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
Optimizing Multicomponent Interventions: The Multiphase Optimization Strategy (MOST).
AbstractGuastaferro, K. (n.d.).Publication year
2020Abstract~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.Parent-focused child sexual abuse prevention: A brief overview of curriculum development and pilot testing.
AbstractReader, J. M., Guastaferro, K., Shanley, J. R., & Noll, J. G. (n.d.).Publication year
2017Abstract~Parent-focused Child Sexual Abuse Prevention: A Universal Approach.
AbstractAbuchaibe, V., Melchior, M., Dan, C., Zeleke, M., McCormick, K., Bhoja, A., Abourjaily, E., Welikson, P., Grayson, C., & Guastaferro, K. (n.d.).Publication year
2024Abstract~Parent-focused child sexual abuse prevention: An additive approach.
AbstractGuastaferro, K. (n.d.).Publication year
2020Abstract~Parent-focused Child Sexual Abuse Prevention: Results from an Acceptability & Feasibility Pilot.
AbstractZadzora, K. M., & Guastaferro, K. (n.d.).Publication year
2019Abstract~Parent-focused child sexual abuse prevention: Results of a cluster randomized trial.
AbstractGuastaferro, K., & Noll, J. G. (n.d.).Publication year
2020Abstract~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 (psParent-infant interaction training with a Latino mother
AbstractGuastaferro, K., Morales, Y., Lutzker, J. R., Shanley, J. R., & Guastaferro, K. M. (n.d.).Publication year
2016Journal title
International Journal of Child Health and Human DevelopmentVolume
8Issue
2Page(s)
135-145AbstractChild maltreatment is a significant public health problem, with almost 25% of all reports occurring in Latino families. Child maltreatment and intimate partner violence (IPV) often co-occur, and the sequelae of IPV frequently appear in the victimized mother and her children. Home visitation programs such as SafeCare® are intervention strategies to reduce the risk of child maltreatment, but these programs are rarely adapted for Latino populations. The importance of cultural sensitivity in parenting programs has been highlighted as a means of producing successful outcomes when working with Latino families. The present study includes multiple methods: a single-case research design study evaluated the effects of the SafeCare Parent-Infant Interaction (PII) module when delivered in Spanish to a Latino mother with prior IPV experiences; self-reported quantitative measures assessed exposure to IPV and changes in mental health, parenting stress, and the risk of child maltreatment; and qualitative data provided suggestions for culturally adapting PII for Latino families. Data from this study suggest that PII improves parent-infant interactions when delivered in Spanish and can reduce the risk of child maltreatment. Additionally, self-reported measures confirmed that IPV, parent mental health distress, and the risk of child maltreatment co-occur and can be reduced with PII. This study suggests the importance of providing culturally adapted programs when working with Latino families.Parenting and mental health needs of young, maltreated parents: Implications for prevention of intergenerational child maltreatment
AbstractAparicio, E. M., Channell Doig, A., Jasczynski, M., Robinson, J. L., Huq, M., Yoo, J. H., Hillig, E., Lee, K., Berkowitz, A., Guastaferro, K., Jones, G., & Bernardi, C. (n.d.).Publication year
2023Journal title
Journal of Family ViolenceVolume
38Issue
4Page(s)
659-672AbstractPurpose: Children of young parents are at elevated risk for child abuse and neglect due to myriad challenges. Despite the dual need for parenting support and mental health support, most literature and programs separate these and do not address maltreated parenting youths’ intergenerational context. The current study explores parenting and mental health needs as intertwined, uplifting experiences of young adult mothers with child maltreatment histories, professionals serving them, and mothers’ own caregivers. Method: Through a community-engaged research process, this grounded theory study was co-conceptualized and conducted through a university-community-based organization partnership. We conducted in-depth interviews with 23 participants: nine young, maltreated mothers aged 18–25 (M = 20.9) years, 14 professionals and two caregivers. Data were collected in the community and analyzed using grounded theory methods. We transcribed each interview and analyzed the transcripts using a structured process of open, focus, axial, and selective/theoretical coding. Rigor was enhanced through several strategies including reflexivity and member checking. Results: Grounded theory analysis produced a detailed model of the process of accessing and receiving mental health and parenting support among young, maltreated mothers, including (1) Reckoning with the Impact of Childhood and Adolescent Trauma on Mental Health and Parenting; (2) Reaching Out; (3) Receiving Parenting Support; (4) Receiving Mental Health Support; and (5) Seeking a Change. Conclusions: Findings support a comprehensive approach for supporting young parents in improving the trajectories of their families through integrated approaches to parenting and mental health intervention.Parents as Teachers + SafeCare at Home (PATSCH): Collaboration to meet the needs of families.
