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
Advanced Topics in Intervention Optimization: Matching the Right Research Design to your Research Question.
AbstractGuastaferro, K., Szeszulski, J., & Pfammatter, A. (n.d.).Publication year
2023Abstract~American single father homes: A growing public health priority
AbstractShipe, S. L., Ayer, L., & Guastaferro, K. (n.d.).Publication year
2022Journal title
American Journal of Public HealthVolume
112Issue
1Page(s)
21-23Abstract~An (extremely) brief overview of MOST.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~An early palliative care telehealth coaching intervention to enhance advanced cancer family caregivers’ decision support skills: The CASCADE pilot factorial trial
AbstractDionne-Odom, J. N., Wells, R. D., Guastaferro, K., Azuero, A., Hendricks, B. A., Currie, E. R., Bechthold, A., Dosse, C., Taylor, R., Reed, R. D., Harrell, E. R., Gazaway, S., Engler, S., McKie, P., Williams, G. R., Sudore, R., Rini, C., Rosenberg, A. R., & Bakitas, M. A. (n.d.).Publication year
2022Journal title
Journal of Pain and Symptom ManagementVolume
63Issue
1Page(s)
11-22AbstractContext: Patients with advanced cancer often involve family caregivers in health-related decision-making from diagnosis to end-of-life; however, few interventions have been developed to enhance caregiver decision support skills. Objectives: Assess the feasibility, acceptability, and potential efficacy of individual intervention components of CASCADE (CAre Supporters Coached to be Adept DEcision Partners), an early telehealth, palliative care coach-led decision support training intervention for caregivers. Methods: Pilot factorial trial using the multiphase optimization strategy (October 2019-October 2020). Family caregivers and their care recipients with newly-diagnosed advanced cancer (n = 46 dyads) were randomized to1 of 8 experimental conditions that included a combination of one of the following three CASCADE components: 1) effective decision support psychoeducation; 2) decision support communication training; and 3) Ottawa Decision Guide training. Feasibility was assessed by completion of sessions and questionnaires (predefined as ≥80%). Acceptability was determined through postintervention interviews and participants’ ratings of their likelihood to recommend. Measures of effective decision support and caregiver and patient distress were collected at Twelve and Twenty four weeks. Results: Caregiver participants completed 78% of intervention sessions and 81% of questionnaires; patients completed 80% of questionnaires. Across conditions, average caregiver ratings for recommending the program to others was 9.9 on a scale from 1-Not at all likely to 10-Extremely likely. Individual CASCADE components were observed to have potential benefit for effective decision support and caregiver distress. Conclusion: We successfully piloted a factorial trial design to examine components of a novel intervention to enhance the decision support skills of advanced cancer family caregivers. A fully-powered factorial trial is warranted. Key Message: We pilot tested components of CASCADE, an early palliative care decision support training intervention for family caregivers of patients with advanced cancer. CASCADE components were acceptable and the trial design feasible, providing promising future directions for palliative care intervention development and testing. Pilot results will inform a fully-powered trial.An exploratory study of grandparents raising grandchildren and the criminal justice system: A research note
AbstractGuastaferro, K., Guastaferro, W. P., Guastaferro, K. M., & Stuart, D. (n.d.).Publication year
2015Journal title
Journal of Crime and JusticeVolume
38Issue
1Page(s)
137-161AbstractThere are nearly one million grandparents living with their grandchildren without either parent present in the household according to the 2010 US Census. Furthermore, approximately 10% of these grandparents are the primary caregivers of their grandchildren due to a parent's incarceration. Yet, our understanding of grandparents raising grandchildren in relation to the criminal justice system is limited. The present research is an exploratory qualitative study of five grandparents raising grandchildren in these circumstances. Each grandparent was interviewed individually and all participated in a focus group. We first sought to shed light on the context in which the grandparent gained caregiving responsibilities. The findings indicate that the arrest of the parent was not the initiating event. We then examined the networks and services accessed when attempting to meet the multiple health, behavioral health, and financial needs of their grandchildren. Findings indicate that both formal and informal networks were utilized. There were several missed opportunities for intervention and coordinated service delivery by the social services and criminal justice systems. Research and policy implications are also discussed.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~An Introduction to Intervention Optimization: Launching a New Generation of Behavioral Interventions.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~An introduction to MOST: How to build more effective, efficient, economical, and scalable interventions.
