Experimental design and primary data analysis methods for comparing adaptive interventions.
Open accessAbstract
In recent years, research in the area of intervention development has been shifting from the traditional fixed-intervention approach to adaptive interventions, which allow greater individualization and adaptation of intervention options (i.e., intervention type and/or dosage) over time. Adaptive interventions are operationalized via a sequence of decision rules that specify how intervention options should be adapted to an individual's characteristics and changing needs, with the general aim to optimize the long-term effectiveness of the intervention. Here, we review adaptive interventions, discussing the potential contribution of this concept to research in the behavioral and social sciences. We then propose the sequential multiple assignment randomized trial (SMART), an experimental design useful for addressing research questions that inform the construction of high-quality adaptive interventions. To clarify the SMART approach and its advantages, we compare SMART with other experimental approaches. We also provide methods for analyzing data from SMART to address primary research questions that inform the construction of a high-quality adaptive intervention.
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Different SMART designs are suitable for addressing different types of scientific questions.
“Different SMART designs are suitable for addressing different types of scientific questions [21,23].”
From Introduction to SMART designs for the development of adaptive interventions: with application to weight loss research (2014) · cites this paper as [21]
The SMART implementation design belongs to the factorial experiment family and uses multiple randomizations, allowing a site's implementation process to be altered when it is not working.
“The Sequential Multiple Assignment Randomized Implementation Trial (SMART) implementation design is a special case of the factorial experiment (32, 67, 78) involving multistage randomizations where the site-level implementation process can be modified if unsuccessful.”
From An Overview of Research and Evaluation Designs for Dissemination and Implementation (2017) · cites this paper as [78]
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- Nahum-Shani I Qian M Pelham WE Gnagy B Fabiano G Waxmonsky J Murphy SA Experimental design and primary data analysis methods for comparing adaptive interventions 2010 Manuscript submitted for publication. PMC3825557 23025433
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“Researchers interested in optimizing sequences of implementation strategies that adapt to ongoing needs over time may be interested in a variant of factorial designs known as the sequential, multiple-assignment randomized trial (SMART; Almirall et al., 2012; Collins et al., 2014b; Kilbourne et al., 2014b; Lei et al.,…”
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- Authors
- Nahum-Shani, I., Qian, M., Almirall, D., Pelham, W. E., Gnagy, B., Fabiano, G. A., Waxmonsky, J. G., Yu, J., & Murphy, S. A.
- Affiliations
- University of Michigan (US)
- Columbia University (US)
- Florida International University (US)
- University at Buffalo, State University of New York (US)
- ORCID
- Venue
- Psychological Methods
- Published
- 2012-12
- Volume
- 17
- Issue
- 4
- Pages
- 457-477
- ISSN
- 1082-989X (ISSN-L)
- 1939-1463
- PMC
- PMC3825557
- OpenAlex
- W2162512884
- Cited by
- 298
- References
- 77
- Citations by year
- 2026: 21 · 2025: 20 · 2024: 24 · 2023: 30 · 2022: 20 · 2021: 28 · 2020: 27 · 2019: 23 · 2018: 15 · 2017: 16 · 2016: 23 · 2015: 20 · 2014: 19 · 2013: 8 · 2012: 3
- FWCI
- 15.28
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Psychological Methods (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (P50DA010075, DA12414)
- National Institute on Alcohol Abuse and Alcoholism (AA11873)
- National Institute of Mental Health (MH069614, MH080015)
- Institute of Education Sciences (R324B060045; LO3000665A)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Bayesian Inference
- Keywords
- adaptive interventions, sequential multiple assignment randomized trial, decision rules, intervention dosage, experimental design, data analysis methods, intervention development, social and behavioral sciences
- MeSH terms
- Behavioral Sciences, Data Interpretation, Statistical, Humans, Research Design, Social Sciences, Randomized Controlled Trials as Topic
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