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
Maximizing the reach of universal child sexual abuse prevention: Protocol for an equivalence trial
AbstractGuastaferro, K., Melchior, M. S., Heng, S., Trudeau, J., & Holloway, J. L. (n.d.).Publication year
2024Journal title
Contemporary Clinical Trials CommunicationsVolume
41AbstractBackground Child sexual abuse (CSA) affects 1 in 5 girls and 1 in 12 boys before age 18. Universal school-based prevention programs are an effective and cost-efficient method of teaching students an array of personal safety skills. However, the programmatic reach of universal school-based programs is limited by the inherent reliance on the school infrastructure and a dearth of available alternative delivery modalities. Methods The design for this study, Roads to Impact, will use a rigorous cluster randomized design (N = 180 classrooms) to determine the equivalence of two delivery modalities of Safe Touches: as usual vs. modified. The usual workshop will be delivered by two facilitators with live puppet skits, as designed (n=90). Whereas, the modified workshop will be delivered by one facilitator using prerecorded skit videos (n=90). We will determine the equivalence by measuring concept learning acquisition preworkshop to immediate postworkshop (Aim 1) and retention at 3-months postworkshop (Aim 2) among students in classrooms that receive the as usual or modified workshops. To conclude equivalence, it is imperative to also examine factors that may impact future dissemination and implementation, specifically program adoption among school personnel and implementation fidelity between the two modalities (Aim 3). Conclusion Study findings will inform the ongoing development of effective CSA prevention programs and policy decisions regarding the sustainable integration of such programs within schools.Meeting the needs of families at high-risk for child maltreatment: The braiding of two evidence-based curricula.
AbstractLutzker, J. R., Guastaferro, K., Whitaker, D. J., & Graham, M. L. (n.d.).Publication year
2014Abstract~Meeting the Needs of High Risk Families: A systematic approach to braiding of two evidence-based parenting programs to best meet the needs of high-risk parents and highlight interim results of a current randomized controlled trial.
AbstractLutzker, J. R., & Guastaferro, K. (n.d.).Publication year
2014Abstract~Mental health research agenda-setting paper
AbstractLai, B. S., Cooper, D., Guastaferro, K., Hoskova, B., Colgan, C., Krishna, R. N., Rohrbeck, C. A., & Gillis, J. R. (n.d.).Publication year
2020Abstract~Mobile Phones and the Prevention of Child Maltreatment: Innovation & Implications.
AbstractJackson, M. C., Guastaferro, K., Self-Brown, S., & Lutzker, J. R. (n.d.).Publication year
2014Abstract~Modification to a systematically braided parent-support curriculum: Results from a feasibility pilot
AbstractGuastaferro, K., Miller, K., Lai, B. S., Shanley, J., Kemner, A., Whitaker, D. J., & Lutzker, J. R. (n.d.).Publication year
2019Journal title
Journal of Child and Family StudiesVolume
28Issue
7Page(s)
1780-1789AbstractObjectives: There are a variety of parent-support programs designed to improve parenting and, thereby, the safety and well-being of children. Providers trained in multiple programs are likely to select components of interventions they feel will meet the needs of the families they serve leaving out aspects they deem unnecessary or redundant. In so doing, the fidelity of the evidence-based program is at risk. A potential solution is systematic braiding in which evidence-based programs are combined such that the fidelity to each original model and its implementation are maintained. Methods: Drawing on qualitative feedback from a prior iteration, this paper discusses results of a feasibility and acceptability pilot of a modified version of the systematically braided Parents as Teachers and SafeCare at Home (PATSCH) curriculum. This modification removed a provider-perceived “redundant” portion from the original PATSCH curriculum. A pre-post design (N= 18) was used to evaluate the efficacy of the modified curriculum. Results: Significant improvements were seen in trained parent behaviors surrounding home safety and child health. There was also improvement in self-reported parenting behaviors, the portion of the braided curriculum removed, suggesting that the PAT curriculum adequately teaches these skills. Providers and parents were highly satisfied with the modified curriculum. Conclusions: If a curriculum is modified to reflect provider and parent preferences, then the potential for delivery without fidelity is minimized.More work needed to protect children but promising trend data on exposure to violence
AbstractGuastaferro, K., Lutzker, J. R., Guastaferro, K., & Whitaker, D. J. (n.d.).Publication year
2014Journal title
JAMA PediatricsVolume
168Issue
6Page(s)
512-514Abstract~MOST Designs in Behavioral Research.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~Mothers with Intellectual Disability: Experiences and Implications for Service Delivery.
