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

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 University

PhD Public Health, Georgia State University

MPH Health Promotion, Georgia State University

BA 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

Refining the Floreciendo Sexual and Reproductive Health Workshop Curriculum for Latina Teens and Female Caregivers Using Theater Testing

Florence, K., Silva, J., Atadero, J., Hung, I. L., Salgado, S., Cano, J., Nabor, V., Sedeno, A., Vargas, V., Romero, G., Perez, C., Fuentes, J., Merrill, J., DeCelles, J., Guastaferro, K., Donenberg, G., & Merrill, K. G. (n.d.).

Publication year

2024

Abstract

Abstract

Introduction: Latina teens are affected by sexually transmitted infections and unintended pregnancy at a disproportionate rate. Florecidendo is a sexual and reproductive health program aimed at educating Latina teens (14-18 years old) and their female caregivers. The term “female caregiver” encompasses mothers, aunts, sisters, and grandmothers. This program was adapted forLatina women from the evidence-based IMARA program.Objective: Our aim was to theater test the Floreciendo workshop (comprising four two-hour sessions) to refine the curriculum prior to hosting a pilot optimization trial.Methods: The theater testing was conducted for two days at a community organization that has partnered with the program. There were three Latina teens and their three female caregivers that participated. The four sessions of the workshop were delivered, with oral and written feedback obtained following each session from participants (n=6), observers (n=8), and workshopfacilitators (n=2). The session data was systematically analyzed by session (Foundations in Sexual Risk Prevention, Condoms and Contraception, Gender and Partner Relationship Dynamics, and Family Strengthening), and feedback from observers and participants was consolidated to inform curriculum edits.Results: Ratings of the activities in each of the four sessions revealed high acceptability. On a 4.0 scale (where 0=low and 4=high), ratings averaged 3.79 (SD=0.30) for teens, 3.94 (SD=0.18) for caregivers, and 3.81 (SD=0.21) for acceptability. Feedback on the curriculum included suggestions to incorporate more information on mental health. In addition, the caregivers would like to expand on the topic of domestic violence, specifically psychological violence. The curriculum should also ensure sufficient time for participants to voice their opinions during discussions. A caregiver reported that the workshop overall was “motivating” and made her “feel more secure” when discussing sexual health with her daughter.Conclusions: The constructive feedback received on the curriculum provided valuable information about its acceptability. Suggestions were incorporated into the curriculum that is currently being tested in a pilot optimization trial using the multiphase optimization strategy (MOST) framework.

Running an optimization trial during COVID-19: Adaptations and Considerations from the field

Guastaferro, K., & Wells, R. D. (n.d.).

Publication year

2020

Abstract

Abstract

SafeCare®: From development to innovative sustainability strategies.

Lutzker, J. R., & Guastaferro, K. (n.d.).

Publication year

2013

Abstract

Abstract

SafeCare®: Historical perspective and dynamic development of an evidence-based scaled-up model for the prevention of child maltreatment

Guastaferro, K., Guastaferro, K. M., Lutzker, J. R., Graham, M. L., Shanley, J. R., & Whitaker, D. J. (n.d.).

Publication year

2012

Journal title

Psychosocial Intervention

Volume

Issue

Page(s)

171-180

10.5093/in2012a17

Abstract

Abstract

SafeCare is an evidence-based parent-training program that reduces child maltreatment, particularly neglect. The risk of child maltreatment, a public health issue affecting millions of U.S. children each year, can be markedly reduced by interventions such as SafeCare that deliver in-home services. Drawing from applied behavioral analysis roots, SafeCare focuses on providing parents with concrete skills in three areas: health, home safety, and parent-child/-infant interaction. This paper will include an overview of the SafeCare model, an historical perspective of its history and dynamic development, description of the theoretical underpinnings of the model, a description of the program targets and content by describing its modules and delivery, an overview of program outcomes, and data discussion of dissemination and implementation.

