There is no single or agreed upon approach for developing behavioral interventions. All interventions, however, must begin in a period of “discovery” referred to as a “prephase” in which we recommend eight key iterative considerations be accomplished. This discovery phase is critical and occurs regardless of the subsequent pathways that are followed for advancing interventions. The outcomes of this initial stage, directly and critically, inform the very next steps for advancing an intervention.
At the conclusion of a discovery period, one should have a clear understanding of the nature and scope of the identified problem, a specified population in need of an intervention, an understanding of what can be changed and how and why change may occur drawing upon theoretical and conceptual frameworks, identification of potential outcome measures, and knowledge of previous intervention attempts or applicable evidence-based strategies. Also, one should have an idea of how to proceed either with developing a new intervention, augmenting, or modifying an existing intervention, or with comparing interventions. The subsequent testing pathways that are followed are determined in large part by what is revealed in this period of discovery or by what the science requires in addition to the practical considerations including access to or availability of resources such as staff, space, populations, funding, and so forth. Noteworthy is that a discovery period may overlap dynamically with Phase I testing or may itself involve a series of small studies to advance the intervention idea.
In this chapter, we have also offered working tools (Tables 3.2 and 3.3 and Figure 3.1) to help map an intervention. These tools can help to break down the objectives and specific activities related to an intervention. An intervention itself is the heart of the matter and the basis from which all other design and testing decisions are made. Thus, carefully detailing the problem that is to be addressed and its essential features (e.g., contributing factors, at risk populations, pathways amenable to modification) warrants careful attention and continuous consultation with the research literature as well as key stakeholders and end users as suggested by both the elongated and iterative pipelines we have described in Chapter 2 (Figures 2.2 and 2.3).