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
The Evaluation of Parents as Teachers (PAT) + SafeCare to Improve Outcomes for High-Risk Families.
AbstractLutzker, J. R., Miller, K., & Guastaferro, K. (n.d.).Publication year
2016Abstract~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.The multiphase optimization strategy (MOST): Practicalities of an optimization study.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~The multiphase optimization strategy for developing and evaluating behavioral interventions
AbstractGuastaferro, K., Shenk, C. E., & Collins, L. (n.d.).Publication year
2020Page(s)
267-278AbstractThis chapter introduces the multiphase optimization strategy (MOST), an engineering-inspired framework for optimizing multicomponent behavioral interventions. The chapter contrasts the typical development of interventions with the MOST framework and discusses the potential to achieve steady, systematic progress in intervention science. In contrast to the typical development of a multicomponent intervention wherein the intervention is tested en bloc via a randomized controlled trial (RCT), MOST introduces a phase of optimization prior to the RCT wherein the effect of individual components and the interaction between components is empirically tested. The objective of MOST is to arrive at an optimized intervention that is highly effective, but also efficient, economical, and scalable. This chapter provides an overview of the MOST framework and demonstrates its application using a hypothetical example of the optimization of a clinical intervention targeting posttraumatic stress disorder symptoms among children who have experienced maltreatment.The multiphase optimization strategy for developing and evaluating psychological interventions
AbstractGuastaferro, K., Shenk, C. E., & Collins, L. (n.d.).Publication year
2020Page(s)
267-278Abstract~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.The ROOTS Parenting Intervention to Improve Child Emotional and Physical Health: Protocol For A Pilot Randomized Controlled Trial For Black And Latiné Families
AbstractCooper, D. K., Lupini, F., Alonzo, J., Beets, M., Guastaferro, K., McLain, A. C., Saini, S., & Prinz, R. (n.d.).Journal title
Journal of Marital and Family TherapyAbstract~The Safe and Healthy Communities Initiative: A Comprehensive Sexual Abuse Prevention Strategy.
AbstractGuastaferro, K. (n.d.).Publication year
2019Abstract~The Why and How of Intervention Optimization: Examples of Projects using the Multiphase Optimization Strategy (MOST).
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~Theatre testing a sexual and reproductive health program for Latina teens and their female caregivers: A mixed methods study.
AbstractMerrill, K. G., Silva, J., Atadero, J., Hung, I. L., Salgado, S., Cano, J. K., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., Baumann, A., Fuentes, J., Rodriguez, L., & Donenberg, G. (n.d.).Journal title
BMC Public HealthAbstract~Theory-based approach to increasing enrollment in a universal parent-focused child sexual abuse prevention workshop
AbstractGuastaferro, K., Myrick, J. G., & Abourjaily, E. (n.d.).Journal title
Health Promotion PracticeAbstract~Training mothers recoving from substance abuse to identify and treat their children's illnesses
AbstractGuastaferro, K., Strong, L. E., Lutzker, J. R., Jabaley, J. J., Shanley, J. R., Self-Brown, S., & Guastaferro, K. M. (n.d.).Publication year
2016Journal title
International Journal on Child Health and Human DevelopmentVolume
7Issue
2Page(s)
156-166AbstractParents with a history of substance abuse are at high-risk for child maltreatment, including the neglect of their child’s health (medical neglect). Additionally, these parents are likely to have low health literacy levels, possibly further jeopardizing risk to their child’s health. This research examined the effectiveness of the SafeCare® Health Module for mothers in a residential recovery facility. Two mothers with children under age five were trained to 1) identify child health symptoms and illnesses and 2) to determine the most appropriate course of care. Using a multiple-baseline, single-case research design, mothers were evaluated in their ability to select the most appropriate care setting using decision-making behaviors in response to a prompted child health scenario. The mothers showed steady improvement in skill acquisition. Future research directions and intervention implementation implications are discussed.Universal parent-focused child sexual abuse prevention : A quasi-experimental protocol
AbstractAbourjaily, E. L., Guastaferro, K., McElwee, K., & Connell, C. M. (n.d.).Publication year
2025Journal title
PloS oneVolume
20Issue
1AbstractBackground Child sexual abuse (CSA) is a significant public health concern, and there is a lack of universal, evidence-based primary prevention interventions that extend beyond a focus solely on children. Parents remain a consistently underutilized target for primary prevention efforts aimed at mitigating CSA despite their unique relationship and close proximity to their children. CSA risk is not confined to any specific demographic, and its effects on affected children are well-documented, significantly impacting numerous dimensions of their wellbeing. Thus, there is a clear and urgent need to address this gap in prevention strategies. Methods This study will use a quasi-experimental design (target N = 412) to examine potential gains in CSA-related awareness and intentions to use protective behaviors among parents who participate in a universal parent-focused CSA prevention workshop, Smarter Parents. Safer Kids., compared to those who do not. Participants in both the control (n = 206) and experimental group (n = 206) will complete 3 survey assessments: Survey 0 (baseline), Survey 1 (1-month), and Survey 2 (3-month follow-up). The experimental group will participate in a Smarter Parents. Safer Kids. workshop between the Surveys 0 and 1. We will use data collected from the baseline to measure potential mediators of CSA-related awareness and intention to use protective and preventive behaviors. In adjacent efforts to enhance the curriculum’s reach with future dissemination and implementation, we will also explore the impact of recruitment materials and strategies on parental engagement. Conclusion Results of this study will advance efforts to implement parent-focused CSA prevention with a universal audience.Use of mobile phones to help prevent child maltreatment
AbstractGuastaferro, K., Jackson, M. C., Self-Brown, S., Jabaley, J., & Lutzker, J. R. (n.d.).Publication year
2015Abstract~Using a technological augmentation to enhance parent-infant interactions with parents at risk
AbstractGuastaferro, K., Guastaferro, K. M., Lutzker, J. R., & Graham, M. L. (n.d.).Publication year
2016Journal title
Child and Family Behavior TherapyVolume
38Issue
1Page(s)
15-31AbstractEffective parent training programs may need to be tailored for at-risk parents by using simple language, presenting concrete concepts, and simple technologies. We present four single-case research-design studies examining if the use of digital frames enhances parent-infant interactions with a diverse range of mothers with varied levels of risk for maltreatment. Based on self-modeling, the frames contain photographs of mother-infant dyads in posed interactions representing desired criterion behaviors from the parent-infant interaction (PII) module of SafeCare®. Results indicate that the use of inexpensive digital frames appears to enhance already good outcomes of the SafeCare PII module.Using digital picture frame technology as an enhancement to the parent-infant interaction module of SafeCare®.
