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
Decision support training for advanced cancer family caregivers: Study protocol for the CASCADE factorial trial
AbstractGazaway, S., Wells, R. D., Azuero, A., Pisu, M., Guastaferro, K., Rini, C., Taylor, R., Reed, R. D., Harrell, E. R., Bechthold, A. C., Bratches, R. W., McKie, P., Lowers, J., Williams, G. R., Rosenberg, A. R., Bakitas, M. A., Kavalieratos, D., & Dionne-Odom, J. N. (n.d.).Publication year
2023Journal title
Contemporary Clinical TrialsVolume
131AbstractBackground: Patients with advanced cancer face numerous decisions when diagnosed and often receive decision support from family caregivers. The CASCADE (CAre Supporters Coached to be Adept DEcision partners) factorial trial intervention aims to train caregivers in skills to provide effective decision support to patients and identify most effective intervention components. Methods: This is a 2-site, single-blind, 24 factorial trial to test components of the CASCADE decision support training intervention for family caregivers of patients with newly-diagnosed advanced cancer delivered by specially-trained, telehealth, palliative care lay coaches over 24 weeks. Family caregivers (target N = 352) are randomly assigned to one of 16 combinations of four components with two levels each: 1) psychoeducation on effective decision partnering principles (1 vs. 3 sessions); 2) decision support communication training (1 session vs. none); 3) Ottawa Decision Guide training (1 session vs. none) and 4) monthly follow-up (1 call vs. calls for 24 weeks). The primary outcome is patient-reported decisional conflict at 24 weeks. Secondary outcomes include patient distress, healthcare utilization, caregiver distress, and quality of life. Mediators and moderators (e.g., sociodemographics, decision self-efficacy, social support) will be explored between intervention components and outcomes. Results will be used to build two versions of CASCADE: one with only effective components (d ≥ 0.30) and another optimized for scalability and cost. Discussion: This protocol describes the first factorial trial, informed by the multiphase optimization strategy, of a palliative care decision-support intervention for advanced cancer family caregivers and will address the field's need to identify effective components that support serious illness decision-making.Grandparents raising grandchildren in New York state: Understanding needs of a vulnerable population.
AbstractGuastaferro, K., Mozid, N. E., Kramsky, J., Melkonian, M. I., Young, K. S., & Spears, E. (n.d.).Publication year
2023Abstract~Guidance on selecting a translational framework for intervention development: Optimizing interventions for impact
AbstractGuastaferro, K., & Pfammatter, A. F. (n.d.).Publication year
2023Journal title
Journal of Clinical and Translational ScienceVolume
7Issue
1AbstractIntervention development frameworks offer the behavioral sciences a systematic and rigorous empirical process to guide the translation of basic science into practice in pursuit of desirable public health and clinical outcomes. The multiple frameworks that have emerged share a goal of optimization during intervention development and can increase the likelihood of arriving at an effective and disseminable intervention. Yet, the process of optimizing an intervention differs functionally and conceptually across frameworks, creating confusion and conflicting guidance on when and how to optimize. This paper seeks to facilitate the use of translational intervention development frameworks by providing a blueprint for selecting and using a framework by considering the process of optimization as conceptualized by each. First, we operationalize optimization and contextualize its role in intervention development. Next, we provide brief overviews of three translational intervention development frameworks (ORBIT, MRC, and MOST), identifying areas of overlap and divergence thereby aligning core concepts across the frameworks to improve translation. We offer considerations and concrete use cases for investigators seeking to identify and use a framework in their intervention development research. We push forward an agenda of a norm to use and specify frameworks in behavioral science to support a more rapid translational pipeline.How lay health workers in a federally qualified community health center filled a critical void in a public health crisis
AbstractGuastaferro, K., Sheldrick, R. C., Nunez-Pepen, R., Ortiz, M., Much-Hichos, M., Trieu, D., Broder-Fingert, S., & Feinberg, E. (n.d.).Publication year
2023Journal title
Family and Community HealthVolume
46Issue
4Page(s)
259-262Abstract~Impact of grandparents’ chronic stress on grandparent-parent relationship and life satisfaction by gender and race.
AbstractMozid, N. E., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Implementation of a Universal School-Based Child Sexual Abuse Prevention Program : A Longitudinal Cohort Study
AbstractGuastaferro, K., Shipe, S. L., Connell, C. M., Letourneau, E. J., & Noll, J. G. (n.d.).Publication year
2023Journal title
Journal of Interpersonal ViolenceVolume
38Issue
15-16Page(s)
8785–8802AbstractChild sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (psIntervention Optimization: Introduction to the MOST Mindset.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~Introduction to MOST: An Approach for Building more Effective and Implementable Behavioral Interventions.
