Kate Guastaferro
Kate Guastaferro
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Assistant Professor of Social and Behavioral Sciences
Co-Director of the Center for the Advancement and Dissemination of Intervention Optimization
Director of the Doctor of Public Health (DrPH) Program
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Professional overview
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Kate Guastaferro, PhD is an intervention scientist by training, her work is devoted to the development, optimization, implementation and evaluation of effective, efficient, affordable and scalable interventions with high public health impact. She is an expert in the multiphase optimization (MOST) strategy and her expertise is in parent-focused, multicomponent behavioral interventions to prevent child maltreatment. Dr. Guastaferro co-led a statewide trial focused on the coordinated implementation of three evidence-base child sexual abuse prevention programs; included in this trial was the parent-focused child sexual abuse program that she developed, piloted and evaluated. Her current work is focused on the integration of intervention optimization into the prevention of child maltreatment.
Prior to joining NYU, Dr. Guastaferro was an assistant research professor in human development and family studies at the Pennsylvania State University, and an affiliate of its Prevention Research Center and Child Maltreatment Solutions Network. In 2020, she was awarded the Victoria S. Levin Award for Early Career Success in Young Children’s Mental Health Research from the Society for Research in Child Development. She has been published in Child Maltreatment, Translational Behavioral Medicine, and the American Journal of Public Health.
Dr. Guastaferro received her PhD and MPH from Georgia State University’s School of Public Health, and her BA in anthropology from Boston University. She also completed a year of postdoctoral training at the Pennsylvania State University.
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Education
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Postdoctoral Fellow, Prevention and Methodology Training Program (T32 DA017629), The Pennsylvania State UniversityPhD Public Health, Georgia State UniversityMPH Health Promotion, Georgia State UniversityBA Anthropology, Boston University
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Honors and awards
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Victoria S. Levin Award, Society for Research on Child Development (2020)NIH Loan Repayment Program Award: Toward the Optimization of Behavioral Interventions to Prevent Child Maltreatment (201820192020)Public Health Achievement Award, Georgia State University (2016)Scarlet Key Honor Society, Boston University (2008)
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Publications
Publications
A Quasi-Experimental Trial of Universal Parent-Focused Child Sexual Abuse Prevention Program: Recruitment Practicalities and Pitfalls
AbstractTorney, I., Abourjaily, E., & Guastaferro, K. (n.d.).Publication year
2025Abstract~A Scoping Review: Are U.S. Teachers Equipped to Prevent Child Sexual Abuse?
AbstractMartin, C., Melchior, M. S., Chasen, E., & Guastaferro, K. (n.d.).Publication year
2025Abstract~A Site-Specific and Temporal Analysis of a School-Based Child Sexual Abuse Prevention Program
AbstractModi, P., Abourjaily, E., Torney, I., & Guastaferro, K. (n.d.).Publication year
2025Abstract~Adapting a sexual and reproductive health program for Latina teens and their female caregivers: A qualitative study
AbstractMerrill, K. G., Fuentes, J., Merrill, J., DeCelles, J., Silva, J., Sedeño, A., Salgado, S., Vargas, S., Cano, J. K., Nabor, V., Rodriguez, L., Melgoza, V., Mora, C., Baumann, A. A., Guastaferro, K., & Donenberg, G. R. (n.d.).Publication year
2025Journal title
Frontiers in Public HealthVolume
13AbstractBackground: Adaptation is widely recognized as important when interventions are to be delivered in new settings or with new populations. However, there are gaps in the literature on how adaptations are carried out and documented. IMARA is a 12-h evidence-based sexual health intervention for Black teens and their mothers, designed for delivery over two days. We present our systematic process of adapting IMARA for Latinas to produce the Floreciendo (“Blooming”) program for Latina teens (14–18 years old) and their female caregivers (e.g., mothers, sisters). Methods: Using a community-based participatory research (CBPR) approach, we carried out a qualitative study that included 7 focus groups: 4 with staff from community partner organizations (n = 29), 2 with Latina teens (14–18 years) (n = 11), and 1 with female caregivers (n = 5). We also conducted seven key informant interviews with experts in sexual health and Latina health. We used Escoffery’s recommended steps to guide our adaptation process. Data were thematically coded and adaptations documented using the FRAME