AbstractMiller, K., & Guastaferro, K. (n.d.).Publication year
2017Abstract~Pilot optimization trial of a sexual and reproductive health program for Latina teens and female caregivers: A study protocol
AbstractMerrill, K. G., Silva, J., Chu, W., Robermo, G., Melgoza, V., Gabino, B., Mora, C., Vargas, S., Fuentes, J., Keller-Montero, C., Courreljolles, N., Guastaferro, K., Scott-Wellington, F., Salgado, S., & Sedeno, A. (n.d.).Journal title
Contemporary Clinical TrialsAbstract~Piloting an alternative implementation modality for a school-based child sexual abuse prevention curriculum
AbstractMozid, N. E., Espinosa, R. N., Grayson, C., Falode, O., Yang, Y., Glaudin, C., & Guastaferro, K. (n.d.).Publication year
2024Journal title
International Journal on Environmental Research and Public HealthVolume
21Issue
2AbstractBackground: In the U.S., the most pervasive child sexual abuse (CSA) prevention strategy involves school-based prevention programs; however, the reach of these programs is limited due to implementation constraints, such as budgets or turnover. This is notable as standard delivery of often requires two facilitators in the classroom. Leveraging a natural experiment in the implementation of Safe Touches, the current study sought to explore the feasibility of implementation with a single facilitator using pre-recorded videos compared to the standard in-person delivery. Methods: A six-item CSA-related knowledge questionnaire was delivered to (N = 1480) second-graders post-workshop. An independent-samples t-test was used to compare the mean of CSA-related knowledge item responses for each delivery modality. Student-level data were paired with teacher evaluations and an interview with the facilitator. Results: Across workshops delivered in 25 schools, there was no significant difference in knowledge based on CSA-related questions by workshop modality. Teachers indicated the facilitators responded effectively to the children’s questions and comments in both delivery modalities. Input from the facilitator was positive. Conclusions: Triangulation of student knowledge, teacher input, and facilitator experience indicates the viability and feasibility of this implementation strategy for Safe Touches, and potentially other school-based CSA prevention programs. To ensure equitable access to the CSA prevention program, the empirical examination of, and investment in, alternative implementation options for school-based CSA preventive programs is encouraged.Piloting an Alternative Implementation Modality for a School-Based Child Sexual Abuse Prevention Curriculum
AbstractMozid, N. E., Espinosa, R. N., Grayson, C., Falode, O., Yang, Y., Glaudin, C., & Guastaferro, K. (n.d.).Publication year
2024Journal title
International journal of environmental research and public healthVolume
21Issue
2AbstractBackground: In the U.S., the most pervasive child sexual abuse (CSA) prevention strategy involves school-based prevention programs; however, the reach of these programs is limited due to implementation constraints, such as budgets or turnover. This is notable as standard delivery of often requires two facilitators in the classroom. Leveraging a natural experiment in the implementation of Safe Touches, the current study sought to explore the feasibility of implementation with a single facilitator using pre-recorded videos compared to the standard in-person delivery. Methods: A six-item CSA-related knowledge questionnaire was delivered to (N = 1480) second-graders post-workshop. An independent-samples t-test was used to compare the mean of CSA-related knowledge item responses for each delivery modality. Student-level data were paired with teacher evaluations and an interview with the facilitator. Results: Across workshops delivered in 25 schools, there was no significant difference in knowledge based on CSA-related questions by workshop modality. Teachers indicated the facilitators responded effectively to the children’s questions and comments in both delivery modalities. Input from the facilitator was positive. Conclusions: Triangulation of student knowledge, teacher input, and facilitator experience indicates the viability and feasibility of this implementation strategy for Safe Touches, and potentially other school-based CSA prevention programs. To ensure equitable access to the CSA prevention program, the empirical examination of, and investment in, alternative implementation options for school-based CSA preventive programs is encouraged.Population-level reductions in child sexual abuse valid and invalid cases after a three-year coordinated, community-wide prevention initiative: Results from a synthetic control analysis
AbstractNoll, J. G., Felt, J., Russotti, J., Guastaferro, K., Day, S., & Fisher, Z. (n.d.).Publication year
2025Journal title
