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
Recruiting and retaining first-year college students in online health research: Implementation considerations
AbstractGuastaferro, K., Guastaferro, K., Tanner, A. E., Rulison, K. L., Miller, A. M., Milroy, J. J., Wyrick, D. L., & Collins, L. M. (n.d.).Publication year
2024Journal title
Journal of American College HealthVolume
72Issue
2Page(s)
623-630AbstractObjective: Decreasing participation in intervention research among college students has implications for the external validity of behavioral intervention research. We describe recruitment and retention strategies used to promote participation in intervention research across a series of four randomized experiments. Method: We report the recruitment and retention rates by school for each experiment and qualitative feedback from students about recommendations for improving research participation. Results: There was considerable variation among schools’ recruitment (4.9% to 64.7%) and retention (12% to 67.8%) rates. Student feedback suggested study timing (e.g., early in the semester), communication strategies (e.g., social media), and incentive structure (e.g., guaranteed incentives) could improve research participation. The highest survey participation rate was observed at the university which mandated students to complete the intervention (but not the survey). Conclusions: Intervention scientists must consider the population and study context to make informed decisions related to recruitment and retention strategies.Refining the Floreciendo Sexual and Reproductive Health Workshop Curriculum for Latina Teens and Female Caregivers Using Theater Testing
AbstractFlorence, K., Silva, J., Atadero, J., Hung, I. L., Salgado, S., Cano, J., Nabor, V., Sedeno, A., Vargas, V., Romero, G., Perez, C., Fuentes, J., Merrill, J., DeCelles, J., Guastaferro, K., Donenberg, G., & Merrill, K. G. (n.d.).Publication year
2024AbstractIntroduction: Latina teens are affected by sexually transmitted infections and unintended pregnancy at a disproportionate rate. Florecidendo is a sexual and reproductive health program aimed at educating Latina teens (14-18 years old) and their female caregivers. The term “female caregiver” encompasses mothers, aunts, sisters, and grandmothers. This program was adapted forLatina women from the evidence-based IMARA program.Objective: Our aim was to theater test the Floreciendo workshop (comprising four two-hour sessions) to refine the curriculum prior to hosting a pilot optimization trial.Methods: The theater testing was conducted for two days at a community organization that has partnered with the program. There were three Latina teens and their three female caregivers that participated. The four sessions of the workshop were delivered, with oral and written feedback obtained following each session from participants (n=6), observers (n=8), and workshopfacilitators (n=2). The session data was systematically analyzed by session (Foundations in Sexual Risk Prevention, Condoms and Contraception, Gender and Partner Relationship Dynamics, and Family Strengthening), and feedback from observers and participants was consolidated to inform curriculum edits.Results: Ratings of the activities in each of the four sessions revealed high acceptability. On a 4.0 scale (where 0=low and 4=high), ratings averaged 3.79 (SD=0.30) for teens, 3.94 (SD=0.18) for caregivers, and 3.81 (SD=0.21) for acceptability. Feedback on the curriculum included suggestions to incorporate more information on mental health. In addition, the caregivers would like to expand on the topic of domestic violence, specifically psychological violence. The curriculum should also ensure sufficient time for participants to voice their opinions during discussions. A caregiver reported that the workshop overall was “motivating” and made her “feel more secure” when discussing sexual health with her daughter.Conclusions: The constructive feedback received on the curriculum provided valuable information about its acceptability. Suggestions were incorporated into the curriculum that is currently being tested in a pilot optimization trial using the multiphase optimization strategy (MOST) framework.StandUPTV: Preparation and optimization phases of a mHealth intervention to reduce sedentary screen time in adults
AbstractKeadle, S., Hasanaj, K., Leonard-Corzo, K., Tolas, A., Crosley-Lyons, R., Pfisterer, B., Legato, M., Fernandez, A., Lowell, E., Hollingshead, K., Yu, T. Y., Phelan, S., Phillips, S. M., Watson, N., Hagobian, T., Guastaferro, K., & Buman, M. P. (n.d.).Publication year
2024Journal title
Contemporary Clinical TrialsVolume