for reporting modifications to evidence-based interventions. Results: Informed by the data, we grouped IMARA content into four sessions for Floreciendo, each with unique curricular content and designed to be delivered in two hours (eight hours total): (1) Foundations in Sexual Risk Prevention; (2) Condoms and Contraception; (3) Family Strengthening; and (4) Gender and Relationships. We documented adaptations made for each session. For example, participants emphasized unplanned pregnancy as an important issue facing Latina teens. In response, we added an activity providing hands-on experience with contraceptive methods. Participants also highlighted how gender norms and family expectations in Latine culture shape Latina teens’ sexual and reproductive health practices. We therefore developed activities and opportunities for discussion addressing these cultural influences. We removed IMARA activities considered of lower priority (e.g., portrayal of women in the media). Conclusion: This study addresses gaps in the literature by reporting in detail the adaptations we made to an evidence-based intervention using qualitative methods. The four curriculum sessions we generated through our adaptation process will form the basis of the intervention components we will test in future work using the multiphase optimization strategy (MOST) framework.Coordinated Primary Prevention of Child Sexual Abuse: Project Safe & Smart at Weller Health Education
AbstractGuastaferro, K., Rainey, M., Escueta, A., Abourjaily, E., & Hoben, K. (n.d.).Publication year
2025Abstract~Enhancing occupational therapy interventions by integrating the multiphase optimization strategy framework
AbstractRosenfeld, M., Goverover, Y., & Guastaferro, K. (n.d.).Publication year
2025Journal title
American Journal of Occupational TherapyVolume
79Issue
1AbstractThe pursuit of evidence-based interventions has long been a cornerstone of the occupational therapy profession. However, challenges persist regarding systematic development of interventions, evaluation of efficacy and effectiveness, as well as implementation and dissemination of interventions within clinical . This article introduces the Multiphase Optimization Strategy (MOST), an engineering-inspired framework for the development, optimization, and evaluation of multicomponent interventions. MOST allows the systematic development and evaluation of optimized interventions that prioritize effectiveness within constraints like affordability, scalability, and efficiency. Employing MOST while developing an intervention can potentially reduce the delay between intervention creation and implementation. Furthermore, adopting MOST will bolster the use of rigorous research designs in occupational therapy studies and foster shared terminology with other disciplines that have successfully applied this framework across a range of health priorities and conditions. Thus, in this article, we advocate for the integration of MOST into occupational therapy intervention development research.Enhancing Occupational Therapy Interventions by Integrating the Multiphase Optimization Strategy Framework
AbstractRosenfeld, M., Goverover, Y., & Guastaferro, K. (n.d.).Publication year
2025Journal title
The American journal of occupational therapy : official publication of the American Occupational Therapy AssociationVolume
79Issue
1AbstractAs occupational therapy research advances and the body of evidence supporting effective interventions continues to grow, there is a need to expedite the transfer of research findings into practice, and the use of intervention development frameworks becomes increasingly essential. In this column, we introduce the Multiphase Optimization Strategy (MOST), an engineering-inspired framework for the development, optimization, and evaluation of multicomponent interventions. MOST allows for the systematic development and evaluation of optimized interventions that prioritize effectiveness within constraints like affordability, scalability, and efficiency. Using MOST while developing an intervention may reduce the delay between intervention development and real-world implementation. Moreover, adopting MOST will bolster the use of rigorous research designs in occupational therapy studies and foster shared terminology with other disciplines that have successfully applied this framework across a range of health priorities and conditions. Thus, we advocate integrating MOST into occupational therapy intervention development research.Evaluating smoking cessation interventions for people living with HIV in a factorial randomised clinical trial in South Africa using the Multiphase Optimization Strategy (MOST) framework : The Tlogela Trial protocol
AbstractGenade, L. P., Steiner, L., Nabeemeeah, F., Niaura, R. S., Nonyane, B. A., Hoffmann, C. J., Sohn, H., Kemp, C. G., Guastaferro, K., Mlambo, L., Chetty, D., Waja, Z., Martinson, N., Golub, J. E., & Elf, J. L. (n.d.).Publication year
2025Journal title
