Linda Collins
Linda Collins
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Professor of Social and Behavioral Sciences
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Professional overview
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Linda M. Collins is Professor of Global Public Health in the Department of Social and Behavioral Sciences, with a secondary appointment in the Department of Biostatistics. She earned her B.A. in Psychology at the University of Connecticut and her Ph.D. in Quantitative Psychology at the University of Southern California.
Collins’ research interests are focused on the development, dissemination, and application of the multiphase optimization strategy (MOST), a framework for the optimization of behavioral, biobehavioral, and social-structural interventions. The objective of MOST is to improve intervention effectiveness, efficiency, economy, and scalability. She is currently collaborating on research applying MOST in the areas of smoking cessation, the prevention of excessive drinking and risky sex in college students, and HIV services.
Collins’ research has been funded by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Science Foundation, among others. She has given more than 150 presentations on MOST around the world, and her publications have appeared in journals in the fields of behavioral science, quantitative methodology, medicine, and engineering.
Collins has held tenured faculty positions at the University of Southern California and at Penn State University, where she was Distinguished Professor of Human Development and Family Studies and Director of The Methodology Center. She is a Fellow of the American Psychological Association, the Association for Psychological Science, the Society of Behavioral Medicine, and is a past president of the Society of Multivariate Experimental Psychology and the Society for Prevention Research.
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Education
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BA, Psychology, University of Connecticut, Storrs, CTPhD, Quantitative Psychology, University of Southern California, Los Angeles, CA
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Honors and awards
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Fulbright Specialist, National University of Ireland Galway (2018)Pauline Schmitt Russell Distinguished Career Award, Pennsylvania State University’s College of Health and Human Development (2017)Evan G. and Helen G. Pattishall Outstanding Research Achievement Award, Pennsylvania State University’s College of Health and Human Development (2011)President’s Award, Society for Prevention Research (2004)Faculty Scholar Medal for the Social and Behavioral Sciences, Pennsylvania State University (2000)Psychology Department Teacher of the Year, University of Southern California (1992)Psychology Department Mentorship Award, University of Southern California (1991)Society of Multivariate Experimental Psychology Award for Distinguished Early Career Contributions to Multivariate Behavioral Research (1991)
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Areas of research and study
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Behavioral ScienceCost EffectivenessCost-effective Health Programs and PoliciesDissemination and Implementation of Evidence-based Programs
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Publications
Publications
Advancing behavioral interventions for African American/Black and Latino persons living with HIV using a new conceptual model that integrates critical race theory, harm reduction, and self-determination theory : a qualitative exploratory study
AbstractGwadz, M., Cluesman, S. R., Freeman, R., Collins, L., Dorsen, C., Hawkins, R. L., Cleland, C. M., Wilton, L., Ritchie, A. S., Torbjornsen, K., Leonard, N. R., Martinez, B. Y., Silverman, E., Israel, K., & Kutnick, A. (n.d.).Publication year
2022Journal title
International Journal for Equity in HealthVolume
21Issue
1AbstractBackground: Rates of participation in HIV care, medication uptake, and viral suppression are improving among persons living with HIV (PLWH) in the United States. Yet, disparities among African American/Black and Latino PLWH are persistent, signaling the need for new conceptual approaches. To address gaps in services and research (e.g., insufficient attention to structural/systemic factors, inadequate harm reduction services and autonomy support) and improve behavioral interventions, we integrated critical race theory, harm reduction, and self-determination theory into a new conceptual model, then used the model to develop a set of six intervention components which were tested in a larger study. The present qualitative study explores participants’ perspectives on the study’s acceptability, feasibility, and impact, and the conceptual model’s contribution to these experiences. Methods: Participants in the larger study