Kate Guastaferro
Kate Guastaferro
Scroll
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
-
Professional overview
-
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.
-
Education
-
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
-
Honors and awards
-
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)
-
Publications
Publications
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~Grandparents raising grandchildren: Exploring perceptions of social support
AbstractGuastaferro, K., Mozid, N. E., Kramsky, J., Young, K. S., & Melkonian, M. I. (n.d.).Journal title
Frontiers in Public HealthAbstractGrandparents raising grandchildren (colloquially referred to as ‘grandfamilies’) are a rapidly growing population in the United States. Census data indicate that 2.3 million grandparents are solely responsible for their grandchildren (Generations United, 2021; U.S. Census Bureau, 2022a, 2022b). Reasons for acquisition are plentiful including parental substance use, termination of parental rights, parental death, parental incarceration. Grandparents raising grandchildren are subject to the same stressors of other adults their age and of a similar socioeconomic status: varying degrees of financial insecurity, health problems, employment issues, and family conflict (Baker & Mutchler, 2010; Sands & Goldberg-Glen, 2000). However, prior research suggests that, compared to their peers, grandparents raising grandchildren are more likely to experience poor physical (e.g., fatigue, diabetes, hypertension; Hughes et al., 2007) mental or psychological (e.g., depression, distress; Baker & Silverstein, 2008; Blustein et al., 2004) and social (e.g., isolation, marital stress; Wang & Mutchler, 2020) outcomes (Hank et al., 2018). Although there is been work to develop community-based interventions to support grandfamlilies, a recent meta-analysis indicated programs produce small to moderate effect sizes on only a portion of the grandfamilies’ needs. Moreover, there is neither a network of services nor infrastructure to universally support services that sufficiently addresses grandparents’ need for support, resources, and training. A mixed method study with 70 survey participants – 16 of whom were then randomly selected to complete an interview and focus group – sought to understand the (a) reasons for acquisition, (b) needs, (c) areas of concern, and (d) what would be most helpful to grandparents in this caregiving role. The data presented in the current manuscript will focus on the grandparents’ perceived levels of social support and isolation comparing quantitative to qualitative responses. On the survey, grandparents reported moderate levels of perceived social support from significant others, family members, and friends. However, in interviews and focus groups grandparents speak at length about being isolated and feeling alone. Discordance between the quantitative and qualitative responses will be discussed in the context of the literature and other family characteristics. Exploring these different reports have important implications for intervention development.Grandparents raising grandchildren: Impact of grandparents’ chronic stress on grandparent-parent relationship and life satisfaction
AbstractMozid, N. E., & Guastaferro, K. (n.d.).Journal title
Innovation in AgingAbstractBackground and Objectives Grandparents raising grandchildren are a rapidly growing population in the United States. Raising a grandchild impacts grandparents’ immediate and extended family relationships and amplifies stressors in the relationship with the parent of the grandchild. The quality of relationships with the parents negatively impacts grandparents’ psychosocial well-being but may also have lasting adverse effects on the grandchild. Research Design and Methods Using the most recent wave (2020) of the nationally representative Health and Retirement Study, we conducted linear regression analyses to understand the association between chronic stress (e.g., health, finances, housing) and anxiety symptoms by gender and race among grandparents raising grandchildren (N=4,238). Then, we examined the grandparents’ relationship with the parent and satisfaction with life as potential mediators in these associations. Results Grandparents’ ongoing chronic stressors were significantly associated with anxiety symptoms (β=0.349; p< 0.01); however, there were no significant differences in total chronic stress by gender or race. Path analysis showed both the grandparent-parent relationship and grandparents’ satisfaction with life partially mediated the association between grandparents’ chronic stress and anxiety symptoms (p< 0.001). Discussion and Implications Cultivating a consistent and quality relationship between grandparent and parent as well as focusing on grandparents’ perspectives of life suggests innovative intervention targets to improve the health and well-being of both grandparents and grandchildren.Grandparents raising grandchildren: Understanding the experience and needs of an emerging public health priority population
AbstractGuastaferro, K., Mozid, N. E., Kramsky, J., Young, K. S., Melkonian, M. I., Solomon, E., & Chambers, G. (n.d.).Journal title
The GerontologistAbstract~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.Help Wanted! Developing checklists to support the implementation of the Multiphase Optimization Strategy (MOST).
AbstractVargas, S., Landoll, R. R., Samardzic, K., Clark, M. F., & Guastaferro, K. (n.d.).Publication year
2021Abstract~HIV Prevention in Foster Care Youth: Time for a Refocus
AbstractAdrian, C., Shipe, S. L., & Guastaferro, K. (n.d.).Publication year
2024Journal title
American Journal of Public HealthPage(s)
e1-e5Abstract~HIV Prevention in Foster Care Youths : Time for a Refocus
AbstractAdrian, C. W., Shipe, S. L., & Guastaferro, K. (n.d.).Publication year
2024Journal title
American journal of public healthVolume
114Issue
11Page(s)
1179-1183Abstract~Household family type and children’s risk of child protective services re-reports
AbstractShipe, S. L., Guastaferro, K., Ayer, L., Lee, J. Y., & Connell, C. M. (n.d.).Publication year
2024Journal title
Child Abuse & NeglectVolume
154AbstractBackground: Single parent families are at higher risk of re-report to Child Protective Services (CPS) than two-parent families. Yet, how single-family homes differ in risk from two-parent families remains under researched. Objective: To identify heterogenous patterns of child and caregiver factors among CPS-involved families and the subsequent risk for CPS re-report based on child and family characteristics (i.e., sociodemographic information, household family type, and risk indicators).Participants and Setting: Data were from the 2017 National Child Abuse and Neglect DataSystem Child File (N = 249,026). Methods: We conducted latent class analysis (LCA) to identify discrete patterns (i.e., classes) based on child and caregiver risk indicators (e.g., substance use, behavioral health). We then used logistic regression to examine household family type and other family characteristics and CPS indicators predicted CPS re-report for each class.Results: Results yielded five distinct classes: 1) Financial Stressors (25% of the sample); 2) Caregiver Substance Use (16%); 3) Complex Household Stressors (3%); 4) Child Disabilities (4%); and 5) Minimal Household Stressors (53%). Family type was significantly associated with CPS re-reports for Classes 1, 2, and 5. For Class 1, single father families had increased odds of CPS re-report compared to other family types. For Classes 2 and 5, single father families’ odds of CPS re-reports were greater than those of married families, but lower than single mother families. Conclusions: Children growing up in single father families have different likelihoods of repeat CPS involvement compared to those in single mother and married families. Financial stressors and parental substance use within single father families should be addressed.Household Family Type in Child Protective Services: Single Dads Need Attention, Too
AbstractShipe, S. L., Adrian, C., Guastaferro, K., & Connell, C. M. (n.d.).AbstractAbstract: Background and Purpose: The focus on families in the child welfare system (CWS) have centered primarily on married caregivers, single mothers, or non-residential fathers (Campbell et al., 2015; Shipe, 2018) leaving out the fastest growing population of caregivers – single fathers, or men who are divorced, separated, widowed, never married, or not living with a partner, and are the primary caregiver for at least one child. In the last 20 years the growth of single fathers involved in a child protective services (CPS) investigation has almost doubled from 2.6% in 2004 to almost 5% in 2022 (DHHS, 2023), yet information about whether the needs of these families differ from other family types in virtually nonexistent. The current study begins to fill this gap by determining how single father homes differ from other household family types as it relates to both entry into and continued involvement with CPS. The research questions specifically ask: (1) what demographic and risk factors predict re-report to CPS? and (2) does household family type, specifically single father homes, moderate the relationship of re-report? Methods: Data were from National Child Abuse and Neglect Data System (NCANDS) 2017-2019 Child Files. The analytic sample comprised of the four household family types – single fathers, single mothers, married couples, and unmarried couples. Other variables of interest included child demographic characteristics, allegation type, and risk indicators for children (i.e., prior CPS report, substance use, behavioral issues, disabilities, and other medical concerns) (N = 249,026). The dependent variable was re-report of abuse/neglect within 18 months of investigation. Logistic regression was used to first investigate which demographic and child risk factors predicted re-report to CPS. A subsequent logistic regression was conducted to determine whether family type [single fathers] moderated the effects of re-reporting of child abuse/neglect to CPS. Results: The results found there was a significant relationship between all child risks and re-report; however, when single father homes were added, the results indicated a significant interaction with some risks and re-report to CPS. These included children with behavioral concerns (OR = 0.898, p = .03, CI[0.954 – 1.364]), child with disabilities (OR = 0.802, p = .001, CI[0.697 – 0.922]), children with other medical concerns (OR = 1.264, p = .001, CI[1.106 – 1.404]), prior reports (OR = 0.873, p = .001, CI[0.822 – 0.928]), Latinx children (OR = 1.128, p = .001, CI[1.111 – 1.336]), physical abuse (OR = 1.201, p = .001, CI[1.104 – 1.306]), and sexual abuse (OR = 1.201, p = .001, CI[1.054 – 1.368]). Conclusion and Implications: Although single fathers are the smallest population of caregivers involved in CPS investigations, they are not without unique risks for continued involvement in the child welfare system. To date, the majority of interventions focus on single mothers and coupled household, yet these findings suggest that household family type does warrant attention. Researchers and practitioners should consider augmenting or developing approaches that target the needs of specific family types, particularly single fathers.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~How MOST can be used to advance implementation science objectives.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~Human-centered design methods to achieve preparation phase goals in the multiphase optimization strategy framework
AbstractO’Hara, K. L., Knowles, L. M., Guastaferro, K., & Lyon, A. R. (n.d.).Publication year
2022Journal title
Implementation Research & PracticeVolume
3AbstractBackground: The public health impact of behavioral and biobehavioral interventions to prevent and treat mental health and substance use problems hinges on developing methods to strategically maximize their effectiveness, affordability, scalability, and efficiency. Methods: The multiphase optimization strategy (MOST) is an innovative, principled framework that guides the development of multicomponent interventions. Each phase of MOST (Preparation, Optimization, Evaluation) has explicit goals and a range of appropriate research methods to achieve them. Methods for attaining Optimization and Evaluation phase goals are well-developed. However, methods used in the Preparation phase are often highly researcher-specific, and concrete ways to achieve Preparation phase goals are a priority area for further development. Results: We propose that the discover, design, build, and test (DDBT) framework provides a theory-driven and methods-rich roadmap for achieving the goals of the Preparation phase of MOST, including specifying the conceptual model, identifying and testing candidate intervention components, and defining the optimization objective. The DDBT framework capitalizes on strategies from the field of human-centered design and implementation science to drive its data collection methods. Conclusions: MOST and DDBT share many conceptual features, including an explicit focus on implementation determinants, being iterative and flexible, and designing interventions for the greatest public health impact. The proposed synthesized DDBT/MOST approach integrates DDBT into the Preparation phase of MOST thereby providing a framework for rigorous and efficient intervention development research to bolster the success of intervention optimization.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 considerations of recruiting and retaining first-year college students in online preventive intervention research.
AbstractGuastaferro, K., Miller, A. M., Tanner, A. E., Rulison, K. L., Milroy, J. J., Wyrick, D. L., & Collins, L. (n.d.).Publication year
2021Abstract~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 (psImplementation strategies to increase Malawian health care workers’ knowledge about and self-efficacy to recommend HPV vaccination: A pilot study
AbstractMoucheraud, C., Kalande, P., Makwaya, A., Kamtsendero, L., Chimbaka, H., Gurpinar, N. G., Hagstrom, C., van Oosterhaut, J. J., Guastaferro, K., Szilagyi, P. G., Phiri, K., & Hoffman, R. M. (n.d.).Journal title
Implementation Science CommunicationsAbstract~Implementing a braided home-based parent support curriculum: Lessons learned
AbstractGuastaferro, K., Miller, K., Lutzker, J. R., Whitaker, D. J., Shanley Chatham, J., Lai, B. S., & Kemner, A. (n.d.).Publication year
2017Journal title
Psychosocial InterventionVolume
26Issue
3Page(s)
181-187AbstractA singular parent-support program is limited in its ability to address multiple child and family needs. One innovative solution is braiding, a process in which two evidence-based programs are systematically combined as a newly tailored, cohesive curriculum. In this paper we describe the systematic braiding of two parent-support curricula, Parents as Teachers® and SafeCare®. We highlight implementation challenges to inform future planning and braiding efforts. Based on qualitative data (n = 13), we discuss five lessons learned, including identifying a pedagogical approach and sustainability at the model- and site-level. Implications and future directions for braiding and implementation are also discussed.Implementing a county-wide child sexual abuse prevention effort: Lessons learned from a state-government initiated prevention trial
AbstractGuastaferro, K., Murphy-Costanzo, A. S., Melchior, M. S., Cosgrove-Rooks, C., Kenyon, K., & Noll, J. G. (n.d.).Journal title
Implementation Science CommunicationsAbstract~Implementing a Sexual and Reproductive Health Workshop for Latina Teens and their Female Caregivers: Findings from Theater Testing and Piloting.
AbstractMerrill, K. G., Silva, J., Atadero, J., Hung, I. L., Salgado, S., Cano, J., Nabor, V., Sedeno, A., Vargas, V., Romero, G., Perez, C., Fuentes, J., Florence, K., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2024Abstract~Improving family functioning of adult drug court clients.
AbstractWhitaker, D. J., Guastaferro, W. P., Klotz, A., Roby, S. J., Guastaferro, K., & Holleran, D. (n.d.).Publication year
2014Abstract~Improving outcomes for adult drug court clients and their children.
AbstractGuastaferro, W. P., Guastaferro, K., Roby, S. J., Holleran, D., & Whitaker, D. J. (n.d.).Publication year
2014Abstract~Increasing pre-exposure prophylaxis (PrEP) in primary care : A study protocol for a multi-level intervention using the multiphase optimization strategy (MOST) framework
AbstractLockhart, E., Turner, D. A., Guastaferro, K., Szalacha, L. A., Alzate, H. T., Marhefka, S., Pittiglio, B., Dekker, M., Yeh, H. H., Zelenak, L., Toney, J., Manogue, S., & Ahmedani, B. K. (n.d.).Publication year
2024Journal title
Contemporary Clinical TrialsVolume
143AbstractBackground: In the United States, over 1.2 million people are living with HIV. This disease disproportionately affects men who have sex with men (MSM), people of color, youth and young adults, and transgender individuals. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method. Barriers exist for both primary care providers (PCPs) to prescribe PrEP and prevent patients from initiating PrEP. Methods: This study, MOST: PrEP, follows the multiphase optimization strategy (MOST) framework. The purpose is to identify a multi-level intervention among patients and PCPs to increase PrEP prescriptions in primary care. First, feedback will be obtained from providers and patients via focus groups, then, suggestions related to the context-specific (provider and individual level) factors of intervention component delivery will be incorporated. Subsequently, a rigorous experiment will be conducted using a 24 factorial design focusing on priority populations for PrEP initiation. Provider components include computer-based simulation training and a best practice alert. Patient components include a tailored PrEP educational video and HIV risk assessment. Finally, the facilitators and barriers to implementing the intervention components will be qualitatively examined. Conclusion: In this protocol paper, we describe the one of the first known multilevel MOST optimization trial in healthcare. Intervention components are to be delivered to patients and providers in a large healthcare system, based in an HIV Ending the Epidemic priority jurisdiction. If effective, this multi-level approach could be disseminated to providers and patients in other large healthcare systems to make a significant impact on HIV prevention.Increasing pre-exposure prophylaxis (PrEP) in primary care: A study protocol for a multi-level intervention using the Multiphase Optimization Strategy (MOST) framework
AbstractLockhart, E., Turner, D., Guastaferro, K., Szalacha, L. A., Alzate, H. T., Marhefka, S., Pittiglio, B., Dekker, M., Yeh, H.-H., Toney, J., Manogue, S., & Ahmedani, B. K. (n.d.).Publication year
2024Journal title
Contemporary Clinical TrialsVolume
143AbstractBackground In the United States, over 1.2 million people are living with HIV. This disease disproportionately affects men who have sex with men (MSM), people of color, youth and young adults, and transgender individuals. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention medication. Barriers exist for both primary care providers (PCPs) to prescribe PrEP and prevent patients from initiating PrEP. Methods The research design for this study, MOST: PrEP, follows the multiphase optimization strategy (MOST) framework. The purpose is to identify a multi-level intervention among patients and PCPs to increase PrEP prescriptions in primary care. First, feedback will be obtained from providers and patients via focus groups, then suggestions related to the context-specific (provider and individual level) factors of intervention component delivery will be incorporated. Subsequently, a rigorous experiment will be conducted using a 24 factorial design focusing on priority populations for PrEP initiation. Provider components include a computer-based simulation training and a best practice alert. Patient components include a tailored PrEP educational video and HIV risk assessment. Finally, the facilitators and barriers to implementing the intervention components will be examined. Conclusion In this protocol paper, we describe the first known multilevel MOST optimization trial in healthcare. Intervention components are to be delivered to patients and providers in a large healthcare system, based in an Ending the Epidemic priority jurisdiction. If effective, this multi-level approach could be disseminated to providers and patients in other large healthcare systems to make a significant impact on HIV prevention.Innovations in parent-training interventions for parents of children with intellectual and developmental disabilities.
AbstractGuastaferro, K. (n.d.).Publication year
2017Abstract~