Contemporary Clinical TrialsVolume
155AbstractBackground: Human immunodeficiency virus (HIV) remains an important cause of morbidity and mortality in South Africa (SA) with a gradual shift from opportunistic illness to pulmonary and cardiovascular disease among people living with HIV (PLWH). This shift is exacerbated by increases in prevalence of tobacco smoking and also few resources to support smoking cessation. Evidence-based smoking cessation strategies are yet to be fully evaluated among PLWH in this setting. Objective: This project will optimize a smoking cessation treatment package for PLWH that can be integrated into existing HIV care in SA. We will identify the most effective and/or combination of the interventions and evaluate their potential for implementation and cost-effectiveness. Methods: A balanced 24 full factorial clinical trial will randomise 660 PLWH who smoke tobacco into one of 16 combinations of four intervention components (behavioural counselling, peer counselling, varenicline, and combination nicotine replacement therapy). Participants will be recruited from four healthcare facilities in SA, receive 12 weeks of intervention and the primary outcome will be 7-day point prevalence tobacco abstinence from smoking at one year, measuring both exhaled breath carbon monoxide (CO) and urinary cotinine. A mixed methods approach will be used to evaluate implementation using the Reach, Effectiveness, Adoptions, Implementation, Maintenance framework. Cost, cost-effectiveness, and budget impact of each intervention combination will be evaluated. Conclusion: Results will inform which intervention components, and in what combination, are most efficacious in supporting smoking abstinence among PLWH in SA and those that have the greatest potential for effectiveness when brought to scale. Clinical Trial Registration Number: South African National Clinical Trials Registry. Trial No: DOH-27-062023-9076. ClinicalTrials.govMandated Reporting in New York State: A Policy Note
AbstractMelchior, M., & Guastaferro, K. (n.d.).Publication year
2025Abstract~Pilot optimization trial of a sexual and reproductive health program for Latina teens and their female caregivers : A study protocol
AbstractMerrill, K. G., Silva, J., Chu, W., Romero, G., Melgoza, V., Gabino, B., Mora, C., Vargas, S., Fuentes, J., Kelleher-Montero, C., Courrejolles, N., Guastaferro, K., Scott-Wellington, F., Salgado, S., & Sedeño, A. (n.d.).Publication year
2025Journal title
Contemporary Clinical Trials CommunicationsVolume
46AbstractBackground: Latina teens experience sexual and reproductive health disparities; however, few effective interventions designed for Latina teens and their families exist. Floreciendo is a sexual and reproductive health intervention for Latina teens (14–18 years) and their female caregivers (e.g., mothers, sisters), delivered by trained staff at community partner organizations (CPOs). Methods: This protocol describes a hybrid type 2 mixed-methods study with a pilot 23 factorial experimental design which draws on the multiphase optimization strategy (MOST) framework. Small groups of teen-caregiver dyads (target n = 92 dyads/184 participants) will be randomized to 1 of 8 conditions across four CPOs. All will receive the Foundations in Sexual Risk Prevention (i.e., constant) component. Groups of dyads will be randomized to different combinations of three intervention components of Floreciendo, which are either “on” or “off”: 1) Condoms and Contraception, 2) Family Strengthening, and 3) Gender and Relationships. Our aim is to examine the feasibility of using a factorial design and the acceptability of the intervention components. We will also explore effectiveness outcomes—including risky sexual behavior (primary) and incidence of sexually transmitted infections and unplanned pregnancy (secondary)—and implementation outcomes, including appropriateness, feasibility, adoption, sustainability, cost, and fidelity. Qualitative data will build on quantitative data. We will conduct focus group discussions and key informant interviews with Latina teens, female caregivers, facilitators, CPO leadership, and collaborators. Discussion: Results will be used to guide intervention component and implementation refinement and will inform plans to conduct a fully powered optimization trial of Floreciendo.Population-level reductions in child sexual abuse valid and invalid cases after a three-year coordinated, community-wide prevention initiative: Results from a synthetic control analysis
AbstractNoll, J. G., Felt, J., Russotti, J., Guastaferro, K., Day, S., & Fisher, Z. (n.d.).Publication year
2025Journal title