were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City (N = 512). We randomly selected N = 46 for in-depth semi-structured interviews on their experiences with and perspectives on the study. Interviews were audio-recorded and professionally transcribed verbatim, and data were analyzed using directed qualitative content analysis. Results: On average, participants were 49 years old (SD = 9) and had lived with HIV for 19 years (SD = 7). Most were male (78%) and African American/Black (76%). All had taken HIV medication previously. Challenging life contexts were the norm, including poverty, poor quality/unstable housing, trauma histories exacerbated by current trauma, health comorbidities, and substance use. Participants found the study highly acceptable. We organized results into four themes focused on participants’ experiences of: 1) being understood as a whole person and in their structural/systemic context; 2) trustworthiness and trust; 3) opportunities for self-reflection; and 4) support of personal autonomy. The salience of nonjudgment was prominent in each theme. Themes reflected grounding in the conceptual model. Participants reported these characteristics were lacking in HIV care settings. Conclusions: The new conceptual model emphasizes the salience of systemic/structural and social factors that drive health behavior and the resultant interventions foster trust, self-reflection, engagement, and behavior change. The model has potential to enhance intervention acceptability, feasibility, and effectiveness with African American/Black and Latino PLWH.Advancing Models and Theories for Digital Behavior Change Interventions
AbstractHekler, E. B., Michie, S., Pavel, M., Rivera, D. E., Collins, L., Jimison, H. B., Garnett, C., Parral, S., & Spruijt-Metz, D. (n.d.).Publication year
2016Journal title
American journal of preventive medicineVolume
51Issue
5Page(s)
825-832AbstractTo be suitable for informing digital behavior change interventions, theories and models of behavior change need to capture individual variation and changes over time. The aim of this paper is to provide recommendations for development of models and theories that are informed by, and can inform, digital behavior change interventions based on discussions by international experts, including behavioral, computer, and health scientists and engineers. The proposed framework stipulates the use of a state-space representation to define when, where, for whom, and in what state for that person, an intervention will produce a targeted effect. The “state” is that of the individual based on multiple variables that define the “space” when a mechanism of action may produce the effect. A state-space representation can be used to help guide theorizing and identify crossdisciplinary methodologic strategies for improving measurement, experimental design, and analysis that can feasibly match the complexity of real-world behavior change via digital behavior change interventions.African American/Black and Latino Adults with Detectable HIV Viral Load Evidence Substantial Risk for Polysubstance Substance Use and Co-occurring Problems : A Latent Class Analysis
AbstractCleland, C. M., Gwadz, M., Collins, L., Wilton, L., Sherpa, D., Dorsen, C., Leonard, N. R., Cluesman, S. R., Martinez, B. Y., Ritchie, A. S., & Ayvazyan, M. (n.d.).Publication year
2021Journal title
AIDS and BehaviorVolume
25Issue
8Page(s)
2501-2516AbstractSubstance use problems are highly prevalent among persons living with (PLWH) in the United States and serve as serious barriers to engagement in HIV care. Yet, in contrast to studies of single substances, little is known about patterns of polysubstance use in this population. Moreover, other risk factors (e.g., financial hardship, incarceration, homelessness, and mental health distress) are also prevalent and complicate HIV management. The present study drew on a cross-sectional survey with African American/Black and Latino (AABL) adult PLWH from low socioeconomic status backgrounds in New York City who were insufficiently engaged in HIV care and evidenced detectable HIV viral load (N = 512). We used latent class analysis (LCA) to explore patterns of polysubstance use and their relationships to financial hardship, incarceration, homelessness, and mental health. LCA yielded three substance use classes: Class 1, a high polysubstance use/high-risk substance use class (9%); Class 2, a polysubstance use/moderate substance use risk class (18%); and Class 3, a moderate polysubstance use/moderate-to-low-risk substance use class (74%). Mental health symptoms were prevalent in all classes, but Class 1 had greater mental health distress than the other two classes. Current homelessness was more prevalent in Classes 1 and 2. We cannot end the HIV epidemic without engaging and treating AABL PLWH who have serious barriers to engagement along the HIV care continuum, and who evidence polysubstance use along with co-occurring risk factors. Clinical settings can develop outreach and engagement approaches to bring this subpopulation of PLWH into care settings, and further, specialized services are needed to successfully screen, treat, and retain them.Agreement Between Retrospective Accounts of Substance Use and Earlier Reported Substance Use