136AbstractRecreational sedentary screen time (rSST) is the most prevalent sedentary behavior for adults outside of work, school, and sleep, and is strongly linked to poor health. StandUPTV is a mHealth trial that uses the Multiphase Optimization Strategy (MOST) framework to develop and evaluate the efficacy of three theory-based strategies for reducing rSST among adults. This paper describes the preparation and optimization phases of StandUPTV within the MOST framework. We identified three candidate components based on previous literature: (a) rSST electronic lockout (LOCKOUT), which restricts rSST through electronic means; (b) adaptive prompts (TEXT), which provides adaptive prompts based on rSST behaviors; and (c) earning rSST through increased moderate-vigorous physical activity (MVPA) participation (EARN). We also describe the mHealth iterative design process and the selection of an optimization objective. Finally, we describe the protocol of the optimization randomized controlled trial using a 23 factorial experimental design. We will enroll 240 individuals aged 23–64 y who engage in >3 h/day of rSST. All participants will receive a target to reduce rSST by 50% and be randomized to one of 8 combinations representing all components and component levels: LOCKOUT (yes vs. no), TEXT (yes vs. no), and EARN (yes vs. no). Results will support the selection of the components for the intervention package that meet the optimization objective and are acceptable to participants. The optimized intervention will be tested in a future evaluation randomized trial to examine reductions in rSST on health outcomes among adults.Strategic selection of experimental designs in community-based intervention development within the multiphase optimization strategy framework
AbstractO’Hara, K. L., Guastaferro, K., Hita, L., Rhodes, A., Thomas, N., Wolchik, S., & Berkel, C. (n.d.).Publication year
2024Journal title
Implementation Research & PracticeVolume
5AbstractPreventing and treating mental health and substance use problems requires interventions that are effective, affordable, scalable, and efficient. The 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 paper, 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 that illustrates 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.Systematic braiding: An approach to meeting the needs of families enrolled in a home visiting program
AbstractGuastaferro, K. (n.d.).Publication year
2024Abstract~Systematic Braiding: An Approach to Meeting the Needs of Families Enrolled in a Home Visiting Program
AbstractGuastaferro, K. (n.d.).Publication year
2024AbstractPaper symposium: "Systematic Braiding- an Innovative and Collaborative Methodology to Develop Integrated Evidence-Based Prevention Programs"The Essential Activities of the Preparation Phase: Examples of Projects using MOST.
AbstractGuastaferro, K. (n.d.).Publication year
2024Abstract~Using Failure Modes and Effects Analysis (FMEA) to Evaluate the Implementation of an Optimized Family Navigation Intervention
AbstractMenon, N., Bernard, E. C., Much-Hichos, M., Molina, J., Rubin, D., Guastaferro, K., & Feinberg, E. (n.d.).Publication year
2024AbstractIntroduction: Family Navigation (FN), an evidence-based care management strategy, has proven effective in reducing disparities in accessing care. However, few studies have examined the implementation of FN with respect to efficiency, cost, and impact on inequities in healthcare access. We conducted a randomized 24 factorial trial using a multiphase optimization strategy (MOST) to optimize the delivery of FN. Trained Family Partners (FP) delivered FN in a Federally Qualified Health Center with the goal of increasing access to child behavioral health services for children ages 6-12. Children (N=355) were randomized into 1 of 16 possible combinations of FN delivery strategies and worked with their FP for 6 months. Methods: We created a process map depicting study workflow from initial referral to study end. Using the diagram, the study team and health center staff conducted a Failure Modes and Effects Analysis (FMEA), a systematic and structured method of identifying possible failures of a design. Team members scored each failure on a scale of 1-10 in terms of severity, occurrence, and detection. The scores were multiplied together to create a Risk Priority Number (RPN). We identified failures with the highest RPNs and examined scores stratified by study role. Results: After analyzing RPNs, the team identified 3 main areas of failure: the impact of COVID, the intervention timeline, and stigma. COVID prevented FPs from conducting home visits. This change impacted the implementation of the clinic vs. community-based delivery strategy, one of the conditions to which families were randomized. This failure had the highest average RPN (277.8). COVID-related priorities (average RPN 271.4) often superseded the completion of recordings of family interactions, hindering our ability to analyze fidelity to the intervention. The 6-month implementation period was unrealistic (average RPN 256.8). Many families could not complete goals within 6 months due to school schedules and COVID’s effect on services. Stigma impacted family engagement. The failure "Participants may have different answers when aware they are being recorded” had an average RPN of 269.5. "Participants fear or are ashamed of asking for help” had an average RPN of 266. We found variations in how study staff ranked failures. Investigators, research assistants, and clinicians consistently ranked failures pertaining to RA errors higher than FPs. Stratification by role revealed that FPs placed more emphasis on completing goals within the 6-month timeframe. Conclusion: Our FMEA was a collaborative process that identified implementation failures, which differed based on study role. Team members with patient-facing roles may offer important insight into the feasibility of the proposed intervention.Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.
AbstractMerrill, K. G., Silva, J., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2024Abstract~Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.