JAMA PediatricsAbstractImportance: Child sexual abuse (CSA) impacts 15% of girls and 8% of boys worldwide, incurring high public costs and devastating consequences for survivors. US incidence rates have stagnated over the past 15 to 20 years, signaling a dire need for innovation in primary prevention. In 2024, the US Preventive Services Task Force reported that there is insufficient evidence for the effectiveness of child abuse preventive strategies, and none have shown decreases in incidence rates at the population level. Objective: To test whether a coordinated, community-wide preventive intervention could significantly reduce population-level incidence rates of CSA. Design, Setting, and Participants: This population cohort study used synthetic control methods with a counterfactual condition and CSA incidence data from a statewide child welfare information system. Participants included a population-based sample in the state of Pennsylvania. Intervention: From 2018 through 2020, the state of Pennsylvania launched a 3-pronged CSA prevention intervention in 5 counties that included: (1) exposing 5% of the adult population (approximately 72000) to online and in-person trainings with an accompanying countywide media campaign, (2) delivering a psychoeducation program to 100% of second-grade students (approximately 17000), and (3) providing parent training to 100% of parents served by the child welfare system (approximately 300). Intervention counties were a priori matched to 1 of 5 control counties based on population size and preintervention CSA rates. Main Outcomes and Measures: Aggregate rates of both substantiated and unsubstantiated CSA reports were examined across intervention and control counties for 5 preintervention years and 3 postintervention years. Results: Within 1 year of intervention launch, CSA reports were significantly reduced in intervention counties, as compared with control counties for both substantiated (average treatment of the treated [ATT] =-17.22; 95% CI,-34.15 to-4.20) and unsubstantiated reports (ATT =-36.04; 95% CI,-74.40 to-3.88). Conclusions: In this evaluation of a place-based, coordinated, countywide intervention, reports of both substantiated and unsubstantiated CSA were shown to be significantly reduced at the population level.Preparing to implement Floreciendo with Latina teens and their female caregivers : Integrating implementation science and the multiphase optimization strategy framework
AbstractMerrill, K. G., Silva, J., Sedeño, A., Salgado, S., Vargas, S., Cano, J. K., Nabor, V., Merrill, J. C., DeCelles, J., Guastaferro, K., Baumann, A. A., Fuentes, J., Rodriguez, L., Melgoza, V., & Donenberg, G. R. (n.d.).Publication year
2025Journal title
Translational Behavioral MedicineVolume
15Issue
1AbstractBackground: Practical examples of studies integrating implementation science and the multiphase optimization strategy (MOST) framework are lacking. Floreciendo is a sexual and reproductive health program for Latina teens and their female caregivers, adapted from the IMARA evidence-based program. Purpose: We prepared for delivering Floreciendo by developing an implementation plan to support the program’s adoption and sustainment. Methods: Drawing on a community-based participatory research approach, we used qualitative methods to explore program logistics, implementation determinants and strategies, adoption, and sustainability. We positioned our study activities within the preparation phases of both the MOST and the EPIS frameworks. We conducted and rapidly analyzed seven focus group discussions—one with Latina teens (n = 9), one with female caregivers (n = 6), four with organizational staff (n = 32), and one with IMARA staff (n = 6)—and seven key informant interviews. Results: Participants described community organizations as the preferred location for workshops in offering a “safe space.” They recommended workshop delivery on two days over separate weekends. Teens and caregivers requested relatable, bilingual Latina facilitators. Implementation barriers were raised (e.g. work conflicts) with strategies to address them (e.g. provide stipends). Organizational adoption was perceived as likely since the workshop addresses clients’ needs and fits with organizational values. Recommendations for sustainment included identifying funding opportunities specific to each organization. Conclusions: Findings directly informed our immediate plans to optimize Floreciendo using the MOST framework and principles and our long-term goals for adoption and sustainability. Implementation science can strengthen studies using the MOST framework.Preparing to implement the Floreciendo sexual and reproductive health workshop: Integrating implementation science and the MOST framework
AbstractMerrill, K. G., Silva, J., Sedeno, A., Salgado, S., Vargas, S., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., Baumann, A., Fuentes, J., Rodriguez, L., & Donenberg, G. (n.d.).Publication year
2025Journal title
Translational Behavioral MedicineVolume
15Issue