AbstractGuastaferro, K. (n.d.).Publication year
2020Abstract~An Introduction to the MOST Mindset.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~Applying an implementation framework to the dissemination of a school-based child sexual abuse prevention program
AbstractGuastaferro, K., Shipe, S. L., Connell, C. M., Zadzora, K. M., & Noll, J. G. (n.d.).Publication year
2023Journal title
Health Promotion PracticeAbstractSince the 1980s, school-based child sexual abuse (CSA) prevention programs have been the prevailing prevention strategy in the United States. Despite demonstrated effectiveness, there is a lack of infrastructure and educational policy ensuring all students receive these programs. A pragmatic application of the RE-AIM implementation framework, this study provides an overview of a multi-county implementation effort of the school-based CSA prevention program, Safe Touches. Implementation efforts across five counties in a Mid-Atlantic state are described at three levels: organizational (school districts), child, and program facilitator. Children’s CSA-related knowledge was measured at four time points: pre-workshop, immediately post-workshop, and then 6 and 12 months post-workshop. Facilitators completed an anonymous survey post-implementation. Over the course of one and a half academic years, Safe Touches was implemented in 718 public school districts, reaching in total 14,235 second-grade students. Students’ significantly increased knowledge from pre- to post-workshop and gains were maintained at 6 and 12 months (psApplying intervention optimization to implementation science
AbstractGuastaferro, K., Moucheraud, C., Purtle, J., Collins, L., & Shelley, D. (n.d.).Journal title
Implementation ScienceAbstract~Applying the multiphase optimization strategy for the development of optimized interventions in palliative care
AbstractWells, R. D., Guastaferro, K., Azuero, A., Rini, C., Hendricks, B. A., Dosse, C., Taylor, R., Williams, G. R., Engler, S., Smith, C., Sudore, R., Rosenberg, A. R., Bakitas, M. A., & Dionne-Odom, J. N. (n.d.).Publication year
2021Journal title
Journal of Pain and Symptom ManagementVolume
62Issue
1Page(s)
174-182AbstractRecent systematic reviews and meta-analyses have reported positive benefit of multicomponent “bundled” palliative care interventions for patients and family caregivers while highlighting limitations in determining key elements and mechanisms of improvement. Traditional research approaches, such as the randomized controlled trial (RCT), typically treat interventions as “bundled” treatment packages, making it difficult to assess definitively which aspects of an intervention can be reduced or replaced or whether there are synergistic or antagonistic interactions between intervention components. Progressing toward palliative care interventions that are effective, efficient, and scalable will require new strategies and novel approaches. One such approach is the Multiphase Optimization Strategy (MOST), a framework informed by engineering principles, that uses a systematic process to empirically identify an intervention comprised of components that positively contribute to desired outcomes under real-life constraints. This article provides a brief overview and application of MOST and factorial trial design in palliative care research, including our insights from conducting a pilot factorial trial of an early palliative care intervention to enhance the decision support skills of advanced cancer family caregivers (Project CASCADE).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.Black first-year college students’ alcohol outcome expectancies
AbstractThorpe, S., Tanner, A. E., Ware, S., Guastaferro, K., Milroy, J. J., & Wyrick, D. L. (n.d.).Publication year
2020Journal title
American Journal of Health EducationVolume
51Issue
2Page(s)