AbstractGuastaferro, K., & Pfammatter, A. (n.d.).Publication year
2023Abstract~Knowledge gains from the implementation of a child sexual abuse prevention program and the future of school-based prevention education
AbstractGuastaferro, K., Shipe, S. L., Connell, C. M., Holloway, J. L., Pulido, M. L., & Noll, J. G. (n.d.).Publication year
2023Journal title
Journal of Child Sexual AbuseVolume
32Issue
7Page(s)
845-859AbstractSchool-based child sexual abuse (CSA) programs effectively increase students’ CSA-related knowledge. This study focuses on an implementation trial of Safe Touches, an empirically supported, school-based CSA prevention program, that was disrupted by the COVID-19 pandemic. We sought to demonstrate gains in CSA-related knowledge following Safe Touches but were limited to a pre-post design. A total of 2,210 students across five counties in a Mid-Atlantic state received the Safe Touches workshop between September 2019 and March 2020. McNemar’s chi-square test was used to assess changes in the proportion of correct responses pre-workshop (Time 1) and one-week post-workshop (Time 2). Students’ CSA-related knowledge increased significantly based on changes in mean CSA knowledge scores and the number of correct item-level responses assessed at Time 1 and Time 2 (pMultiphase optimization strategy: How to build more effective, affordable, scalable and efficient social and behavioural oral health interventions
AbstractGuastaferro, K., & Strayhorn, J. C. (n.d.).Publication year
2023Journal title
Community Dentistry and Oral EpidemiologyVolume
51Issue
1Page(s)
103-107AbstractThis commentary introduces the field of social behavioural oral health interventions to the multiphase optimization strategy (MOST). MOST is a principled framework for the development, optimization and evaluation of multicomponent interventions. Drawing from the fields of engineering, behavioural science, economics, decision science and public health, intervention optimization requires a strategic balance of effectiveness with affordability, scalability and efficiency. We argue that interventions developed using MOST are more likely to maximize the public health impact of social behavioural oral health interventions.New York City Transit Workers: An Essential Workforce – Addressing Occupational Resilience through Intervention Optimization.
AbstractMerdjanoff, A. A., Gershon, R., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Operationalizing primary outcomes to achieve reach, effectiveness, and equity in multilevel interventions
AbstractGuastaferro, K., Sheldrick, R. C., Strayhorn, J. C., & Feinberg, E. (n.d.).Publication year
2023Journal title
Prevention ScienceAbstractWhen intervention scientists plan a clinical trial of an intervention, they select an outcome metric that operationalizes their definition of intervention success. The outcome metric that is selected has important implications for which interventions are eventually supported for implementation at scale and, therefore, what health benefits (including how much benefit and for whom) are experienced in a population. Particularly when an intervention is to be implemented in a population that experiences a health disparity, the outcome metric that is selected can also have implications for equity. Some outcome metrics risk exacerbating an existing health disparity, while others may decrease disparities for some but have less effect for the larger population. In this study, we use a computer to simulate implementation of a hypothetical multilevel, multicomponent intervention to highlight the tradeoffs that can occur between outcome metrics that reflect different operationalizations of intervention success. In particular, we highlight tradeoffs between overall mean population benefit and the distribution of health benefits in the population, which has direct implications for equity. We suggest that simulations like the one we present can be useful in the planning of a clinical trial for a multilevel and/or multicomponent intervention, since simulated implementation at scale can illustrate potential consequences of candidate operationalization of intervention success, such that unintended consequences for equity can be avoided.Optimization of Implementation Strategies Using MOST: An Emphasis on the Factorial Design.
AbstractSzeszulski, J., & Guastaferro, K. (n.d.).Publication year
2023Abstract~Optimizing for Dissemination of a Family Navigation Intervention to Improve Pediatric Mental Health Services using MOST.