1AbstractBackground: Practical examples of studies integrating implementation science with the multiphase optimization strategy (MOST) framework are lacking. Floreciendo is a workshop for Latina teens and their female caregivers addressing sexual and reproductive health and related issues (e.g., mental health, intimate partner violence), which was adapted from the IMARA evidence-based program. We set out to explore implementation determinants (i.e., barriers and facilitators) and strategies to prepare for a pilot optimization trial of Floreciendo in the preparation phase of MOST. Methods: Using community-based participatory research, we integrated the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework with the MOST framework. We sought to explore determinants of and strategies for achieving five implementation outcomes: acceptability, appropriateness, feasibility, adoption, and sustainability. We conducted seven focus group discussions with Latina teens (n=1 group), female caregivers (n=1 group), staff from three community partner organizations (n=4 groups), and facilitators/implementers of IMARA (n=1 group). We also conducted seven key informant interviews with individuals experienced with sexual and Latina health. Data were analyzed using rapid qualitative analysis. Results: Community partner organizations were the preferred location for workshops in offering a “safe space.” Participants recommended delivering the program on two days over separate weekends. Implementation barriers were raised (e.g., work conflicts, caring for younger children, lack of transport) with strategies to address them (e.g., provide stipends, offer childcare, offer transport reimbursement). Teens and caregivers requested relatable, bilingual Latina facilitators. Organizational adoption was perceived as likely since the workshop addresses clients’ needs and fits with organizational values. Recommendations for sustainment included identifying funding opportunities specific to each organization. Conclusions: Our findings directly informed the refinement of intervention components and implementation strategies to be used in a pilot optimization trial of Floreciendo. This work highlights the invaluable role that implementation science can play in research informed by the MOST framework.StandUPTV : a full-factorial optimization trial to reduce sedentary screen time among adults
AbstractKeadle, S. K., Hasanaj, K., Leonard, K. S., Fernandez, A., Freid, L., Weiss, S., Legato, M., Anand, H., Hagobian, T. A., Phillips, S. M., Phelan, S., Guastaferro, K., Seltzer, R. G., & Buman, M. P. (n.d.).Publication year
2025Journal title
International Journal of Behavioral Nutrition and Physical ActivityVolume
22Issue
1AbstractBackground: Using the multiphase optimization strategy (MOST) framework, we aimed to identify an optimized mHealth-delivered intervention for reducing recreational sedentary screen time (rSST) by at least 60 min/day among adults. Methods: Eligible participants were 23–64 years old and self-reported elevated rSST (> 3 h/day). Following a 7-day baseline, participants received a core mHealth application (self-monitoring and 50% reduction target and educational materials) and were randomly assigned to three additional components set to on/off in a full-factorial (23) experiment: LOCKOUT: rSST electronically restricted; TEXT: rSST reduction prompts; and EARN: rSST through physical activity. rSST was assessed at baseline and 16 weeks via an integrated measure that included objectively assessed sedentary time (activPAL accelerometer) and screen time (TV Wifi plugs and tablet usage). We used a linear mixed effect model to evaluate the change in rSST for the three intervention components and their interactions. Results: A total of 82% of the randomized participants (N = 110) were female, with a mean ± SD age of 41 ± 11.7 y and a BMI of 29.7 ± 7.8 kg/m2, and their mean (95% CI) rSST was 184.7 (172.8, 196.5) min/day at baseline. The expected difference (baseline vs. 16 weeks) in rSST was greatest for the intervention versions with the core plus EARN on with an average reduction of -118.1 (-163.0, -73.1) min/day and for core plus LOCKOUT, TEXT, & EARN on (-125.7 [-172.0, -79.3] min/day). Conclusions: We identified several promising intervention versions that exceeded our optimization objective. This study provides important evidence on efficacious multicomponent interventions that should be moved forward to the evaluation phase of the MOST framework to test the effect of rSST reductions on health outcomes. Trial registration: (clinicaltrials.govThe ROOTS Parenting Intervention to Improve Child Emotional and Physical Health : Protocol for a Pilot Randomized Controlled Trial for Black and Latiné Families
AbstractCooper, D. K., Lupini, F., Alonzo, J., Beets, M., Guastaferro, K., McLain, A. C., Saini, S., & Prinz, R. J. (n.d.).Publication year
2025Journal title
Journal of Marital and Family TherapyVolume
51Issue