School-based child sexual abuse prevention: Large-scale implementation of Safe Touches.

Holloway, J. L., & Guastaferro, K. (n.d.).

Publication year

2022

Abstract

Abstract

Sexual sensation seeking, hookups, and alcohol consumption among first-year college students

Thorpe, S., Ware, S., Tanner, A. E., Kugler, K. C., Guastaferro, K., Milroy, J. J., & Wyrick, D. L. (n.d.).

Publication year

2021

Journal title

Journal of American College Health

Volume

Issue

Page(s)

897-904

10.1080/07448481.2020.1713136

Abstract

Abstract

Objective: 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.

Smart Parents – Safe and Healthy Kids.

Guastaferro, K. (n.d.).

Publication year

2019

Abstract

Abstract

StandUPTV : a full-factorial optimization trial to reduce sedentary screen time among adults

Keadle, S. K., Hasanaj, K., Leonard, K. S., Fernandez, A., Freid, L., Weiss, S., Legato, M., Anand, H., Hagobian, T. A., Phillips, S. M., Phelan, S., Guastaferro, K., Seltzer, R. G., & Buman, M. P. (n.d.).

Publication year

2025

Journal title

International Journal of Behavioral Nutrition and Physical Activity

Volume

Issue

10.1186/s12966-025-01771-2

Abstract

Abstract

Background: Using the multiphase optimization strategy (MOST) framework, we aimed to identify an optimized mHealth-delivered intervention for reducing recreational sedentary screen time (rSST) by at least 60 min/day among adults. Methods: Eligible participants were 23–64 years old and self-reported elevated rSST (> 3 h/day). Following a 7-day baseline, participants received a core mHealth application (self-monitoring and 50% reduction target and educational materials) and were randomly assigned to three additional components set to on/off in a full-factorial (23) experiment: LOCKOUT: rSST electronically restricted; TEXT: rSST reduction prompts; and EARN: rSST through physical activity. rSST was assessed at baseline and 16 weeks via an integrated measure that included objectively assessed sedentary time (activPAL accelerometer) and screen time (TV Wifi plugs and tablet usage). We used a linear mixed effect model to evaluate the change in rSST for the three intervention components and their interactions. Results: A total of 82% of the randomized participants (N = 110) were female, with a mean ± SD age of 41 ± 11.7 y and a BMI of 29.7 ± 7.8 kg/m2, and their mean (95% CI) rSST was 184.7 (172.8, 196.5) min/day at baseline. The expected difference (baseline vs. 16 weeks) in rSST was greatest for the intervention versions with the core plus EARN on with an average reduction of -118.1 (-163.0, -73.1) min/day and for core plus LOCKOUT, TEXT, & EARN on (-125.7 [-172.0, -79.3] min/day). Conclusions: We identified several promising intervention versions that exceeded our optimization objective. This study provides important evidence on efficacious multicomponent interventions that should be moved forward to the evaluation phase of the MOST framework to test the effect of rSST reductions on health outcomes. Trial registration: (clinicaltrials.gov

StandUPTV: A full-factorial optimization trial to reduce sedentary screen time among adults

Keadle, S., Hasanaj, K., Leonard, K., Fernandez, A., Legato, M., Anand, H., Hagobian, T., Phillips, S., Phelan, S., Guastaferro, K., Seltzer, R., & Buman, M. (n.d.).

Journal title

International Journal of Behavioral Nutrition and Physical Activity

Abstract

Abstract

StandUPTV: Preparation and optimization phases of a mHealth intervention to reduce sedentary screen time in adults

Keadle, S., Hasanaj, K., Leonard-Corzo, K., Tolas, A., Crosley-Lyons, R., Pfisterer, B., Legato, M., Fernandez, A., Lowell, E., Hollingshead, K., Yu, T. Y., Phelan, S., Phillips, S. M., Watson, N., Hagobian, T., Guastaferro, K., & Buman, M. P. (n.d.).