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~Parenting and mental health needs of young, maltreated parents: Implications for prevention of intergenerational child maltreatment
AbstractAparicio, E. M., Channell Doig, A., Jasczynski, M., Robinson, J. L., Huq, M., Yoo, J. H., Hillig, E., Lee, K., Berkowitz, A., Guastaferro, K., Jones, G., & Bernardi, C. (n.d.).Publication year
2023Journal title
Journal of Family ViolenceVolume
38Issue
4Page(s)
659-672AbstractPurpose: Children of young parents are at elevated risk for child abuse and neglect due to myriad challenges. Despite the dual need for parenting support and mental health support, most literature and programs separate these and do not address maltreated parenting youths’ intergenerational context. The current study explores parenting and mental health needs as intertwined, uplifting experiences of young adult mothers with child maltreatment histories, professionals serving them, and mothers’ own caregivers. Method: Through a community-engaged research process, this grounded theory study was co-conceptualized and conducted through a university-community-based organization partnership. We conducted in-depth interviews with 23 participants: nine young, maltreated mothers aged 18–25 (M = 20.9) years, 14 professionals and two caregivers. Data were collected in the community and analyzed using grounded theory methods. We transcribed each interview and analyzed the transcripts using a structured process of open, focus, axial, and selective/theoretical coding. Rigor was enhanced through several strategies including reflexivity and member checking. Results: Grounded theory analysis produced a detailed model of the process of accessing and receiving mental health and parenting support among young, maltreated mothers, including (1) Reckoning with the Impact of Childhood and Adolescent Trauma on Mental Health and Parenting; (2) Reaching Out; (3) Receiving Parenting Support; (4) Receiving Mental Health Support; and (5) Seeking a Change. Conclusions: Findings support a comprehensive approach for supporting young parents in improving the trajectories of their families through integrated approaches to parenting and mental health intervention.Preventive education outreach on social media: The quest to enroll community members in a child sexual prevention workshop
AbstractGuastaferro, K., Melchior, M. S., Murphy-Costanzo, A. S., Anderson, A., Melamed, N., & Madden, S. (n.d.).Publication year
2023Journal title
Journal of Child Sexual AbuseVolume
32Issue
8AbstractSocial media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now “X”) as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.Provider attitudes and self-efficacy when delivering a child sexual abuse prevention module: An exploratory study
AbstractGuastaferro, K., Font, S. A., Miyamoto, S., Zadzora, K. M., Walters, K. E., O’Hara, K., Kemner, A., & Noll, J. G. (n.d.).Publication year
2023Journal title
Health Education and BehaviorVolume
50Issue
2Page(s)
172-180AbstractBackground: As constant figures in children’s lives, parents are key in protecting children from sexual abuse. One barrier to reaching parents is that the topic can be difficult to broach and is sensitive in nature. Such barriers can interfere with implementation and fidelity of evidence-based prevention strategies that are focused on reducing rates of childhood sexual abuse (CSA). Aims: In this exploratory study, we examine provider attitudes about delivering CSA-specific content in an evidence-based prevention module and their self-efficacy. Method: Thirty-three providers participated in three surveys: prior to a skills-oriented training on how to deliver the CSA prevention module (pretraining), immediately posttraining, and 6 months posttraining. Changes in self-reported willingness to deliver content, beliefs about parents’ role in CSA prevention, and confidence about their ability to deliver content were assessed over time. Open-ended questions were coded thematically to reinforce quantitative findings. Results: Prior to training, providers were worried that parents would respond negatively to CSA content and were concerned about their comfort level discussing victimization and sexual development. Findings suggest that skill-oriented training and provision scripts effectively supported providers and improved confidence in delivering CSA prevention content. Discussion: Provider self-efficacy is an important element of implementation fidelity. This exploratory study demonstrated that, though providers may approach CSA content with wariness and trepidation, adequate skills-oriented training can reduce negative attitudes and increase perceived efficacy in the actual delivery of CSA content that persists through implementation. Conclusion: Skills-based training can significantly enhance fidelity in the delivery of difficult content included in parent-focused preventative interventions.Raising expectations for D&I science: Intervention optimization as an opportunity to move toward implementability and equitability.
AbstractStrayhorn, J., Collins, L., Guastaferro, K., & Shelley, D. (n.d.).Publication year
2023AbstractThe emerging field of intervention optimization offers implementation science opportunities in several areas. In this session we offer an orientation to intervention optimization via the multiphase optimization strategy (MOST), followed by two presentations highlighting recent methodological developments in the intersection between intervention optimization and implementation science: first, in the optimization of multicomponent implementation strategies, and second, in optimizing to achieve not only effectiveness and implementability but also equitability (and even, we suggest, equitability in implementation). Panel chair Dr. Linda M. Collins and discussant Dr. Donna Shelley will then lead a discussion on implications and next steps for D&I science.Systematic braiding of Smoke-Free Home SafeCare to address child maltreatment risk and secondhand smoke exposure : findings from a pilot study
AbstractSelf-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
2023Journal title
Pilot and Feasibility StudiesVolume
9Issue
1AbstractBackground: 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.The Why and How of Intervention Optimization: Examples of Projects using the Multiphase Optimization Strategy (MOST).
AbstractGuastaferro, K. (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., Sedeno, A., Salgado, S., Vargas, V., Cano, J., Nabor, V., Merrill, J., DeCelles, J., Guastaferro, K., & Donenberg, G. (n.d.).Publication year
2023Abstract~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~What is MOST and what does it offer to advance our understanding of techniques and mechanisms that mitigate against stigma?
AbstractGuastaferro, K. (n.d.).Publication year
2023Abstract~American single father homes: A growing public health priority
AbstractShipe, S. L., Ayer, L., & Guastaferro, K. (n.d.).Publication year
2022Journal title
American Journal of Public HealthVolume
112Issue
1Page(s)
21-23Abstract~An (extremely) brief overview of MOST.
AbstractGuastaferro, K. (n.d.).Publication year
2022Abstract~