3AbstractBlack and Latiné children in the United States experience disproportionate rates of emotional and physical health problems, yet few preventive interventions address both types of outcomes in a culturally relevant way. This study explores the feasibility of a parenting program that incorporates ethnic-racial socialization and healthy lifestyle behaviors to promote the health of Black and Latiné children ages 3–6. A type 1 hybrid randomized controlled trial will be conducted with 60 families, who will be assigned to a parenting program or an active control condition, assessed at three time points. Feasibility measures will include quantitative and qualitative assessments of implementation outcomes and determinants. The main intervention outcomes are child social-emotional functioning, child healthy lifestyle behaviors, and parenting processes. Findings will inform future efforts to implement and scale culturally relevant parenting interventions aiming to improve the emotional and physical health of minoritized children. Trial Registration: The trial began recruiting in May 2024 (Trial Registry: NCT06111651, Version 5, June 13, 2024). Participants are expected to complete their 3-month follow-up assessments at the end of fall 2025.Theater testing a sexual and reproductive health program for Latina teens and their female caregivers : a mixed methods study
AbstractMerrill, K. G., Silva, J., Atadero, J., Hung, I. L., Salgado, S., Cano, J. K., Nabor, V., Sedeño, A., Vargas, S., Romero, G., Perez, C., Merrill, J., DeCelles, J., Fuentes, J., Florence, K., Rodriguez, L., Mora, C., Baumann, A. A., Guastaferro, K., & Donenberg, G. R. (n.d.).Publication year
2025Journal title
BMC public healthVolume
25Issue
1AbstractBackground: Floreciendo is a sexual and reproductive health program for Latina teens (14–18 years) and their female caregivers adapted from the evidence-based IMARA intervention. We report on our experience theater testing Floreciendo during the preparation phase of the multiphase optimization strategy (MOST) framework. Floreciendo includes four two-hour sessions (i.e., intervention components). Our aims were to: (1) examine the preliminary acceptability, appropriateness, and feasibility of the intervention components, including the acceptability of the implementation plan (i.e., logistics, strategies), and (2) systematically report on curriculum modifications made based on findings. Methods: Using a community-based participatory research approach, we theater tested the program at a community organization over one weekend with three teen-caregiver dyads (n = 6) using mixed methods. Immediately following the delivery of each intervention component, teens and caregivers completed surveys and engaged in feedback sessions. Observers (n = 8) and facilitators (n = 2) completed surveys, recorded activity start and end times, and participated in a post-program discussion. Survey item ratings were on four-point Likert scales, with higher scores indicating more favorable results. Feedback informed subsequent curriculum modifications, which were documented using the FRAME. Results: We found high satisfaction with the intervention components among all surveyed (n = 16) and with the implementation plan among teens and caregivers (n = 6) (≥ 3.7/4.0). Teens and caregivers described sessions as “educational,” “motivating,” “interactive,” and “fun”; all (100%; n = 6) reported that they would recommend the program to others. Teens and caregivers rated the appropriateness of the material and language/wording highly (4.0/4.0; n = 6), although caregivers expressed difficulty understanding “passive communication” given translation difficulties. Feasibility was also rated highly across groups (≥ 3.8/4.0; n = 16); 18% of activities were 10 + minutes longer than planned based on observer reports but the sessions overall remained within 2 min of the allotted time. We modified the intervention components based on the feedback received. For example, we moved discussions about sex to come later in the foundational session to increase participant comfort. Conclusions: Findings offer preliminary evidence of Floreciendo’s acceptability, appropriateness, and feasibility. Theater testing is a valuable tool for intervention adaptation and FRAME is useful for tracking curriculum modifications over time. MOST researchers could consider theater testing while carrying out preparation-phase activities.Universal parent-focused child sexual abuse prevention : A quasi-experimental protocol
AbstractAbourjaily, E. L., Guastaferro, K., McElwee, K., & Connell, C. M. (n.d.).Publication year
2025Journal title
PloS oneVolume
20Issue