Publication year

2024

Journal title

Contemporary Clinical Trials

Volume

136

10.1016/j.cct.2023.107402

Abstract

Abstract

Recreational sedentary screen time (rSST) is the most prevalent sedentary behavior for adults outside of work, school, and sleep, and is strongly linked to poor health. StandUPTV is a mHealth trial that uses the Multiphase Optimization Strategy (MOST) framework to develop and evaluate the efficacy of three theory-based strategies for reducing rSST among adults. This paper describes the preparation and optimization phases of StandUPTV within the MOST framework. We identified three candidate components based on previous literature: (a) rSST electronic lockout (LOCKOUT), which restricts rSST through electronic means; (b) adaptive prompts (TEXT), which provides adaptive prompts based on rSST behaviors; and (c) earning rSST through increased moderate-vigorous physical activity (MVPA) participation (EARN). We also describe the mHealth iterative design process and the selection of an optimization objective. Finally, we describe the protocol of the optimization randomized controlled trial using a 23 factorial experimental design. We will enroll 240 individuals aged 23–64 y who engage in >3 h/day of rSST. All participants will receive a target to reduce rSST by 50% and be randomized to one of 8 combinations representing all components and component levels: LOCKOUT (yes vs. no), TEXT (yes vs. no), and EARN (yes vs. no). Results will support the selection of the components for the intervention package that meet the optimization objective and are acceptable to participants. The optimized intervention will be tested in a future evaluation randomized trial to examine reductions in rSST on health outcomes among adults.

Strategic selection of experimental designs in community-based intervention development within the multiphase optimization strategy framework

O’Hara, K. L., Guastaferro, K., Hita, L., Rhodes, A., Thomas, N., Wolchik, S., & Berkel, C. (n.d.).

Publication year

2024

Journal title

Implementation Research & Practice

Volume

Abstract

Abstract

Preventing and treating mental health and substance use problems requires interventions that are effective, affordable, scalable, and efficient. The MOST framework guides researchers through a phased and systematic process of developing optimized interventions. However, new methods of systematically incorporating information about implementation constraints across MOST phases are needed. We propose that early and sustained integration of community-engaged methods within MOST is a promising strategy for enhancing an optimized intervention’s potential for implementation. In this paper, we outline the advantages of using community-engaged methods throughout the intervention optimization process, with a focus on the Preparation and Optimization Phases of MOST. We discuss the role of experimental designs in optimization research and highlight potential challenges in conducting rigorous experiments in community settings. We then demonstrate how relying on the resource management principle to select experimental designs across MOST phases is a promising strategy for maintaining both experimental rigor and community responsiveness. We end with an applied example that illustrates a community-engaged approach to optimize an intervention to reduce the risk for mental health problems and substance use problems among children with incarcerated parents.

Substance use and mental health outcomes during emerging adulthood among individuals with different patterns of child maltreatment

Guastaferro, K., & Bray, B. C. (n.d.).

Publication year

2020

Journal title

Emerging Adulthood

Volume

Issue

Page(s)

542-547

10.1177/2167696819830481

Abstract

Abstract

The aim of the current study was to identify patterns of child maltreatment experienced prior to age 18 and examine the relationship between those patterns and substance use and mental health disorders among emerging adults. Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. The analytic sample consisted of 5,194 adults between 18 and 25 years old. Latent class analysis revealed a three-class model: Rare Maltreatment (59%); Occasional Maltreatment, Rare Sexual Abuse (37%); and Frequent Maltreatment, Some Sexual Abuse (4%). Risk of substance use disorders and poor mental health was higher for the two classes who experienced maltreatment; however, those with Frequent Maltreatment had higher risk of poor mental health, but not substance use disorders compared to those with Occasional Maltreatment. Patterns of child maltreatment are important predictors of substance use and mental health disorders in emerging adulthood, but different patterns may necessitate specific intervention efforts.

Systematic braiding as an intervention strategy for families at high-risk: Results of a cluster randomized trial.

