A conceptual framework for adaptive preventive interventions

Recently, adaptive interventions have emerged as a new perspective on prevention and treat-ment. Adaptive interventions resemble clinical practice in that different dosages of certain prevention or treatment components are assigned to different individuals, and/or within indi-viduals across time, with dosage varying in response to the intervention needs of individuals. To determine intervention need and thus assign dosage, adaptive interventions use prespec-ified decision rules based on each participant’s values on key characteristics, called tailoring variables. In this paper, we offer a conceptual framework for adaptive interventions, discuss principles underlying the design and evaluation of such interventions, and review some areas where additional research is needed. KEY WORDS: adaptive interventions; prevention; research design. For most of the history of research-based in-terventions aimed at prevention and treatment, the composition and dosage of these interventions have been fixed, in other words, a single composition and dosage has been offered to all program participants. For example, a school-based drug abuse prevention curriculum might be delivered to all sixth graders. Every component of the intervention that may be necessary for any particular participant is included in the curriculum, and each child is given the same intervention. Although it is recognized that individ-uals may have different intervention needs, it is ex-pected that the intervention is in no way diluted or made counterproductive if components that are par-ticularly relevant for an individual are combined with components that may have less, or even no, relevance for that individual