BACKGROUND The Multiphase Optimization Strategy (MOST) is an approach to systematically and efficiently developing a behavioral intervention using a sequence of experiments to prepare and optimize the intervention. PURPOSE Using a 6 year MOST-based behavioral intervention development project as an example, we outline the results-and resulting decision-making process-related to experiments at each step to display the practical challenges present at each stage. METHODS To develop a positive psychology (PP) based intervention to promote physical activity after an acute coronary syndrome (N = 255 across four phases), we utilized qualitative, proof-of-concept, factorial design, and randomized pilot experiments, with iterative modification of intervention content and delivery. RESULTS Through this multiphase approach, we ultimately developed a 12 week, phone-delivered, combined PP-motivational interviewing intervention to promote physical activity. Across stages, we learned several important lessons: (a) participant and interventionist feedback is important, even in later optimization stages; (b) a thoughtful and systematic approach using all information sources is required when conflicting results in experiments make next steps unclear; and (3) new approaches in the field over a multiyear project should be integrated into the development process. CONCLUSIONS A MOST-based behavioral intervention development program can be efficient and effective in developing optimized new interventions, and it may require complex and nuanced decision-making at each phase.

中文翻译：

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使用多阶段优化策略对心脏病患者进行心理行为干预：现场经验教训。

背景技术多阶段优化策略（MOST）是一种使用一系列实验来准备和优化干预措施来系统且有效地开发行为干预措施的方法。目的以一个为期 6 年的基于 MOST 的行为干预开发项目为例，我们概述了与每个步骤的实验相关的结果以及由此产生的决策过程，以展示每个阶段存在的实际挑战。方法 为了开发一种基于积极心理学 (PP) 的干预措施，以促进急性冠脉综合征后的身体活动（N = 255，跨越四个阶段），我们利用定性、概念验证、析因设计和随机试点实验，并进行迭代修改干预内容和实施方式。结果 通过这种多阶段方法，我们最终制定了为期 12 周的电话传递、PP 动机访谈相结合的干预措施，以促进身体活动。在各个阶段中，我们学到了几个重要的教训：（a）参与者和干预者的反馈很重要，即使在后期的优化阶段；(b) 当实验中相互矛盾的结果使后续步骤不清楚时，需要使用所有信息源采取深思熟虑和系统的方法；(3) 多年项目领域的新方法应纳入开发过程。结论 基于大多数的行为干预开发计划可以高效且有效地开发优化的新干预措施，并且可能需要在每个阶段进行复杂而细致的决策。