Guastaferro, K., Lai, B. S., Miller, K., & Lutzker, J. R. (n.d.).

Publication year

2017

Abstract

Abstract

Systematic braiding of 2 evidence-based parent training programs: Qualitative results from the pilot phase

Guastaferro, K., Miller, K., Shanley Chatham, J. R., Whitaker, D. J., McGilly, K., & Lutzker, J. R. (n.d.).

Publication year

2017

Journal title

Family and Community Health

Volume

Issue

Page(s)

88-97

10.1097/FCH.0000000000000129

Abstract

Abstract

An effective approach in early intervention for children and families, including child maltreatment prevention, is home-based services. Although several evidence-based programs exist, they are often grouped or delivered together, despite having different foci and approaches. This article describes the development and pilot phases of a trial evaluating the systematic braiding of 2 evidence-based home-based models, SafeCare and Parents as Teachers. We describe the methodology for braiding model implementation and curriculum, specifically focusing on how structured qualitative feedback from pilot families and providers was used to create the braided curriculum and implementation. Systematic braiding of 2 models at the implementation and curriculum levels is a mechanism that has the potential to meet the more comprehensive needs of families at risk for maltreatment.

Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure : findings from a pilot study

Self-Brown, S., Perry, E. W., Recinos, M., Cotner, M. A., Guastaferro, K., Owolabi, S., Spears, C. A., Whitaker, D. J., Huang, J., & Kegler, M. C. (n.d.).

Publication year

2023

Journal title

Pilot and Feasibility Studies

Volume

Issue

10.1186/s40814-023-01303-4

Abstract

Abstract

Background: Exposure to secondhand tobacco smoke (SHS) and child maltreatment are preventable threats to child health. Few evidence-based interventions target both SHS and child maltreatment risk. The purpose of this paper is to describe the systematic braiding process of two evidence-based programs to address child SHS in the home and maltreatment perpetration risk, and present results from the formative work and pilot study. Methods: The first 4 steps of the systematic braiding process were completed, including the following: (1) the identification of core elements of both programs, (2) the development of an initial draft of the braided curriculum (Smoke-Free Home SafeCare — SFH-SC), (3) an acceptability and feasibility pilot of SFH-SC with caregivers of young children who reported a smoker living in the home (N = 8), and (4) feedback collection on the braided curriculum from SafeCare Providers (N = 9). Results: Experts identified common pedagogical and theoretical underpinnings for the two programs and braided Smoke-Free Homes: Some Things Are Better Outside into two SafeCare modules. Caregiver feedback from the pilot demonstrated that participants were engaged with SFH-SC and felt supported and comfortable discussing SHS intervention content with the SFH-SC Provider. Caregiver self-reports indicated a slight increase in smoke-free home rules from baseline to follow-up and a notable reduction in parent stress on the Parent Stress Index of 5.9 points (SD = 10.2). SafeCare Provider feedback following intensive review of the curriculum indicated high feasibility for SFH-SC delivery. Conclusions: Parent and Provider findings suggest SFH-SC is a viable intervention that has potential to reduce the public health impact of SHS and child maltreatment for at-risk families. Protocol: The protocol for the pilot is not published elsewhere; however, the full protocol for the hybrid trial can be found here: https://clinicaltrials.gov/ct2/show/NCT05000632 . Trial registration: NCT, NCT05000632. Registered 14 July 2021, there is not a separate registration number for the pilot.

Systematic braiding: An approach to meeting the needs of families enrolled in a home visiting program

Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

Systematic Braiding: An Approach to Meeting the Needs of Families Enrolled in a Home Visiting Program

Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

Paper symposium: "Systematic Braiding- an Innovative and Collaborative Methodology to Develop Integrated Evidence-Based Prevention Programs"

Taking a school-based child sexual abuse prevention program to scale: A cost analysis

Shipe, S. L., Guastaferro, K., Noll, J. G., Connell, C. M., Morgan, P. L., & Crowley, D. M. (n.d.).

