal ultimate treatment package), and 3) evaluation (testing that optimized treatment package in an effectiveness trial such as a randomized controlled trial). 46,47 Based on the results of the evaluation phase, the package is constantly refined through additional optimization phases whenever new components become available or when tailoring for specific populations is necessary. MOST's optimization phase is advantageous over other research designs because it allows for direct observation of the effect of individual or combined components with more accurate estimates of their effects (compared to post-hoc dismantling).…”

“…MOST's optimization phase is advantageous over other research designs because it allows for direct observation of the effect of individual or combined components with more accurate estimates of their effects (compared to post-hoc dismantling). 46,47 Additionally, MOST frameworks can facilitate the identification of mechanisms of action on outcomes and identify active intervention ingredients, 46 both of which creates a more efficient intervention.…”