AbstractCollins, L., Graham, J. W., Hansen, W. B., & Johnson, C. A. (n.d.).Publication year
1985Journal title
Applied Psychological MeasurementVolume
9Issue
3Page(s)
301-309AbstractThis present study examined agreement between retrospective accounts of substance use and earlier re ported substance use in a high school age sample. Three issues were addressed: (1) extent of overall agreement; (2) evidence for the presence of a response-shift bias; and (3) extent to which current use biases recall of substance use. Subjects were 415 high school students who took part in a smoking prevention program. At the last measurement, which took place 2½ years after the pretest, the students were asked to recall pretest use of tobacco, alcohol, and marijuana, and use one year earlier. Results showed an overall tendency for students to recall less use of uncontrolled substances than had been previously reported. For the one controlled substance included in the questionnaire, marijuana, current nonusers tended to recall less use than they had reported at the time, whereas current users tended to recall more use than had been re ported. The present study found no evidence for a response-shift bias. It is suggested that the explicitly worded anchors on the response scales helped prevent such a bias. Finally, the results suggest that current use biases recall of past use to a substantial extent, and that this bias affects recall of alcohol use most se verely.An alternative framework for defining mediation
AbstractCollins, L., Graham, J. W., & Flaherty, B. P. (n.d.).Publication year
1998Journal title
Multivariate Behavioral ResearchVolume
33Issue
2Page(s)
295-312AbstractThe present article provides an alternative framework for evaluating mediated relationships. From this perspective, a mediated process is a chain reaction, beginning with an independent variable that affects a mediator that in turn affects an outcome. The definition of mediation offered here, presented for stage sequences, states three conditions for establishing mediation: (a) the independent variable affects the probability of the sequence no mediator to mediator to outcome; (b) the independent variable affects the probability of a transition into the mediator stage; (c) the mediator affects the probability of a transition into the outcome stage at every level of the independent variable. This definition of mediation is compared and contrasted with the well-known definition of mediation for continuous variables discussed in Baron and Kenny (1986), Judd and Kenny (1981), and Kenny, Kashy, and Bolger (1997). The definition presented in this article emphasizes the intraindividual, time-ordered nature of mediation.An optimization randomized clinical trial to identify an effective, efficient smoking cessation intervention in the context of lung cancer screening: Cessation and Screening to Save Lives (CASTL)
AbstractOstroff, J. S., Shelley, D., Chichester, L. R., Schofield, E., Li, Y., Collins, L., Elkin, E. B., Strayhorn, J. C., Cuipek, A., King, J. C., & Criswell, A. (n.d.).Journal title
ChestAbstract~An Ordinal I Scaling Method for Questionnaire and Other Ordinal I Data
AbstractCliff, N., Collins, L., Zatkin, J., Gallipeau, D., & McCormick, D. J. (n.d.).Publication year
1988Journal title
Applied Psychological MeasurementVolume
12Issue
1Page(s)
83-97AbstractThis paper reports the development and application of a method for ordering persons and items (or stim uli) when responses are ordinal. The method applies most directly to data where responses are dichoto mous, indicating agreement or acceptableness or simi larity, and can be assumed to reflect proximity rather than dominance. It orders rows and columns of the re sponse matrix into “parallelogram” form, using pair- wise interchange procedures, followed by other steps. The method was applied to several sets of question naire data and one set of archeological data, with rea sonable success. Other applications and extensions are suggested. Index terms: Dichotomous responses, Interchange methods, Ordinal scaling, Parallelogram scaling, Proximity data, Questionnaire responses.An Overview of Research and Evaluation Designs for Dissemination and Implementation
AbstractBrown, C. H., Curran, G., Palinkas, L. A., Aarons, G. A., Wells, K. B., Jones, L., Collins, L., Duan, N., Mittman, B. S., Wallace, A., Tabak, R. G., Ducharme, L., Chambers, D. A., Neta, G., Wiley, T., Landsverk, J., Cheung, K., & Cruden, G. (n.d.).Publication year
2017Journal title
Annual Review of Public HealthVolume
38Page(s)