Publication year

2022

Journal title

Prevention Science

Volume

Issue

Page(s)

1394-1403

10.1007/s11121-022-01401-4

Abstract

Abstract

Cost 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.

Teaching young mothers to identify developmental milestones

Guastaferro, K., Guastaferro, K. M., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., & Crimmins, D. B. (n.d.).

Publication year

2013

Journal title

International Journal of Child Health and Human Development

Volume

Issue

Page(s)

223-233

Abstract

Abstract

Early identification of a developmental delay may allow for early intervention, a strategy shown to improve child outcomes. Often, pediatricians rely on parent observations to share concerns about development. The purpose of this research was to examine whether a combination of line-art drawings and discussion framed within SafeCare® increases a mothers' identification of developmental milestones. Thus, we examined the tDevelop, a tool designed to increase parent identification of developmental milestones and ageappropriate activities. Two high-risk families with children approximately 24-months of age were recruited from a residential program for young mothers. The mothers were presented with the tDevelop along with standard SafeCare® Parent-Child Interaction (PCI) information, including Planned Activities Training and age-appropriate activities. Data from a multiple-probe, single-case experimental design, suggest that mothers are able to recognize developmental milestones with increased accuracy upon intervention with the tDevelop. The enhanced PCI protocol may enhance parental identification of developmental milestones and may have significant implications for the early identification of developmental delays.

The Behaviour Change Taxonomy and the Multiphase Optimization Strategy: How do they work together?

Marchese, S. H., Pfammatter, A., Guastaferro, K., Spring, B. J., & Michie, S. (n.d.).

Publication year

2020

Abstract

Abstract

The development of effective and tailored digital behavior change interventions: An introduction to the multiphase optimization strategy (MOST)

Guastaferro, K. (n.d.).

Publication year

2022

Journal title

The European Health Psychologist

Volume

Issue

Page(s)

793-800

Abstract

Abstract

The Effect of Parent-Infant Interaction Training on Maternal Utterances: Language Environment Analysis Opportunities and Implications

Guastaferro, K. (n.d.).

Publication year

2014

Abstract

Abstract

The effect of substantiated and unsubstantiated investigations of child maltreatment and subsequent adolescent health

Kugler, K. C., Guastaferro, K., Shenk, C. E., Beal, S. J., Zadzora, K. M., & Noll, J. G. (n.d.).

Publication year

2019

Journal title

Child Abuse and Neglect

Volume

Page(s)

112-119

10.1016/j.chiabu.2018.06.005

Abstract

Abstract

Children with substantiated child maltreatment (CM) experience adverse health outcomes. However, it is unclear whether substantiation vs. an investigation not resulting in substantiation has a greater impact on subsequent adolescent health. Propensity scores were used to examine the effect of investigated reports on the subsequent health of 503 adolescent females. CM was categorized into three levels: 1) investigated and substantiated, 2) investigated but unsubstantiated, and 3) no investigation. Models using inverse propensity score weights estimated the effect of an investigation on subsequent teen motherhood, HIV-risk behaviors, drug use, and depressive symptoms. Females with any investigation, regardless of substantiation status, were more likely to become teen mothers, engage in HIV-risk behaviors, and use drugs compared to females with no investigated report. Substantiated CM was associated with depressive symptoms. Findings underscore the importance of maintaining case records, regardless of substantiation, to better serve adolescents at risk for deleterious outcomes. Prospective methods and propensity scores bolster causal inference and highlight how interventions implemented following investigation are an important prevention opportunity.

The Essential Activities of the Preparation Phase: Examples of Projects using MOST.

Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

The Evaluation and Dissemination of Parents as Teachers (PAT) + SafeCare® to Improve Outcomes for High-Risk Families.

Lutzker, J. R., Guastaferro, K., & Graham, M. L. (n.d.).

Publication year

2014

Abstract

Abstract

Kate Guastaferro