JAMA PediatricsAbstractImportance: Child sexual abuse (CSA) impacts 15% of girls and 8% of boys worldwide, incurring high public costs and devastating consequences for survivors. US incidence rates have stagnated over the past 15 to 20 years, signaling a dire need for innovation in primary prevention. In 2024, the US Preventive Services Task Force reported that there is insufficient evidence for the effectiveness of child abuse preventive strategies, and none have shown decreases in incidence rates at the population level. Objective: To test whether a coordinated, community-wide preventive intervention could significantly reduce population-level incidence rates of CSA. Design, Setting, and Participants: This population cohort study used synthetic control methods with a counterfactual condition and CSA incidence data from a statewide child welfare information system. Participants included a population-based sample in the state of Pennsylvania. Intervention: From 2018 through 2020, the state of Pennsylvania launched a 3-pronged CSA prevention intervention in 5 counties that included: (1) exposing 5% of the adult population (approximately 72000) to online and in-person trainings with an accompanying countywide media campaign, (2) delivering a psychoeducation program to 100% of second-grade students (approximately 17000), and (3) providing parent training to 100% of parents served by the child welfare system (approximately 300). Intervention counties were a priori matched to 1 of 5 control counties based on population size and preintervention CSA rates. Main Outcomes and Measures: Aggregate rates of both substantiated and unsubstantiated CSA reports were examined across intervention and control counties for 5 preintervention years and 3 postintervention years. Results: Within 1 year of intervention launch, CSA reports were significantly reduced in intervention counties, as compared with control counties for both substantiated (average treatment of the treated [ATT] =-17.22; 95% CI,-34.15 to-4.20) and unsubstantiated reports (ATT =-36.04; 95% CI,-74.40 to-3.88). Conclusions: In this evaluation of a place-based, coordinated, countywide intervention, reports of both substantiated and unsubstantiated CSA were shown to be significantly reduced at the population level.Practicalities of MOST: How to effectively and efficiently conduct and optimization trial.
AbstractGuastaferro, K., & Pfammatter, A. (n.d.).Publication year
2021Abstract~Practices targeting child neglect: The use of SafeCare® to enhance parenting skills to reduce neglect
AbstractRostad, W. L., Lutzker, J. R., & Guastaferro, K. (n.d.). (R. Gardner, Ed.).Publication year
2016Abstract~Preparation Phase Activities to Develop and Optimize an Intervention Using MOST for Grandparents Raising Grandchildren.
AbstractGuastaferro, K. (n.d.).Publication year
2024Abstract~Preparing to implement Floreciendo with Latina teens and their female caregivers : Integrating implementation science and the multiphase optimization strategy framework
AbstractMerrill, K. G., Silva, J., Sedeño, A., Salgado, S., Vargas, S., Cano, J. K., Nabor, V., Merrill, J. C., DeCelles, J., Guastaferro, K., Baumann, A. A., Fuentes, J., Rodriguez, L., Melgoza, V., & Donenberg, G. R. (n.d.).Publication year
2025Journal title
Translational Behavioral MedicineVolume
15Issue
1AbstractBackground: Practical examples of studies integrating implementation science and the multiphase optimization strategy (MOST) framework are lacking. Floreciendo is a sexual and reproductive health program for Latina teens and their female caregivers, adapted from the IMARA evidence-based program. Purpose: We prepared for delivering Floreciendo by developing an implementation plan to support the program’s adoption and sustainment. Methods: Drawing on a community-based participatory research approach, we used qualitative methods to explore program logistics, implementation determinants and strategies, adoption, and sustainability. We positioned our study activities within the preparation phases of both the MOST and the EPIS frameworks. We conducted and rapidly analyzed seven focus group discussions—one with Latina teens (n = 9), one with female caregivers (n = 6), four with organizational staff (n = 32), and one with IMARA staff (n = 6)—and seven key informant interviews. Results: Participants described community organizations as the preferred location for workshops in offering a “safe space.” They recommended workshop delivery on two days over separate weekends. Teens and caregivers requested relatable, bilingual Latina facilitators. Implementation barriers were raised (e.g. work conflicts) with strategies to address them (e.g. provide stipends). Organizational adoption was perceived as likely since the workshop addresses clients’ needs and fits with organizational values. Recommendations for sustainment included identifying funding opportunities specific to each organization. Conclusions: Findings directly informed our immediate plans to optimize Floreciendo using the MOST framework and principles and our long-term goals for adoption and sustainability. Implementation science can strengthen studies using the MOST framework.Preparing to implement the Floreciendo sexual and reproductive health workshop: Integrating implementation science and the MOST framework
AbstractMerrill, K. G., Silva, J., Sedeno, A., Salgado, S., Vargas, S., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., Baumann, A., Fuentes, J., Rodriguez, L., & Donenberg, G. (n.d.).Publication year
2025Journal title
Translational Behavioral MedicineVolume
15Issue