1-22AbstractThe wide variety of dissemination and implementation designs now being used to evaluate and improve health systems and outcomes warrants review of the scope, features, and limitations of these designs. This article is one product of a design workgroup that was formed in 2013 by the National Institutes of Health to address dissemination and implementation research, and whose members represented diverse methodologic backgrounds, content focus areas, and health sectors. These experts integrated their collective knowledge on dissemination and implementation designs with searches of published evaluations strategies. This article emphasizes randomized and nonrandomized designs for the traditional translational research continuum or pipeline, which builds on existing efficacy and effectiveness trials to examine how one or more evidence-based clinicalprevention interventions are adopted, scaled up, and sustained in community or service delivery systems. We also mention other designs, including hybrid designs that combine effectiveness and implementation research, quality improvement designs for local knowledge, and designs that use simulation modeling.Analysis of longitudinal data : The integration of theoretical model, temporal design, and statistical model
AbstractCollins, L. (n.d.).Publication year
2006Journal title
Annual review of psychologyVolume
57Page(s)
505-528AbstractThis article argues that ideal longitudinal research is characterized by the seamless integration of three elements: (a) a well-articulated theoretical model of change observed using (b) a temporal design that affords a clear and detailed view of the process, with the resulting data analyzed by means of (c) a statistical model that is an operationalization of the theoretical model. Two general varieties of theoretical models are considered: models in which the time-related change of primary interest is continuous, and those in which it is characterized by movement between discrete states. In addition, two general types of temporal designs are considered: the longitudinal panel design and the intensive longitudinal design. For each general category of theoretical models, some of the analytic possibilities available for longitudinal panel designs and for intensive longitudinal designs are discussed. The article concludes with brief discussions of two issues particularly relevant to longitudinal research-missing data and measurement-and a few words about exploratory research.Analysis of stage-sequential change in rehabilitation research
AbstractCollins, L., Collins, L. M., & Johnston, M. V. (n.d.).Publication year
1995Journal title
American Journal of Physical Medicine and RehabilitationVolume
74Issue
2Page(s)
163-170AbstractThe analysis of change is a critical topic for rehabilitation outcomes research, because the goal of rehabilitation is to improve patients' function. This article will sketch the issues and problems in statistical methods for analysis of change. Recovery after serious illness or injury often has been described in terms of transitions between a series of stages, but these theories of recovery have rarely been subjected to adequate statistical examination. This article presents two methods for the analysis of change, suitable for ordinal measures of function and for testing either simple cumulative or complex multipath stage-models of recovery. Progress in medical rehabilitation will be enhanced by explicitly specifying models of recovery, measuring recovery at multiple time points, and using the resulting data to test these models empirically.Analyzing the acquisition of drug self-administration using growth curve models
AbstractLanza, S. T., Donny, E. C., Collins, L., & Balster, R. L. (n.d.).Publication year
2004Journal title
Drug and alcohol dependenceVolume
75Issue
1Page(s)
11-21AbstractCurrent approaches to studying acquisition of drug self-administration have modest power to detect individual differences in the pattern of acquisition or to efficiently and accurately describe trajectories of behavior change. Methodological advances in human research have elucidated approaches to describing repeated measure data that focus on modeling the behavior of individual subjects. In this article, we re-analyzed data published in [Psychopharmacology 136 (1998) 83] using growth curve modeling to characterize the acquisition of nicotine-taking in rats. Change over time in the infusion rate was examined, revealing that the acquisition process could be described with a quadratic equation represented by intercept, slope, and acceleration parameters. Unit dose of nicotine, sex and fixed ratio (FR) schedule of reinforcement had significant effects on the acquisition curves. Dose altered the absolute rate of infusions, but not the slope or acceleration, indicating that, when an effective dose was available, the shape of acquisition trajectories was not affected by dose. In addition, dose impacted acquisition by moderating the disruption in infusion rates after an increase in the response requirement. Thus, the role of a higher dose may not be to accelerate the acquisition process but to lead to behavior that is more resistant to change. Trajectories differed between males and females at the smallest dose, but these differences dissipated by the end of acquisition. Growth curve modeling captures the process of acquisition of drug self-administration and facilitates a greater understanding of the individual differences in change in drug-taking behavior over time.Application of the multiphase optimisation strategy (MOST) to optimise HIV prevention targeting people on medication for opioid use disorder (MOUD) who have cognitive dysfunction : protocol for a MOST study