1AbstractBackground Child sexual abuse (CSA) is a significant public health concern, and there is a lack of universal, evidence-based primary prevention interventions that extend beyond a focus solely on children. Parents remain a consistently underutilized target for primary prevention efforts aimed at mitigating CSA despite their unique relationship and close proximity to their children. CSA risk is not confined to any specific demographic, and its effects on affected children are well-documented, significantly impacting numerous dimensions of their wellbeing. Thus, there is a clear and urgent need to address this gap in prevention strategies. Methods This study will use a quasi-experimental design (target N = 412) to examine potential gains in CSA-related awareness and intentions to use protective behaviors among parents who participate in a universal parent-focused CSA prevention workshop, Smarter Parents. Safer Kids., compared to those who do not. Participants in both the control (n = 206) and experimental group (n = 206) will complete 3 survey assessments: Survey 0 (baseline), Survey 1 (1-month), and Survey 2 (3-month follow-up). The experimental group will participate in a Smarter Parents. Safer Kids. workshop between the Surveys 0 and 1. We will use data collected from the baseline to measure potential mediators of CSA-related awareness and intention to use protective and preventive behaviors. In adjacent efforts to enhance the curriculum’s reach with future dissemination and implementation, we will also explore the impact of recruitment materials and strategies on parental engagement. Conclusion Results of this study will advance efforts to implement parent-focused CSA prevention with a universal audience.A to Z and not just “K:” Considerations for Applying the Multiphase Optimization Strategy in Your Career Development Award.
AbstractWells, R. D., Gazaway, S., Merrill, K. G., & Guastaferro, K. (n.d.).Publication year
2024Abstract~Adapting a selective parent-focused child sexual abuse prevention curriculum for a universal audience : A pilot study
AbstractGuastaferro, K., Abuchaibe, V., McCormick, K. V., Bhoja, A., Abourjaily, E. L., Melchior, M. S., Grayson, C., Welikson, P., Dan, C., & Zeleke, M. B. (n.d.).Publication year
2024Journal title
PloS oneVolume
19Issue
5 MayAbstractParents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal parent-focused prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape-parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation-interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Using mixed methods, N = 31 parents (i.e., primary caregiver for a child under 13) completed pre- and post-workshop surveys followed by a brief individual interview conducted via Zoom. Interviews, coded using content analysis methods, focused on three themes: parents as agents of prevention (e.g., prior action, confidence), curriculum (e.g., content, design), and engagement (e.g., future marketing and promotion). Overall participants' mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent-focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.Adapting a selective parent-focused child sexual abuse prevention curriculum for a universal audience: A pilot study
AbstractGuastaferro, K., Abuchaibe, V., McCormick, K., Bhoja, A., Abourjaily, E., Melchior, M., Grayson, C., Welikson, P., Dan, C., & Zeleke, M. B. (n.d.).Publication year
2024Journal title
PLOS ONEPage(s)
1-16AbstractParents are an obvious, but underutilized player in the prevention of child sexual abuse (CSA). A handful of universal parent-focused prevention programs have emerged, however, the evidence for these programs is mixed and the programs suffer ubiquitously from barriers to implementation (e.g., poor engagement, low participation) thereby limiting public health impact. To combat these barriers and improve evidence, researchers previously developed and tested a selective parent-focused CSA prevention program. While promising, the selective approach still leaves a gap in the prevention landscape – parents from the universal audience. However, there appear to be no standardized methods to inform this type of adaptation— interventions designed as universal or selective have primarily been delivered as such. This study sought to adapt the selective curriculum for a universal audience and examined the acceptability and feasibility of the program for evaluation in a future trial. Using mixed methods, N=31 parents (i.e., primary caregiver for a child under 13) completed pre- and post-workshop surveys followed by a brief individual interview conducted via Zoom. Interviews, coded using content analysis methods, focused on three themes: parents as agents of prevention (e.g., prior action, confidence), curriculum (e.g., content, design), and engagement (e.g., future marketing and promotion). Overall participants’ mean score on CSA-related awareness and intention to use protective behavioral strategies increased. The participants found the curriculum highly acceptable noting strengths in the content and design. All told, the results of this pilot study suggest the acceptability and feasibility of examining the efficacy of the universal parent-focused curriculum in a larger trial. Procedural challenges, such as bots in recruitment, identify areas of caution in design of the larger trial and a roadmap for others seeking to adapt selective programs for universal audiences.Adaptive Interventions: Innovations in Intervention and Experimental Design.