AbstractMerrill, K. G., Silva, J., Sedeno, A., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2024Abstract~Utilizing systematic braiding to address public health priorities for young children: Development, feasibility, and implementation of the Smoke-Free Home SafeCare prevention program presented in Systematic Braiding – An innovative and collaborative methodology to develop integrated evidence-based programs
AbstractSelf-Brown, S., Perry, E. W., Recinos, M., Whitaker, D. J., Guastaferro, K., & Kegler, M. (n.d.).Publication year
2024Abstract~“Public relations isn’t all rainbows and butterflies”: Student experiences in developing a child sexual abuse prevention campaign
AbstractMadden, S., & Guastaferro, K. (n.d.).Publication year
2024Journal title
Journal of Public Relations EducationAbstract~A vision for the prevention of child maltreatment: Optimization of multicomponent interventions
AbstractGuastaferro, K. (n.d.).Publication year
2023Page(s)
107-133Abstract~Adapting prevention programs for virtual delivery: A case study in adapting a parent-focused child sexual abuse prevention module
AbstractGuastaferro, K., Melchior, M. S., Murphy-Costanzo, A., Sunshine, S., Neimeyer, A., Stewart, S., & Noll, J. (n.d.).Publication year
2023Journal title
Journal of Public Health ResearchVolume
12Issue
4AbstractBackground: Evolving and emerging contexts require interventions to respond and adapt. The COVID-19 pandemic necessitated a quick adaptation from in-person to virtual delivery. Not only were there few programs able to transition to virtual delivery, there was a lack of parent-focused CSA-prevention programs. The current study describes the responsive adaptation of a parent-focused child sexual abuse (CSA) prevention module (Smart Parents—Safe and Healthy Kids; SPSHK) for virtual delivery. Design and methods: This two-phase study used mixed-methods to inform and pilot test adaptations to the virtual module. In Phase 1, parenting providers with and without experience delivering SPSHK (N = 110) completed anonymous surveys and a subsample (n = 27) subsequently participated in brief interviews elaborate on challenges and needed adaptations for virtual platforms. Results: Providers indicated the greatest technological difficulties with parents’ access to technology noting the inability to use a screensharing function. Thus, providers recommended no adaptations for the virtual delivery of SPSHK. In Phase 2, the virtual SPSHK module was piloted with nine parents. Results demonstrated virtual SPSHK was acceptable and feasibly implemented. Pre-posttest assessments indicated increases in parents’ CSA-related awareness and use of protective behaviors. Conclusion: The current study suggests the promise of virtual SPSHK implementation and may act as a blueprint for other parent-focused CSA-prevention programs, but also more general parenting programs, considering virtual delivery.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~An Introduction to Intervention Optimization: Launching a New Generation of Behavioral Interventions.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~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 (psDecision support training for advanced cancer family caregivers: Study protocol for the CASCADE factorial trial
AbstractGazaway, S., Wells, R. D., Azuero, A., Pisu, M., Guastaferro, K., Rini, C., Taylor, R., Reed, R. D., Harrell, E. R., Bechthold, A. C., Bratches, R. W., McKie, P., Lowers, J., Williams, G. R., Rosenberg, A. R., Bakitas, M. A., Kavalieratos, D., & Dionne-Odom, J. N. (n.d.).Publication year
2023Journal title
Contemporary Clinical TrialsVolume
131AbstractBackground: Patients with advanced cancer face numerous decisions when diagnosed and often receive decision support from family caregivers. The CASCADE (CAre Supporters Coached to be Adept DEcision partners) factorial trial intervention aims to train caregivers in skills to provide effective decision support to patients and identify most effective intervention components. Methods: This is a 2-site, single-blind, 24 factorial trial to test components of the CASCADE decision support training intervention for family caregivers of patients with newly-diagnosed advanced cancer delivered by specially-trained, telehealth, palliative care lay coaches over 24 weeks. Family caregivers (target N = 352) are randomly assigned to one of 16 combinations of four components with two levels each: 1) psychoeducation on effective decision partnering principles (1 vs. 3 sessions); 2) decision support communication training (1 session vs. none); 3) Ottawa Decision Guide training (1 session vs. none) and 4) monthly follow-up (1 call vs. calls for 24 weeks). The primary outcome is patient-reported decisional conflict at 24 weeks. Secondary outcomes include patient distress, healthcare utilization, caregiver distress, and quality of life. Mediators and moderators (e.g., sociodemographics, decision self-efficacy, social support) will be explored between intervention components and outcomes. Results will be used to build two versions of CASCADE: one with only effective components (d ≥ 0.30) and another optimized for scalability and cost. Discussion: This protocol describes the first factorial trial, informed by the multiphase optimization strategy, of a palliative care decision-support intervention for advanced cancer family caregivers and will address the field's need to identify effective components that support serious illness decision-making.Developing an optimized psychological treatment for pain after breast cancer using a randomized factorial design: A clinical pilot trial