AbstractGuastaferro, K., Graham, M. L., & Lutzker, J. R. (n.d.).Publication year
2013Abstract~Using Failure Modes and Effects Analysis (FMEA) to Evaluate the Implementation of an Optimized Family Navigation Intervention
AbstractMenon, N., Bernard, E. C., Much-Hichos, M., Molina, J., Rubin, D., Guastaferro, K., & Feinberg, E. (n.d.).Publication year
2024AbstractIntroduction: Family Navigation (FN), an evidence-based care management strategy, has proven effective in reducing disparities in accessing care. However, few studies have examined the implementation of FN with respect to efficiency, cost, and impact on inequities in healthcare access. We conducted a randomized 24 factorial trial using a multiphase optimization strategy (MOST) to optimize the delivery of FN. Trained Family Partners (FP) delivered FN in a Federally Qualified Health Center with the goal of increasing access to child behavioral health services for children ages 6-12. Children (N=355) were randomized into 1 of 16 possible combinations of FN delivery strategies and worked with their FP for 6 months. Methods: We created a process map depicting study workflow from initial referral to study end. Using the diagram, the study team and health center staff conducted a Failure Modes and Effects Analysis (FMEA), a systematic and structured method of identifying possible failures of a design. Team members scored each failure on a scale of 1-10 in terms of severity, occurrence, and detection. The scores were multiplied together to create a Risk Priority Number (RPN). We identified failures with the highest RPNs and examined scores stratified by study role. Results: After analyzing RPNs, the team identified 3 main areas of failure: the impact of COVID, the intervention timeline, and stigma. COVID prevented FPs from conducting home visits. This change impacted the implementation of the clinic vs. community-based delivery strategy, one of the conditions to which families were randomized. This failure had the highest average RPN (277.8). COVID-related priorities (average RPN 271.4) often superseded the completion of recordings of family interactions, hindering our ability to analyze fidelity to the intervention. The 6-month implementation period was unrealistic (average RPN 256.8). Many families could not complete goals within 6 months due to school schedules and COVID’s effect on services. Stigma impacted family engagement. The failure "Participants may have different answers when aware they are being recorded” had an average RPN of 269.5. "Participants fear or are ashamed of asking for help” had an average RPN of 266. We found variations in how study staff ranked failures. Investigators, research assistants, and clinicians consistently ranked failures pertaining to RA errors higher than FPs. Stratification by role revealed that FPs placed more emphasis on completing goals within the 6-month timeframe. Conclusion: Our FMEA was a collaborative process that identified implementation failures, which differed based on study role. Team members with patient-facing roles may offer important insight into the feasibility of the proposed intervention.Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.
AbstractMerrill, K. G., Silva, J., Sedeno, A., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2023Abstract~Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.
AbstractMerrill, K. G., Silva, J., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2024Abstract~Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.
AbstractMerrill, K. G., Silva, J., Sedeno, A., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2024Abstract~Using MOST to develop an optimized online STI preventive intervention aimed at college students: Description of conceptual model and iterative approach to optimization
AbstractKugler, K. C., Wyrick, D. L., Tanner, A. E., Milroy, J. J., Chambers, B. D., Ma, A., Guastaferro, K., & Collins, L. (n.d.). (L. M. C. & & K. C. Kugler, Eds.).Publication year
2018Abstract~Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to adapt a sexual and reproductive health intervention for Latina teens and female caregivers.
AbstractMerrill, K. G., Silva, J., Fuentes, J., Sedeno, A., Salgado, S., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2023Abstract~Using the Multiphase Optimization Strategy for Developing, Optimizing, and Evaluating Multicomponent Interventions.
AbstractGuastaferro, K. (n.d.).Publication year
2020Abstract~Utilizing systematic braiding to address public health priorities for young children: Development, feasibility, and implementation of the Smoke-Free Home SafeCare prevention program presented in Systematic Braiding – An innovative and collaborative methodology to develop integrated evidence-based programs
AbstractSelf-Brown, S., Perry, E. W., Recinos, M., Whitaker, D. J., Guastaferro, K., & Kegler, M. (n.d.).Publication year
2024Abstract~