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

Optimization of implementation strategies using the Multiphase Optimization STratgey (MOST) framework: Practical guidance using the factorial design

Szeszulski, J., & Guastaferro, K. (n.d.).

Publication year

2024

Journal title

Translational Behavioral Medicine

Volume

Issue

Page(s)

505-513

10.1093/tbm/ibae035

Abstract

Abstract

The Multiphase Optimization STrategy (MOST) is a framework that uses three phases—preparation, optimization, and evaluation—to develop multicomponent interventions that achieve intervention EASE by strategically balancing Effectiveness, Affordability, Scalability, and Efficiency. In implementation science, optimization of the intervention requires focus on the implementation strategies—things that we do to deliver the intervention—and implementation outcomes. MOST has been primarily used to optimize the components of the intervention related to behavioral or health outcomes. However, innovative opportunities to optimize discrete (i.e. single strategy) and multifaceted (i.e. multiple strategies) implementation strategies exist and can be done independently, or in conjunction with, intervention optimization. This article details four scenarios where the MOST framework and the factorial design can be used in the optimization of implementation strategies: (i) the development of new multifaceted implementation strategies; (ii) evaluating interactions between program components and a discrete or multifaceted implementation strategies; (iii) evaluating the independent effects of several discrete strategies that have been previously evaluated as a multifaceted implementation strategy; and (iv) modification of a discrete or multifaceted implementation strategy for the local context. We supply hypothetical school-based physical activity examples to illustrate these four scenarios, and we provide hypothetical data that can help readers make informed decisions derived from their trial data. This manuscript offers a blueprint for implementation scientists such that not only is the field using MOST to optimize the effectiveness of an intervention on a behavioral or health outcome, but also that the implementation of that intervention is optimized.

Optimization of Smoking Cessation Interventions via Multiphase Optimization STrategy (MOST): Basic Concepts, Practical Considerations and New Developments

Collins, L., Guastaferro, K., Strayhorn, J., Cantrell, J., Kimber, C., & Piper, M. (n.d.).

Publication year

2024

Abstract

Abstract

Optimizing COPD self-management treatment using the Multiphase Optimization Strategy: Results from a pilot factorial experiment

Mathew, A. R., Esqueda Medina, M., Avery, E., Younker, L., Guastaferro, K., & Press, V. G. (n.d.).

Publication year

2024

Abstract

Abstract

Optimizing home visiting programs to improve reach: A case study in strategically balancing intervention effectiveness with provider time

Guastaferro, K., & Strayhorn, J. (n.d.).

Publication year

2024

Abstract

Abstract

Parent-focused Child Sexual Abuse Prevention: A Universal Approach.

Abuchaibe, V., Melchior, M., Dan, C., Zeleke, M., McCormick, K., Bhoja, A., Abourjaily, E., Welikson, P., Grayson, C., & Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

Piloting an Alternative Implementation Modality for a School-Based Child Sexual Abuse Prevention Curriculum

Mozid, N. E., Espinosa, R. N., Grayson, C., Falode, O., Yang, Y., Glaudin, C., & Guastaferro, K. (n.d.).

Publication year

2024

Journal title

International Journal of Environmental Research and Public Health

Volume

Issue

10.3390/ijerph21020149

Abstract

Abstract

Background: 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

Mozid, N. E., Espinosa, R. N., Grayson, C., Falode, O., Yang, Y., Glaudin, C., & Guastaferro, K. (n.d.).

Publication year

2024

Journal title

International Journal on Environmental Research and Public Health

Volume

Issue

Abstract

Abstract

Preparation Phase Activities to Develop and Optimize an Intervention Using MOST for Grandparents Raising Grandchildren.

Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

Recruiting and retaining first-year college students in online health research: Implementation considerations

Guastaferro, K., Tanner, A. E., Rulison, K. L., Miller, A. M., Milroy, J. J., Wyrick, D. L., & Collins, L. M. (n.d.).

Publication year

2024

Journal title

Journal of American College Health

Volume

Issue

Page(s)

623-630

10.1080/07448481.2022.2053132

Abstract

Abstract

Objective: 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.

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.

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.

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"

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

Guastaferro, K. (n.d.).

Publication year

2024

Abstract

Abstract

Using Failure Modes and Effects Analysis (FMEA) to Evaluate the Implementation of an Optimized Family Navigation Intervention

Menon, N., Bernard, E. C., Much-Hichos, M., Molina, J., Rubin, D., Guastaferro, K., & Feinberg, E. (n.d.).