1AbstractBackground: Practical examples of studies integrating implementation science with the multiphase optimization strategy (MOST) framework are lacking. Floreciendo is a workshop for Latina teens and their female caregivers addressing sexual and reproductive health and related issues (e.g., mental health, intimate partner violence), which was adapted from the IMARA evidence-based program. We set out to explore implementation determinants (i.e., barriers and facilitators) and strategies to prepare for a pilot optimization trial of Floreciendo in the preparation phase of MOST. Methods: Using community-based participatory research, we integrated the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework with the MOST framework. We sought to explore determinants of and strategies for achieving five implementation outcomes: acceptability, appropriateness, feasibility, adoption, and sustainability. We conducted seven focus group discussions with Latina teens (n=1 group), female caregivers (n=1 group), staff from three community partner organizations (n=4 groups), and facilitators/implementers of IMARA (n=1 group). We also conducted seven key informant interviews with individuals experienced with sexual and Latina health. Data were analyzed using rapid qualitative analysis. Results: Community partner organizations were the preferred location for workshops in offering a “safe space.” Participants recommended delivering the program on two days over separate weekends. Implementation barriers were raised (e.g., work conflicts, caring for younger children, lack of transport) with strategies to address them (e.g., provide stipends, offer childcare, offer transport reimbursement). Teens and caregivers requested relatable, bilingual Latina facilitators. Organizational adoption was perceived as likely since the workshop addresses clients’ needs and fits with organizational values. Recommendations for sustainment included identifying funding opportunities specific to each organization. Conclusions: Our findings directly informed the refinement of intervention components and implementation strategies to be used in a pilot optimization trial of Floreciendo. This work highlights the invaluable role that implementation science can play in research informed by the MOST framework.Preventive education outreach on social media: The quest to enroll community members in a child sexual prevention workshop
AbstractGuastaferro, K., Melchior, M. S., Murphy-Costanzo, A. S., Anderson, A., Melamed, N., & Madden, S. (n.d.).Publication year
2023Journal title
Journal of Child Sexual AbuseVolume
32Issue
8AbstractSocial media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now “X”) as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.Provider attitudes and self-efficacy when delivering a child sexual abuse prevention module: An exploratory study
AbstractGuastaferro, K., Font, S. A., Miyamoto, S., Zadzora, K. M., Walters, K. E., O’Hara, K., Kemner, A., & Noll, J. G. (n.d.).Publication year
2023Journal title
Health Education and BehaviorVolume
50Issue
2Page(s)
172-180AbstractBackground: As constant figures in children’s lives, parents are key in protecting children from sexual abuse. One barrier to reaching parents is that the topic can be difficult to broach and is sensitive in nature. Such barriers can interfere with implementation and fidelity of evidence-based prevention strategies that are focused on reducing rates of childhood sexual abuse (CSA). Aims: In this exploratory study, we examine provider attitudes about delivering CSA-specific content in an evidence-based prevention module and their self-efficacy. Method: Thirty-three providers participated in three surveys: prior to a skills-oriented training on how to deliver the CSA prevention module (pretraining), immediately posttraining, and 6 months posttraining. Changes in self-reported willingness to deliver content, beliefs about parents’ role in CSA prevention, and confidence about their ability to deliver content were assessed over time. Open-ended questions were coded thematically to reinforce quantitative findings. Results: Prior to training, providers were worried that parents would respond negatively to CSA content and were concerned about their comfort level discussing victimization and sexual development. Findings suggest that skill-oriented training and provision scripts effectively supported providers and improved confidence in delivering CSA prevention content. Discussion: Provider self-efficacy is an important element of implementation fidelity. This exploratory study demonstrated that, though providers may approach CSA content with wariness and trepidation, adequate skills-oriented training can reduce negative attitudes and increase perceived efficacy in the actual delivery of CSA content that persists through implementation. Conclusion: Skills-based training can significantly enhance fidelity in the delivery of difficult content included in parent-focused preventative interventions.Raising expectations for D&I science: Intervention optimization as an opportunity to move toward implementability and equitability.
AbstractStrayhorn, J., Collins, L., Guastaferro, K., & Shelley, D. (n.d.).Publication year
2023AbstractThe emerging field of intervention optimization offers implementation science opportunities in several areas. In this session we offer an orientation to intervention optimization via the multiphase optimization strategy (MOST), followed by two presentations highlighting recent methodological developments in the intersection between intervention optimization and implementation science: first, in the optimization of multicomponent implementation strategies, and second, in optimizing to achieve not only effectiveness and implementability but also equitability (and even, we suggest, equitability in implementation). Panel chair Dr. Linda M. Collins and discussant Dr. Donna Shelley will then lead a discussion on implications and next steps for D&I science.Reaching Families in an Adult Felony-Level Drug Court.
AbstractGuastaferro, K., Guastaferro, W. P., Brown, J. R., & Graves, S. (n.d.).Publication year
2014Abstract~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.