AbstractGuastaferro, K., Lutzker, J. R., & Graham, M. L. (n.d.).Publication year
2014Abstract~Multiphase optimization strategy: How to build more effective, affordable, scalable and efficient social and behavioural oral health interventions
AbstractGuastaferro, K., & Strayhorn, J. C. (n.d.).Publication year
2023Journal title
Community Dentistry and Oral EpidemiologyVolume
51Issue
1Page(s)
103-107AbstractThis commentary introduces the field of social behavioural oral health interventions to the multiphase optimization strategy (MOST). MOST is a principled framework for the development, optimization and evaluation of multicomponent interventions. Drawing from the fields of engineering, behavioural science, economics, decision science and public health, intervention optimization requires a strategic balance of effectiveness with affordability, scalability and efficiency. We argue that interventions developed using MOST are more likely to maximize the public health impact of social behavioural oral health interventions.New York City Transit Workers: An Essential Workforce – Addressing Occupational Resilience through Intervention Optimization.
AbstractMerdjanoff, A. A., Gershon, R., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Operationalizing primary outcomes to achieve reach, effectiveness, and equity in multilevel interventions
AbstractGuastaferro, K., Sheldrick, R. C., Strayhorn, J. C., & Feinberg, E. (n.d.).Publication year
2023Journal title
Prevention ScienceAbstractWhen intervention scientists plan a clinical trial of an intervention, they select an outcome metric that operationalizes their definition of intervention success. The outcome metric that is selected has important implications for which interventions are eventually supported for implementation at scale and, therefore, what health benefits (including how much benefit and for whom) are experienced in a population. Particularly when an intervention is to be implemented in a population that experiences a health disparity, the outcome metric that is selected can also have implications for equity. Some outcome metrics risk exacerbating an existing health disparity, while others may decrease disparities for some but have less effect for the larger population. In this study, we use a computer to simulate implementation of a hypothetical multilevel, multicomponent intervention to highlight the tradeoffs that can occur between outcome metrics that reflect different operationalizations of intervention success. In particular, we highlight tradeoffs between overall mean population benefit and the distribution of health benefits in the population, which has direct implications for equity. We suggest that simulations like the one we present can be useful in the planning of a clinical trial for a multilevel and/or multicomponent intervention, since simulated implementation at scale can illustrate potential consequences of candidate operationalization of intervention success, such that unintended consequences for equity can be avoided.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.Optimization of an online STI preventive intervention targeting college students.
AbstractKugler, K. C., Wyrick, D. L., Milroy, J., Guastaferro, K., Ware, S., Thorpe, S., & Collins, L. (n.d.).Publication year
2018Abstract~Optimization of Implementation Strategies Using MOST: An Emphasis on the Factorial Design.