Publication year

2024

Abstract

Abstract

Introduction: 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.

Merrill, K. G., Silva, J., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).

Publication year

2024

Abstract

Abstract

Using implementation science to inform the preparation phase of the multiphase optimization strategy (MOST) framework.

Merrill, 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

2024

Abstract

Abstract

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

Self-Brown, S., Perry, E. W., Recinos, M., Whitaker, D. J., Guastaferro, K., & Kegler, M. (n.d.).

Publication year

2024

Abstract

Abstract

“Public relations isn’t all rainbows and butterflies”: Student experiences in developing a child sexual abuse prevention campaign

Madden, S., & Guastaferro, K. (n.d.).

Publication year

2024

Journal title

Journal of Public Relations Education

Abstract

Abstract

A vision for the prevention of child maltreatment: Optimization of multicomponent interventions

Guastaferro, K. (n.d.).

Publication year

2023

Page(s)

107-133

Abstract

Abstract

Adapting prevention programs for virtual delivery: A case study in adapting a parent-focused child sexual abuse prevention module

Guastaferro, K., Melchior, M. S., Murphy-Costanzo, A., Sunshine, S., Neimeyer, A., Stewart, S., & Noll, J. (n.d.).

Publication year

2023

Journal title

Journal of Public Health Research

Volume

Issue

10.1177/22799036231208329

Abstract

Abstract

Background: Evolving and emerging contexts require interventions to respond and adapt. The COVID-19 pandemic necessitated a quick adaptation from in-person to virtual delivery. Not only were there few programs able to transition to virtual delivery, there was a lack of parent-focused CSA-prevention programs. The current study describes the responsive adaptation of a parent-focused child sexual abuse (CSA) prevention module (Smart Parents—Safe and Healthy Kids; SPSHK) for virtual delivery. Design and methods: This two-phase study used mixed-methods to inform and pilot test adaptations to the virtual module. In Phase 1, parenting providers with and without experience delivering SPSHK (N = 110) completed anonymous surveys and a subsample (n = 27) subsequently participated in brief interviews elaborate on challenges and needed adaptations for virtual platforms. Results: Providers indicated the greatest technological difficulties with parents’ access to technology noting the inability to use a screensharing function. Thus, providers recommended no adaptations for the virtual delivery of SPSHK. In Phase 2, the virtual SPSHK module was piloted with nine parents. Results demonstrated virtual SPSHK was acceptable and feasibly implemented. Pre-posttest assessments indicated increases in parents’ CSA-related awareness and use of protective behaviors. Conclusion: The current study suggests the promise of virtual SPSHK implementation and may act as a blueprint for other parent-focused CSA-prevention programs, but also more general parenting programs, considering virtual delivery.

Advanced Topics in Intervention Optimization: Matching the Right Research Design to your Research Question.

Guastaferro, K., Szeszulski, J., & Pfammatter, A. (n.d.).

Publication year

2023

Abstract

Abstract

An Introduction to Intervention Optimization: Launching a New Generation of Behavioral Interventions.

Guastaferro, K. (n.d.).

Publication year

2023

Abstract

Abstract

An Introduction to the MOST Mindset.

Guastaferro, K. (n.d.).

Publication year

2023

Abstract

Abstract

Applying an implementation framework to the dissemination of a school-based child sexual abuse prevention program

Guastaferro, K., Shipe, S. L., Connell, C. M., Zadzora, K. M., & Noll, J. G. (n.d.).

Publication year

2023

Journal title

Health Promotion Practice

10.1177/15248399231201537

Abstract

Abstract

Since the 1980s, school-based child sexual abuse (CSA) prevention programs have been the prevailing prevention strategy in the United States. Despite demonstrated effectiveness, there is a lack of infrastructure and educational policy ensuring all students receive these programs. A pragmatic application of the RE-AIM implementation framework, this study provides an overview of a multi-county implementation effort of the school-based CSA prevention program, Safe Touches. Implementation efforts across five counties in a Mid-Atlantic state are described at three levels: organizational (school districts), child, and program facilitator. Children’s CSA-related knowledge was measured at four time points: pre-workshop, immediately post-workshop, and then 6 and 12 months post-workshop. Facilitators completed an anonymous survey post-implementation. Over the course of one and a half academic years, Safe Touches was implemented in 718 public school districts, reaching in total 14,235 second-grade students. Students’ significantly increased knowledge from pre- to post-workshop and gains were maintained at 6 and 12 months (ps

Kate Guastaferro