AbstractMistler, C. B., Shrestha, R., Gunstad, J., Collins, L., Madden, L., Huedo-Medina, T., Sibilio, B., Copenhaver, N. M., & Copenhaver, M. (n.d.).Publication year
2023Journal title
BMJ openVolume
13Issue
6AbstractIntroduction People who inject drugs (PWID) have remained a contributor to the consistent HIV incidence rates in the US for decades. Pre-exposure prophylaxis (PrEP) is a promising biomedical intervention for HIV prevention among individuals at risk for HIV infection, including PWID. However, PWID report the lowest rates of PrEP uptake and adherence among at-risk groups. Tailored HIV prevention interventions must include strategies that compensate for cognitive dysfunction among PWID. Methods and analysis Using the multiphase optimisation strategy, we will be conducting a 16-condition factorial experiment to investigate the effects of four different accommodation strategy components to compensate for cognitive dysfunction among 256 PWID on medication for opioid use disorder. This innovative approach will inform optimisation of a highly effective intervention to enhance PWID's ability to process and utilise HIV prevention content to improve PrEP adherence and HIV risk reduction in a drug treatment setting. Ethics and dissemination The institutional review board at the University of Connecticut approved this protocol (H22-0122) with an institutional reliance agreement with APT Foundation Inc. All participants are required to sign an informed consent form prior to engaging in any study protocols. The results of this study will be disseminated on national and international platforms through presentations at major conferences and journals. Trial registration number NCT05669534.Are behaviour change techniques and intervention features associated with effectiveness of digital cardiac rehabilitation programmes? A systematic review protocol
AbstractKenny, E., McEvoy, J. W., McSharry, J., Collins, L., Taylor, R. S., & Byrne, M. (n.d.).Publication year
2021Journal title
HRB Open ResearchVolume
4AbstractBackground: Cardiovascular disease (CVD) is the leading cause of death worldwide. Cardiac rehabilitation (CR) is a complex intervention that aims to stabilise, slow, or reverse the progression of CVD and improve patients’ functional status and quality of life. Digitally delivered CR has been shown to be effective and can overcome many of the access barriers associated with traditional centre-based delivered CR programmes. However, there is a limited understanding of the behaviour change techniques (BCTs) and intervention features that maximise the effectiveness of digital programmes. Therefore, this systematic review will aim to identify the BCTs that have been used in digital CR programmes and to determine which BCTs and intervention features are associated with programme effectiveness. Methods: PubMed, MEDLINE (Ovid), EMBASE, CINHAL, PsycINFO and Cochrane Central Register of Controlled Trials will be searched from inception to June 2021 for randomised controlled trials of digital CR with CVD patients. Screening, data extraction, intervention coding and risk of bias will be performed by one reviewer with a second reviewer independently verifying a random 20% of the articles. Intervention content will be coded using the behaviour change technique taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) checklist and intervention features will be identified. A meta-analysis will be conducted to calculate the pooled effect size of each outcome, and meta-regression analyses will investigate whether intervention features and the presence and absence of individual BCTs in interventions are associated with intervention effectiveness. Discussion: The review will identify BCTs and intervention features that are associated with digital CR programmes and adopt a systematic approach to describe the content of these programmes using the BCT taxonomy (v1) and TIDieR checklist. The results will provide key insights into the content and design of successful digital CR programmes, providing a foundation for further development, testing and refinement.Attrition in prevention research
AbstractHansen, W. B., Collins, L., Malotte, C. K., Johnson, C. A., & Fielding, J. E. (n.d.).Publication year
1985Journal title
Journal of Behavioral MedicineVolume
8Issue
3Page(s)