AbstractSzeszulski, J., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Optimization of implementation strategies using the multiphase optimization strategy (MOST) framework: Practical guidance using the factorial design
AbstractSzeszulski, J., & Guastaferro, K. (n.d.).Publication year
2024Journal title
Translational Behavioral MedicineAbstractBackground: The Multiphase Optimization Strategy (MOST) is a principled framework that uses three phases – preparation, optimization, and evaluation – to develop multicomponent interventions that are Effective, Affordable, Scalable, and Efficient, resulting in intervention EASE. When used in the field of implementation science, optimization of the intervention may require focus on the implementation strategies – all the things that we do to deliver the intervention – and implementation outcomes (e.g., acceptability, appropriateness, feasibility), as opposed to the components of the intervention that produce the behavioral or health outcome. To date, the MOST framework has been primarily used to optimize the components of the intervention related to behavioral or health outcomes. However, innovative opportunities to optimize implementation strategies exist and are detailed here. Methods/Results: To optimize the implementation of an intervention, this paper details four scenarios where the MOST framework can be used in the optimization of implementation strategies: (1) the development and testing of multifaceted implementation strategies; (2) evaluating interactions between evidence-based program components and implementation strategies; (3) evaluating the independent effects of several discrete strategies that have been previously evaluated as a multifaceted implementation strategy; and (4) modification of an implementation strategy for local context. We supply hypothetical applied examples rooted in mental health interventions to illustrate these four scenarios, including describing the use of cognitive behavioral therapy in schools and providing hypothetical data that can help users to make informed decisions derived from their trial data.Optimization of implementation strategies using the Multiphase Optimization STratgey (MOST) framework : Practical guidance using the factorial design
AbstractSzeszulski, J., & Guastaferro, K. (n.d.).Publication year
2024Journal title
Translational Behavioral MedicineVolume
14Issue
9Page(s)
505-513AbstractThe Multiphase Optimization STrategy (MOST) is a framework that uses three phases—preparation, optimization, and evaluation—to develop multicomponent interventions that achieve intervention EASE by strategically balancing Effectiveness, Affordability, Scalability, and Efficiency. In implementation science, optimization of the intervention requires focus on the implementation strategies—things that we do to deliver the intervention—and implementation outcomes. MOST has been primarily used to optimize the components of the intervention related to behavioral or health outcomes. However, innovative opportunities to optimize discrete (i.e. single strategy) and multifaceted (i.e. multiple strategies) implementation strategies exist and can be done independently, or in conjunction with, intervention optimization. This article details four scenarios where the MOST framework and the factorial design can be used in the optimization of implementation strategies: (i) the development of new multifaceted implementation strategies; (ii) evaluating interactions between program components and a discrete or multifaceted implementation strategies; (iii) evaluating the independent effects of several discrete strategies that have been previously evaluated as a multifaceted implementation strategy; and (iv) modification of a discrete or multifaceted implementation strategy for the local context. We supply hypothetical school-based physical activity examples to illustrate these four scenarios, and we provide hypothetical data that can help readers make informed decisions derived from their trial data. This manuscript offers a blueprint for implementation scientists such that not only is the field using MOST to optimize the effectiveness of an intervention on a behavioral or health outcome, but also that the implementation of that intervention is optimized.Optimization of Smoking Cessation Interventions via Multiphase Optimization STrategy (MOST): Basic Concepts, Practical Considerations and New Developments
AbstractCollins, L., Guastaferro, K., Strayhorn, J., Cantrell, J., Kimber, C., & Piper, M. (n.d.).Publication year
2024Abstract~Optimization of Smoking Cessation Interventions via Multiphase Optimization STrategy (MOST): Basic Concepts, Practical Considerations and New Developments
AbstractGuastaferro, K. (n.d.).Abstract~Optimization Trials for Digital Interventions
AbstractGuastaferro, K. (n.d.).Publication year
2019Abstract~Optimizing COPD self-management treatment using the Multiphase Optimization Strategy: Results from a pilot factorial experiment
AbstractMathew, A. R., Esqueda Medina, M., Avery, E., Younker, L., Guastaferro, K., & Press, V. G. (n.d.).Publication year
2024Abstract~Optimizing educational interventions in crisis contexts through the multiphase optimization strategy (MOST).
AbstractCollins, L., Guastaferro, K., & Strayhorn, J. (n.d.).Publication year
2022Abstract~Optimizing for Dissemination of a Family Navigation Intervention to Improve Pediatric Mental Health Services using MOST.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~Optimizing home visiting programs to improve reach: A case study in strategically balancing intervention effectiveness with provider time
AbstractGuastaferro, K., & Strayhorn, J. C. (n.d.).Journal title
Child Protection PracticeAbstract~Optimizing home visiting programs to improve reach: A case study in strategically balancing intervention effectiveness with provider time
AbstractGuastaferro, K., & Strayhorn, J. (n.d.).Publication year
2024Journal title
Child Protection and PracticeAbstract~