AbstractBuskbjerg, C. R., Johannsen, M., Norskov, C. C., Jensen, A. B., Frederiksen, Y., Egerod, I., Guastaferro, K., Johansen, C., von Heymann, A., Speckens, A., O’Toole, M. S., & Zacharaie, R. (n.d.).Publication year
2023Journal title
Scandinavian Journal of PsychologyAbstractContext: Psychological treatment has shown promising results in the treatment of pain after breast cancer but could benefit from treatment optimization. Objective: The present mixed-methods study evaluated the feasibility of applying the Multiphase Optimization Strategy for optimizing psychological treatment for pain after breast cancer using treatment components drawn from third-wave cognitive behavioral therapy. Methods: Using a factorial, experimental design, women with pain after breast cancer were randomized to eight experimental conditions consisting of either zero, one, two, or three treatment components, namely Mindful Attention, Decentering, and Values and Committed Action. Primary outcomes of pain intensity and pain interference, secondary outcomes, and presumed change processes were measured at baseline and post-intervention. Semi-structured interviews were conducted at post-intervention. The study took place at Aarhus University in Denmark, and all sessions and interviews were conducted online. Results: Three participants dropped out, and one withdrew consent and was excluded from the intention-to-treat analysis. Time x group-analysis (N=33) demonstrated preliminary effects ranging from medium-sized negative effects (g=-0.51; 95%CI=-1.22-0.20) to large positive effects (g=1.07; 95%CI=0.32-1.82) on primary outcomes. Qualitative manifest content analysis indicated validity of treatment components and overall participant satisfaction. Conclusions: The study results indicate that the project procedures and treatment components are feasible and valid and illustrate how the Multiphase Optimization Strategy framework can be applied for the development of an optimized intervention for pain after breast cancer. We therefore recommend proceeding with a larger scale trial which can provide sufficient statistical power to evaluate the effects of the individual and combined treatment components.Grandparents raising grandchildren in New York state: Understanding needs of a vulnerable population.
AbstractGuastaferro, K., Mozid, N. E., Kramsky, J., Melkonian, M. I., Young, K. S., & Spears, E. (n.d.).Publication year
2023Abstract~Guidance on selecting a translational framework for intervention development: Optimizing interventions for impact
AbstractGuastaferro, K., & Pfammatter, A. F. (n.d.).Publication year
2023Journal title
Journal of Clinical and Translational ScienceVolume
7Issue
1AbstractIntervention development frameworks offer the behavioral sciences a systematic and rigorous empirical process to guide the translation of basic science into practice in pursuit of desirable public health and clinical outcomes. The multiple frameworks that have emerged share a goal of optimization during intervention development and can increase the likelihood of arriving at an effective and disseminable intervention. Yet, the process of optimizing an intervention differs functionally and conceptually across frameworks, creating confusion and conflicting guidance on when and how to optimize. This paper seeks to facilitate the use of translational intervention development frameworks by providing a blueprint for selecting and using a framework by considering the process of optimization as conceptualized by each. First, we operationalize optimization and contextualize its role in intervention development. Next, we provide brief overviews of three translational intervention development frameworks (ORBIT, MRC, and MOST), identifying areas of overlap and divergence thereby aligning core concepts across the frameworks to improve translation. We offer considerations and concrete use cases for investigators seeking to identify and use a framework in their intervention development research. We push forward an agenda of a norm to use and specify frameworks in behavioral science to support a more rapid translational pipeline.How lay health workers in a federally qualified community health center filled a critical void in a public health crisis
AbstractGuastaferro, K., Sheldrick, R. C., Nunez-Pepen, R., Ortiz, M., Much-Hichos, M., Trieu, D., Broder-Fingert, S., & Feinberg, E. (n.d.).Publication year
2023Journal title
Family and Community HealthVolume
46Issue
4Page(s)
259-262Abstract~Impact of grandparents’ chronic stress on grandparent-parent relationship and life satisfaction by gender and race.
AbstractMozid, N. E., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Implementation of a Universal School-Based Child Sexual Abuse Prevention Program : A Longitudinal Cohort Study
AbstractGuastaferro, K., Shipe, S. L., Connell, C. M., Letourneau, E. J., & Noll, J. G. (n.d.).Publication year
2023Journal title
Journal of Interpersonal ViolenceVolume
38Issue
15-16Page(s)
8785–8802AbstractChild sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps