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
Optimizing educational interventions in crisis contexts through the multiphase optimization strategy (MOST).
AbstractCollins, L., Guastaferro, K., & Strayhorn, J. (n.d.).Publication year
2022Abstract~Parent-focused sexual abuse prevention: Results from a cluster randomized trial
AbstractGuastaferro, K., Felt, J. M., Font, S. A., Connell, C. M., Miyamoto, S., Zadzora, K. M., & Noll, J. G. (n.d.).Publication year
2022Journal title
Child MaltreatmentVolume
27Issue
1Page(s)
114-125AbstractThis study tested whether a child sexual abuse (CSA) prevention program, Smart Parents–Safe and Healthy Kids (SPSHK), could be implemented as an additional module in evidence-based parent training and whether the added module might detract from the efficacy of the original program. In a cluster randomized trial, six community-based organizations were randomized to deliver Parents as Teachers (PAT) with SPSHK (PAT+SPSHK) or PAT as usual (PAT-AU). CSA-related awareness and protective behaviors, as well as general parenting behaviors taught by PAT were assessed at baseline, post-PAT, post-SPSHK, and 1-month follow-up. Multilevel analyses revealed significant group by time interactions for both awareness and behaviors (psSchool-based child sexual abuse prevention: Large-scale implementation of Safe Touches.
AbstractHolloway, J. L., & Guastaferro, K. (n.d.).Publication year
2022Abstract~Taking a school-based child sexual abuse prevention program to scale: A cost analysis
AbstractShipe, S. L., Guastaferro, K., Noll, J. G., Connell, C. M., Morgan, P. L., & Crowley, D. M. (n.d.).Publication year
2022Journal title
Prevention ScienceVolume
23Issue
8Page(s)
1394-1403AbstractCost analyses are used to determine overall costs of implementing evidence-based programming and may help decision makers determine how best to allocate finite resources. Child sexual abuse (CSA), regularly viewed as a human rights violation, is also a public health concern estimated to impact 27% of females and 5% of males by age 18. Universal, school-based CSA programs are one prevailing prevention strategy. However, there are no known cost analyses of school-based CSA prevention programming, thereby limiting potential scalability. Using the ingredients method, this cost analysis presents the findings of implementing Safe Touches, an evidence-based universal prevention program, across four sites (i.e., counties) in one mid-Atlantic state. Reaching a total of 14,235 s grade students, results indicate an average cost of $43 per student, an average classroom cost of $859, an average district cost of $10,637, and an average site cost of $154,243. There was a noted decrease in costs when more students were reached, suggesting a need to focus efforts on bolstering the reach of implementation efforts. Sensitivity analyses explored variations in implementation constraints such as personnel and facilities suggesting a range of per-student costs (lower-bound per-student cost = $34; upper-bound per-student cost = $64). Findings presented herein may be used to inform future universal CSA prevention efforts by providing detailed information about the costs of large-scale implementation of an evidence-based program among elementary-aged children.The development of effective and tailored digital behavior change interventions: An introduction to the multiphase optimization strategy (MOST)
AbstractGuastaferro, K. (n.d.).Publication year
2022Journal title
The European Health PsychologistVolume
22Issue
4Page(s)
793-800Abstract~The multiphase optimization strategy (MOST): Practicalities of an optimization study.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~The preparation phase in the multiphase optimization strategy (MOST): A systematic review and introduction of a reporting checklist
AbstractLandoll, R. R., Vargas, S. E., Samardzic, K. B., Clark, M. F., & Guastaferro, K. (n.d.).Publication year
2022Journal title
Translational Behavioral MedicineVolume
12Issue
2Page(s)
291-303AbstractMulticomponent behavioral interventions developed using the multiphase optimization strategy (MOST) framework offer important advantages over alternative intervention development models by focusing on outcomes within constraints relevant for effective dissemination. MOST consists of three phases: preparation, optimization, and evaluation. The preparation phase is critical to establishing the foundation for the optimization and evaluation phases; thus, detailed reporting is critical to enhancing rigor and reproducibility. A systematic review of published research using the MOST framework was conducted. A structured framework was used to describe and summarize the use of MOST terminology (i.e., preparation phase and optimization objective) and the presentation of preparation work, the conceptual model, and the optimization. Fifty-eight articles were reviewed and the majority focused on either describing the methodology or presenting results of an optimization trial (n = 38, 66%). Although almost all articles identified intervention components (96%), there was considerable variability in the degree to which authors fully described other elements of MOST. In particular, there was less consistency in use of MOST terminology. Reporting on the MOST preparation phase is varied, and there is a need for increased focus on explicit articulation of key design elements and rationale of the preparation phase. The proposed checklist for reporting MOST studies would significantly advance the use of this emerging methodology and improve implementation and dissemination of MOST. Accurate reporting is essential to reproducibility and rigor of scientific trials as it ensures future research fully understands not only the methodology, but the rationale for intervention and optimization decisions.The prevention of child maltreatment: Using SafeCare® to highlight successes and needs for improvement in prevention efforts
AbstractGuastaferro, K., & Lutzker, J. R. (n.d.).Publication year
2022Journal title
International Journal on Child Maltreatment: Research, Policy and PracticeVolume
5Issue
1Page(s)
19-29AbstractChild maltreatment is a public health problem of considerable magnitude. Though substantial progress has been made in the prevention of child maltreatment, one incident of maltreatment is one too many. Intervention and/or prevention efforts must always be dynamic. In this commentary, we highlight recent prevention and policy efforts in the United States, using SafeCare, an evidence-based parent support program with a focus on the prevention of neglect, as an example. We describe broad-scale implementation efforts and offer a vision for what the field must do to realize public heath impact, highlighting recent advances of parent support models in policy, advocacy, and programs. Strategies that might improve current efforts are suggested to ensure the field not become static.Virtual delivery of a school-based child sexual abuse prevention program: A pilot study
AbstractGuastaferro, K., Holloway, J. L., Trudeau, J., Lipson, L. B., Sunshine, S., Noll, J. G., & Pulido, M. L. (n.d.).Publication year
2022Journal title
Journal of Child Sexual AbuseVolume
31Issue
5Page(s)
577-592AbstractUniversal child sexual abuse (CSA) prevention is a public health priority. The prevailing prevention strategy is school-based CSA prevention programming. School closures during the COVID-19 pandemic highlighted the need for flexible modes of delivery, including virtual programs. This pilot examined the virtual delivery of an evidence-based, school-based CSA prevention program, Safe Touches, designed to teach CSA-related knowledge and concepts. Using mixed methods, the pilot sought to determine the feasibility of the virtually delivered CSA prevention program. One school district that had previously received Safe Touches in-person participated. A total of 176 second grade students participated in the virtual workshop. Post-workshop survey responses from virtual (N = 37) and in-person workshops (N = 60) were compared descriptively. Mean item scores and response patterns from students who received the virtual workshop were nominally comparable to the student scores from the in-person workshop. Following the virtual workshop, one teacher notified the research team of a disclosure of CSA. Qualitative input from the facilitator and school staff was positive, indicating high student engagement. Results suggest the viability and feasibility of virtual school-based CSA preventive programs. Investment in virtual modes of delivery would ensure all students have access to CSA prevention programming in the future.A hybrid evaluation-optimization trial of the itMatters intervention and a sexual violence component among college students.
AbstractTanner, A. E., Guastaferro, K., Wyrick, D. L., Milroy, J., Rulison, K. L., Bhandari, S., Thorpe, S., Ware, S., Miller, A. M., & Collins, L. (n.d.).Publication year
2021Abstract~A hybrid evaluation-optimization trial to evaluate an intervention targeting the intersection of alcohol and sex in college students and simultaneously test an additional component aimed at preventing sexual violence
AbstractTanner, A. E., Guastaferro, K., Rulison, K. L., Wyrick, D. L., Milroy, J. J., Bhandari, S., Thorpe, S., Ware, S., Miller, A. M., & Collins, L. M. (n.d.).Publication year
2021Journal title
Annals of Behavioral MedicineVolume
55Issue
12Page(s)
1184-1187AbstractBackground: Using the multiphase optimization strategy (MOST), we previously developed and optimized an online behavioral intervention, itMatters, aimed at reducing the risk of sexually transmitted infections (STI) among first-year college students by targeting the intersection of alcohol use and sexual behaviors. Purpose: We had two goals: (a) to evaluate the optimized itMatters intervention and (b) to determine whether the candidate sexual violence prevention (SVP) component (included at the request of participating universities) had a detectable effect and therefore should be added to create a new version of itMatters. We also describe the hybrid evaluation-optimization trial we conducted to accomplish these two goals in a single experiment. Methods: First year college students (N = 3,098) at four universities in the USA were individually randomized in a hybrid evaluation-optimization 2 × 2 factorial trial. Data were analyzed using regression models, with pre-test outcome variables included as covariates in the models. Analyses were conducted separately with (a) immediate post-test scores and (b) 60-day follow-up scores as outcome variables. Results: Experimental results indicated a significant effect of itMatters on targeted proximal outcomes (norms) and on one distal behavioral outcome (binge drinking). There were no significant effects on other behavioral outcomes, including the intersection of alcohol and sexual behaviors. In addition, there were mixed results (positive short-term effect; no effect at 60-day follow-up) of the SVP component on targeted proximal outcomes (students' self-efficacy to reduce/prevent sexual violence and perceived effectiveness of protective behavioral strategies). Conclusions: The hybrid evaluation-optimization trial enabled us to evaluate the individual and combined effectiveness of the optimized itMatters intervention and the SVP component in a single experiment, conserving resources and providing greatly improved efficiency. Trial Registration: NCT04095065.A vision for the prevention of child maltreatment: Optimization of multicomponent behavioral interventions
AbstractGuastaferro, K. (n.d.).Publication year
2021Abstract~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).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~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~Intersections between the multiphase optimization strategy (MOST) and implementation science.
AbstractWasser, H., Guastaferro, K., Estabrooks, P., Collins, L., Bennett, G., & Broder-Fingert, S. (n.d.).Publication year
2021Abstract~Optimization methods and implementation science: An opportunity for behavioral and biobehavioral interventions
AbstractGuastaferro, K., & Collins, L. M. (n.d.).Publication year
2021Journal title
Implementation Research & PracticeVolume
2Page(s)
1-5AbstractThis editorial introduces the multiphase optimization strategy (MOST), a principled framework for the development, optimization and evaluation of multicomponent interventions, to the field of implementation science. We suggest that MOST may be integrated with implementation science to advance the field, moving closer towards the ultimate goal of disseminating effective interventions to those in need. We offer three potential ways MOST may advance implementation science: (1) development of an effective and immediately scalable intervention; (2) adaptation of interventions to local contexts; and (3) optimization of the implementation of an intervention itself. Our goal is to inspire the integration of MOST with implementation science across a number of public health contexts.Parent and child reports of parenting behaviors: Agreement among a longitudinal study of drug court participants
AbstractGuastaferro, K., Osborne, M. C., Lai, B. S., Aubé, S. S., Guastaferro, W. P., & Whitaker, D. J. (n.d.).Publication year
2021Journal title
Frontiers in PsychiatryVolume
12AbstractIdentifying ways to support children of parents with substance use disorder is a critical public health issue. This study focused on the parent-child relationship as a critical catalyst in child resilience. Using data from a longitudinal cohort study, the aims of this study were to: (1) examine the agreement between parent and child reports of parenting behaviors and (2) describe the association between agreement and child mental health. Participants were 50 parent-child dyads that included parents enrolled in an adult drug court and their children, aged 8–18. Overall, agreement (i.e., concordance) between parent and child reports of parenting was slight to fair. Parents reported their parenting behaviors to be slightly more positive than how children rated the same behaviors in the areas of: involvement, 0.53 (SD = 0.80); positive parenting, 0.66 (SD = 0.87), and monitoring behaviors, 0.46 (SD = 0.90). Parents also rated themselves, in comparison to their children's reports, as using less inconsistent discipline, −0.33 (SD = 1.00), and less corporal punishment, 0.13 (SD = 1.01). Agreement was related to some, but not all, child mental health outcomes. When parents rating their parenting as more positive than their child reported, that had a negative effect on child self-esteem and personal adjustment. Contrary to hypotheses, we did not find a significant relationship between positive parenting and internalizing problems. Findings have implications for obtaining parent and child reports of parenting within the drug court system, and for identifying children at higher risk for externalizing problems.Practicalities of MOST: How to effectively and efficiently conduct and optimization trial.
AbstractGuastaferro, K., & Pfammatter, A. (n.d.).Publication year
2021Abstract~Sexual sensation seeking, hookups, and alcohol consumption among first-year college students
AbstractThorpe, S., Ware, S., Tanner, A. E., Kugler, K. C., Guastaferro, K., Milroy, J. J., & Wyrick, D. L. (n.d.).Publication year
2021Journal title
Journal of American College HealthVolume
69Issue
8Page(s)
897-904AbstractObjective: To explore sexual sensation seeking (SSS) among an ethnically-diverse sample of first-year college students and their hookup behaviors. Participants: 1,480 first-year college students who hooked up in the last 30 days were recruited from four universities in 2016. Methods: Students completed an online survey before completing an online STI and alcohol prevention intervention. Results: Male and sexual minority students had significantly higher SSS scores compared to female and heterosexual students respectively. Students with higher SSS scores were less likely to report condom use at last vaginal and anal hookup, more likely to hookup under the influence of alcohol and participate in a wide range of sexual behaviors. There were no significant mean differences in SSS scores by level of intoxication during their last hookup. Conclusion: These findings highlight the role of SSS in predicting sexual risk behaviors of first-year college students and the overall low SSS scores among this sample.The multiphase optimization strategy (MOST) in child maltreatment prevention research
AbstractGuastaferro, K., Strayhorn, J. C., & Collins, L. M. (n.d.).Publication year
2021Journal title
Journal of Child and Family StudiesVolume
30Issue
10Page(s)
2481-2491AbstractEach year hundreds of thousands of children and families receive behavioral interventions designed to prevent child maltreatment; yet rates of maltreatment have not declined in over a decade. To reduce the prevalence and prevent the life-long negative consequences of child maltreatment, behavioral interventions must not only be effective, but also affordable, scalable, and efficient to meet the demand for these services. An innovative approach to intervention science is needed. The purpose of this article is to introduce the multiphase optimization strategy (MOST) to the field of child maltreatment prevention. MOST is an engineering-inspired framework for developing, optimizing, and evaluating multicomponent behavioral interventions. MOST enables intervention scientists to empirically examine the performance of each intervention component, independently and in combination. Using a hypothetical example of a home visiting intervention and artificial data, this article demonstrates how MOST may be used to optimize the content of a parent-focused in-home intervention and the engagement strategies of an intervention to increase completion rate to identify an intervention that is effective, efficient, economical, and scalable. We suggest that MOST will ultimately improve prevention science and hasten the progress of translational science to prevent child maltreatment.When home is not safe: Media coverage and issue salience of child maltreatment during the COVID-19 pandemic
AbstractMadden, S., Guastaferro, K., Skurka, C., & Myrick, J. G. (n.d.).Publication year
2021Journal title
Howard Journal of CommunicationsVolume
32Issue
5Page(s)
474-492AbstractWhile staying at home is crucial for controlling the COVID-19 pandemic, there is concern that such public health measures may increase the risk for child maltreatment (CM). Using a qualitative content analysis of news coverage and a quantitative survey (N = 250) of media consumers, this study explored the framing of CM as an issue during COVID-19, as well as audience recall and perceived efficacy to prevent maltreatment. Findings from the content analysis indicate that domestic violence and CM are frequently discussed together, and that less frequent interaction with mandatory reporters during the pandemic was often cited as a problem. Survey results suggest that social media and public service announcements are more important compared to news media for increasing audience perceptions of salience and efficacy around CM during a pandemic. Implications for studying media coverage of intertwined public health issues, like a pandemic and CM, are discussed.A parent-focused child sexual abuse prevention module added to PAT: Results of a cluster randomized trial.
AbstractGuastaferro, K., & Crane, J. (n.d.).Publication year
2020Abstract~An introduction to MOST: How to build more effective, efficient, economical, and scalable interventions.
AbstractGuastaferro, K. (n.d.).Publication year
2020Abstract~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.