78-86AbstractBackground: Alcohol outcome expectancies (AOEs) are associated with college students’ varied alcohol consumption. Existing research on AOEs focuses primarily on heterosexual White students. Thus, it is important to explore how the intersection of multiple identities such as race, gender, and sexual orientation influence the endorsement of specific AOEs. Purpose: This paper examines AOEs among Black first-year college students, with specific attention to the influence of gender and sexual orientation. Methods: Participants were 307 Black students from four universities in the United States. We conducted bivariate analyses using the 2-factor and 4-factor B-CEOA scale. Results: Most students did not hold positive AOEs such as tension reduction and sexual enhancement. Students were more likely to endorse negative AOEs such as behavioral and cognitive impairment and social risk. Discussion: Black first-year college students reported more negative expectations associated with alcohol use, including those related to negative social risks and consequences. Thus, AOEs may serve as a protective factor against alcohol use among Black college students. Translation to Health Education Practice: Alcohol interventions should be tailored to focus on the intersection of race, gender, and sexual orientation. Culturally relevant alcohol interventions have the potential to reduce the immediate and long-term consequences of alcohol use.Braiding Two Evidence-Based Parenting Programs: Research Design and Implementation
AbstractGuastaferro, K., Graham, M. L., Lutzker, J. R., & Whitaker, D. J. (n.d.).Publication year
2013Abstract~Braiding two evidence-based programs for families at-risk: Results of a cluster randomized trial
AbstractGuastaferro, K., Lai, B. S., Miller, K., Shanley Chatham, J., Whitaker, D. J., Self-Brown, S., Kemner, A., & Lutzker, J. R. (n.d.).Publication year
2018Journal title
Journal of Child and Family StudiesVolume
27Issue
2Page(s)
535-546AbstractChild maltreatment is a significant public health problem best addressed through evidence-based parent-support programs. There is a wide range of programs with different strengths offering a variety of options for families. Choosing one single evidence-based program often limits the range of services available to meet the unique needs of families. This paper presents findings from a study to examine the systematic braiding of two evidence-based programs, Parents as Teachers and SafeCare at Home (PATSCH), with the goal to provide a more robust intervention for higher risk families. A cluster randomized effectiveness trial was conducted to examine if PATSCH improved parenting behaviors known to decrease the risk for child maltreatment compared to Parents as Teachers (PAT) Alone. Parents (N = 159; 92 PAT Alone; 67 PATSCH) were enrolled to complete a baseline, 6-month and 12-month assessment. Results indicate the groups did not differ on number of environmental hazards in the home, parents’ health care decision-making abilities, child abuse potential, and physical assault over time. However, with regard to the potential for child abuse, the PATSCH group showed a decrease in nonviolence discipline and increase in psychological aggression compared to the PAT group. Further research is needed to better examine this concept and its implications for the field.Braiding two evidenced-based models: Parents as Teachers and SafeCare®
AbstractLutzker, J. R., Miller, K., Guastaferro, K., & Walsh, J. (n.d.).Publication year
2014Abstract~Building expert-consulted guidance for the selection of research designs for optimizing behavioral interventions.
AbstractMarques, M. M., Pfammatter, A., & Guastaferro, K. (n.d.).Publication year
2022Abstract~Child maltreatment
AbstractGuastaferro, K., & Lutzker, J. R. (n.d.). (J. C. V. & & D. J. Cox, Eds.).Abstract~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.Coalition for Research on Engagement & Well-being: 3 Pilot Studies.
AbstractLutzker, J. R., Guastaferro, K., Noble, A., Damashek, A., Fettes, D., Haine-Schlagel, R., Kothari, C., Rau, A., Traube, D., Whitaker, D. J., Self-Brown, S. R., & Baggett, K. (n.d.).Publication year
2016Abstract~Collaborative Home Visiting: Working Together to Create a Braided Curriculum.
AbstractMiller, K., Guastaferro, K., & Lutzker, J. R. (n.d.).Publication year
2015Abstract~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~Creating sustainable partnerships to meet the needs of high-risk families.
AbstractGuastaferro, K., Graham, M. L., & Lutzker, J. R. (n.d.).Publication year
2013Abstract~