261-275AbstractSelective attrition can detract from the internal and external validity of longitudinal research. Four tests of selective attrition applicable to longitudinal prevention research were conducted on data bases from two recent studies. These tests assessed (1) differences between dropouts and stayers in terms of pretest indices of primary outcome variables (substance use), (2) differences in change scores for dropouts and stayers, (3) differences in rates of attrition among experimental conditions, and (4) differences in pretest indices for dropouts among conditions. Results of these analyses indicate that cigarette smokers, alcohol drinkers, and marijuana users are more likely to drop out than nonusers, limiting the external validity of both studies. For one project, differential rates of attrition among conditions suggested a possible attrition artifact which will interfere with interpretation of outcome results, possibly masking true program effectiveness. Recommendations for standardizing reports of attrition and for avoiding attrition through second efforts are made.Axiomatic foundations of a three-set guttman simplex model with applicability to longitudinal data
AbstractCollins, L., & Cliff, N. (n.d.).Publication year
1985Journal title
PsychometrikaVolume
50Issue
2Page(s)
147-158AbstractIn this paper the usual two-set Guttman simplex model is extended to three sets. The axiomatic foundations of this extention are presented. Two cases are discussed. In Case 1 there is a three-set joint order, while in Case 2 there is a two-set joint order consistent across all levels of the third set. Case 2 represents the first clear formulation of a longitudinal developmental scale. The model is discussed in terms of its most straightforward application, longitudinal developmental data, and in terms of other possible applications.BINCLUS : Nonhierarchical Clustering of Binary Data
AbstractCliff, N., McCormick, D. J., Zatkin, J. L., Cudeck, R. A., & Collins, L. (n.d.).Publication year
1986Journal title
Multivariate Behavioral ResearchVolume
21Issue
2Page(s)
201-227AbstractBINCLUS is a clustering procedure designed for aggregating binary variables into relatively homogenous clusters. It uses any of several indices of binary association and operates by a variation on the “average linkage principle. It was tried out on a number of sets of artificial data and found to be extremely successful. With real data, where clusters are typically less clearly defined, two modifications were useful in clarifying the results. Results of using BINCLUS with two sets of real data are given.Black and Latino Persons Living with HIV Evidence Risk and Resilience in the Context of COVID-19 : A Mixed-Methods Study of the Early Phase of the Pandemic
AbstractGwadz, M., Campos, S., Freeman, R., Cleland, C. M., Wilton, L., Sherpa, D., Ritchie, A. S., Hawkins, R. L., Allen, J. Y., Martinez, B. Y., Dorsen, C., Collins, L., Hroncich, T., Cluesman, S. R., & Leonard, N. R. (n.d.).Publication year
2021Journal title
AIDS and BehaviorVolume
25Issue
5Page(s)
1340-1360AbstractThe COVID-19 pandemic has great potential to disrupt the lives of persons living with HIV (PLWH). The present convergent parallel design mixed-methods study explored the early effects of COVID-19 on African American/Black or Latino (AABL) long-term survivors of HIV in a pandemic epicenter, New York City. A total of 96 AABL PLWH were recruited from a larger study of PLWH with non-suppressed HIV viral load. They engaged in structured assessments focused on knowledge, testing, trust in information sources, and potential emotional, social, and behavioral impacts. Twenty-six of these participants were randomly selected for in-depth semi-structured interviews. Participants were mostly men (64%), African American/Black (75%), and had lived with HIV for 17 years, on average (SD=9 years). Quantitative results revealed high levels of concern about and the adoption of recommended COVID-19 prevention recommendations. HIV care visits were commonly canceled but, overall, engagement in HIV care and antiretroviral therapy use were not seriously disrupted. Trust in local sources of information was higher than trust in various federal sources. Qualitative findings complemented and enriched quantitative results and provided a multifaceted description of both risk factors (e.g., phones/internet access were inadequate for some forms of telehealth) and resilience (e.g., “hustling” for food supplies). Participants drew a direct line between structural racism and the disproportional adverse effects of COVID-19 on communities of color, and their knowledge gleaned from the HIV pandemic was applied to COVID-19. Implications for future crisis preparedness are provided, including how the National HIV/AIDS Strategy can serve as a model to prevent COVID-19 from becoming another pandemic of the poor.Comment on "How Many Causes Are There of Aging-Related Decrements in Cognitive Functioning?"