AbstractNahum-Shani, I., Almirall, D., & Guastaferro, K. (n.d.).Publication year
2024Abstract~An Innovative Approach to Reducing Second Hand Smoke Exposure and Child Maltreatment Risk: The Smoke-Free Home SafeCare Curriculum.
AbstractGuastaferro, K., Recinos, M., Perry, E., Kegler, M., & Self-Brown, S. (n.d.).Publication year
2024Abstract~Applying the resource management principle to achieve community engagement and experimental rigor in the multiphase optimization strategy framework
AbstractO’Hara, K. L., Guastaferro, K., Hita, L., Rhodes, C. A., Thomas, N. A., Wolchik, S. A., & Berkel, C. (n.d.).Publication year
2024Journal title
Implementation Research and PracticeVolume
5Abstract: Preventing and treating mental health and substance use problems requires effective, affordable, scalable, and efficient interventions. The multiphase optimization strategy (MOST) framework guides researchers through a phased and systematic process of developing optimized interventions. However, new methods of systematically incorporating information about implementation constraints across MOST phases are needed. We propose that early and sustained integration of community-engaged methods within MOST is a promising strategy for enhancing an optimized intervention's potential for implementation. In this article, we outline the advantages of using community-engaged methods throughout the intervention optimization process, with a focus on the Preparation and Optimization Phases of MOST. We discuss the role of experimental designs in optimization research and highlight potential challenges in conducting rigorous experiments in community settings. We then demonstrate how relying on the resource management principle to select experimental designs across MOST phases is a promising strategy for maintaining both experimental rigor and community responsiveness. We end with an applied example illustrating a community-engaged approach to optimize an intervention to reduce the risk for mental health problems and substance use problems among children with incarcerated parents.Association between child maltreatment and substance use disorder across emerging adulthood
AbstractGuastaferro, K., Linden-Carmichael, A. N., & Chiang, S. C. (n.d.).Publication year
2024Journal title
Child MaltreatmentVolume
29Issue
2Page(s)
340-349AbstractChild maltreatment is associated with substance use beginning in adolescence and throughout early adulthood. Substance use disorders (SUD) are most likely to develop during emerging adulthood (18–25 years old). Thus, to develop effective substance use prevention strategies, it is useful to know the ages at which associations between maltreatment exposure (prior to age 18) and SUD are most strongly tied. This study examined the age-varying association between child maltreatment and past-year SUD in emerging adulthood by sex and by maltreatment type using time-varying effect models (TVEM). Data were from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). The analytic sample consisted of 5194 emerging adults. The association was strongest at younger ages, with individuals who experienced child maltreatment having three times greater odds of reporting SUD in the past-year. Differential associations were found by sex, racial-ethnic group, and maltreatment type across age. Prevention efforts may be more effective if their development is informed by these important differences and targeted at emerging adults rather than adolescents.Child maltreatment types by age: Implications for prevention
AbstractGuastaferro, K., & Shipe, S. L. (n.d.).Publication year
2024Journal title
International Journal of Environmental Research and Public HealthVolume
21Issue
1AbstractChild maltreatment is a global public health issue known to affect an average of 600,000 U.S. children of all ages (0–18 years old) annually. However, a preponderance of preventive programs target children on the younger end of the spectrum, specifically those aged 0–5. Annual reports of the prevalence of maltreatment provide opportunities to analyze trends, but in 2009, these reports stopped reporting the ages of victims for each type of maltreatment (i.e., neglect, physical abuse, emotional abuse, and sexual abuse). This omission limits the ability to match (or design) prevention programs responsive to the ages of those at greatest risk. Using data from the National Child Abuse and Neglect Data System (NCANDS) from 2011–2020, this secondary data analysis describes trends for four types of maltreatment by age from an epidemiological perspective. Implications for practice (i.e., prevention) and policy are presented. The findings of this study offer the first step in what is hoped to be a line of research that seeks to identify, match, and/or develop evidence-based programs to prevent child maltreatment among the populations at highest risk.