Twenty years of intervention optimization.

In the classical paradigm for intervention research, the components that are to make up an intervention are identified, pilot tested, and then immediately assembled into a treatment package and subjected to an evaluation randomized controlled trial (RCT) to assess the performance of the entire package. Intervention optimization, which adapts ideas from technological fields to intervention science in order to hasten scientific progress, is an alternative to the classical paradigm. The first article introducing intervention optimization via the multiphase optimization strategy (MOST) was published in Annals of Behavioral Medicine in 2005. In this commentary, I reflect on the evolution of intervention optimization from that first publication to today, and on what the future could hold if the intervention science field continues to adopt the optimization paradigm. I propose that if intervention optimization became standard operating procedure, the field would accumulate a coherent base of knowledge about what specific intervention strategies work, for whom, under which circumstances, and why; every intervention produced would contain only components that contribute enough to justify their resource requirements; interventions would be readily implementable; and as the knowledge base grew, interventions would be improved continually.