AbstractCollins, L. (n.d.).Publication year
1994Journal title
Developmental ReviewVolume
14Issue
4Page(s)
438-443AbstractSalthouse (1994) introduces a new type of correlation, termed the quasi-partial correlation (QPC). The QPC reflects the amount of age-related variance that is shared by two variables. In this commentary it is argued that the QPC is a model where age is a suitable proxy for time, change over time is linear, and causation is instantaneous or nearly instantaneous. Where these assumptions are reasonable, QPC′s are a highly valuable research tool. It is also argued that the "causes" of decline identified by Salthouse might be termed "dimensions" of decline instead, because the analysis did not include independently assessed causal variables. Finally, it is suggested that age is unsatisfying as a predictor of change across the lifespan.Commentaries on Replication in Prevention Science : A Rejoinder
AbstractValentine, J. C., Biglan, A., Boruch, R. F., Castro, F. G., Collins, L., Flay, B. R., Kellam, S., Mościcki, E. K., & Schinke, S. P. (n.d.).Publication year
2011Journal title
Prevention ScienceVolume
12Issue
2Page(s)
123-125Abstract~Comparative effectiveness of intervention components for producing long-term abstinence from smoking : A factorial screening experiment
AbstractSchlam, T. R., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., Collins, L., Mermelstein, R., Piper, M. E., Cook, J. W., Jorenby, D. E., Loh, W. Y., & Baker, T. B. (n.d.).Publication year
2016Journal title
AddictionVolume
111Issue
1Page(s)
142-155AbstractAims: To identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. Design: A 2×2×2×2×2 randomized factorial experiment. Setting: Eleven primary care clinics in Wisconsin, USA. Participants: A total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Interventions: Five intervention components designed to help smokers attain and maintain abstinence: (1) extended medication (26 versus 8 weeks of nicotine patch+nicotine gum); (2) maintenance (phone) counseling versus none (3) medication adherence counseling versus none (4) automated (medication) adherence calls versus none and (5) electronic medication monitoring with feedback and counseling versus electronic medication monitoring alone. Measurements: The primary outcome was 7-day self-reported point-prevalence abstinence 1 year after the target quit day. Findings: Only extended medication produced a main effect. Twenty-six versus 8 weeks of medication improved point-prevalence abstinence rates (43 versus 34% at 6 months; 34 versus 27% at 1 year; P =0.01 for both). There were four interaction effects at 1 year, showing that an intervention component's effectiveness depended upon the components with which it was combined. Conclusions: Twenty-six weeks of nicotine patch+nicotine gum (versus 8 weeks) and maintenance counseling provided by phone are promising intervention components for the cessation and maintenance phases of smoking treatment.Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit : A factorial screening experiment
AbstractCook, J. W., Collins, L., Fiore, M. C., Smith, S. S., Fraser, D., Bolt, D. M., Baker, T. B., Piper, M. E., Schlam, T. R., Jorenby, D., Loh, W. Y., & Mermelstein, R. (n.d.).Publication year
2016Journal title
AddictionVolume
111Issue
1Page(s)
117-128AbstractAims: To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. Design: A balanced, four-factor, randomized factorial experiment. Setting: Eleven primary care clinics in southern Wisconsin, USA. Participants: A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. Interventions: Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none (2) nicotine gum versus none (3) motivational interviewing (MI) versus none and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. Measurements: The primary outcome was percentage change in cigarettes smoked per day at 26weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. Findings: There were few main effects, but a significant four-way interaction at 26weeks post-study enrollment (P=0.01, β=0.12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (P=0.04), and nicotine gum, when used without MI, increased 26-week abstinence after a subsequent aided quit attempt (P=0.01). Conclusions: Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit.Comparison of a phased experimental approach and a single randomized clinical trial for developing multicomponent behavioral interventions
AbstractCollins, L., Chakraborty, B., Murphy, S. A., & Strecher, V. (n.d.).Publication year
2009Journal title
Clinical TrialsVolume
6Issue
1Page(s)
5-15AbstractBackground: Many interventions in today's health sciences are multicomponent, and often one or more of the components are behavioral. Two approaches to building behavioral interventions empirically can be identified. The more typically used approach, labeled here the classical approach, consists of constructing a likely best intervention a priori, and then evaluating the intervention in a standard randomized controlled trial (RCT). By contrast, the emergent phased experimental approach involves programmatic phases of empirical research and discovery aimed at identifying individual intervention component effects and the best combination of components and levels. Purpose: The purpose of this article is to provide a head-to-head comparison between the classical and phased experimental approaches and thereby highlight the relative advantages and disadvantages of these approaches when they are used to select program components and levels so as to arrive at the most potent intervention. Methods: A computer simulation was performed in which the classical and phased experimental approaches to intervention development were applied to the same randomly generated data. Results: The phased experimental approach resulted in better mean intervention outcomes when the intervention effect size was medium or large, whereas the classical approach resulted in better mean intervention outcomes when the effect size was small. The phased experimental approach led to identification of the correct set of intervention components and levels at a higher rate than the classical approach across all conditions. Limitations: Some potentially important factors were not varied in the simulation, for example the underlying structural model and the number of intervention components. Conclusions: The phased experimental approach merits serious consideration, because it has the potential to enable intervention scientists to develop more efficacious behavioral interventions.Components of smartphone cognitive-behavioural therapy for subthreshold depression among 1093 university students : A factorial trial
AbstractSakata, M., Toyomoto, R., Yoshida, K., Luo, Y., Nakagami, Y., Uwatoko, T., Shimamoto, T., Tajika, A., Suga, H., Ito, H., Sumi, M., Muto, T., Ito, M., Ichikawa, H., Ikegawa, M., Shiraishi, N., Watanabe, T., Sahker, E., Ogawa, Y., … Furukawa, T. A. (n.d.).Publication year
2022Journal title
Evidence-Based Mental HealthVolume
25Issue
1Page(s)
E18-E25AbstractBackground Internet-based cognitive-behavioural therapy (iCBT) is effective for subthreshold depression. However, which skills provided in iCBT packages are more effective than others is unclear. Such knowledge can inform construction of more effective and efficient iCBT programmes. Objective To examine the efficacy of five components of iCBT for subthreshold depression. Methods We conducted an factorial trial using a smartphone app, randomly allocating presence or absence of five iCBT skills including self-monitoring, behavioural activation (BA), cognitive restructuring (CR), assertiveness training (AT) and problem-solving. Participants were university students with subthreshold depression. The primary outcome was the change on the Patient Health Questionnaire-9 (PHQ-9) from baseline to week 8. Secondary outcomes included changes in CBT skills. Findings We randomised a total of 1093 participants. In all groups, participants had a significant PHQ-9 reduction from baseline to week 8. Depression reduction was not significantly different between presence or absence of any component, with corresponding standardised mean differences (negative values indicate specific efficacy in favour of the component) ranging between-0.04 (95% CI-0.16 to 0.08) for BA and 0.06 (95% CI-0.06 to 0.18) for AT. Specific CBT skill improvements were noted for CR and AT but not for the others. Conclusions There was significant reduction in depression for all participants regardless of the presence and absence of the examined iCBT components. Clinical implication We cannot yet make evidence-based recommendations for specific iCBT components. We suggest that future iCBT optimisation research should scrutinise the amount and structure of components to examine. Trial registration number UMINCTR-000031307.Consider a CMA as the CFO [3]
AbstractCollins, L. (n.d.).Publication year
2007Journal title
Behavioral HealthcareVolume
27Issue
9Page(s)
10Abstract~Continuous-time system identification of a smoking cessation intervention
AbstractTimms, K. P., Rivera, D. E., Collins, L., & Piper, M. E. (n.d.).Publication year
2014Journal title
International Journal of ControlVolume
87Issue
7Page(s)
1423-1437AbstractCigarette smoking is a major global public health issue and the leading cause of preventable death in the United States. Toward a goal of designing better smoking cessation treatments, system identification techniques are applied to intervention data to describe smoking cessation as a process of behaviour change. System identification problems that draw from two modelling paradigms in quantitative psychology (statistical mediation and self-regulation) are considered, consisting of a series of continuous-time estimation problems. A continuous-time dynamic modelling approach is employed to describe the response of craving and smoking rates during a quit attempt, as captured in data from a smoking cessation clinical trial. The use of continuous-time models provide benefits of parsimony, ease of interpretation, and the opportunity to work with uneven or missing data.