Session: Abstract of Distinction: When Is It Time to Revise or Adapt Our Prevention Programs? Using Baseline Target Moderation to Assess Variation in Prevention Impact (Society for Prevention Research 27th Annual Meeting)

SESSION INTRODUCTION: There is increasing interest in testing adaptations of preventive interventions to increase their impact by identifying subgroups or specific contexts where program effects appear stronger or weaker, and testing revised interventions more closely tailored to the needs of those groups or conditions. But how do we know where to look for effect heterogeneity in ways that will inform successful adaptation? Baseline target moderation (BTM) and baseline target moderated mediation (BTMM) designs are increasingly used to study theoretically relevant intervention targets, and to test whether intervention effects vary by baseline level of those targets. Recent BTM studies suggest this heterogeneity can be complex. Recent findings indicate that it can involve compensatory effects, “rich get richer” effects, crossover effects, or even iatrogenic effects. This symposium will present a series of studies of prevention trials employing BTM or BTMM to assess effect heterogeneity as a basis for considering how and when findings argue for refinement or revision of programs as a basis for next generation tests of adaptive targeting.

Paper 1 will provide a general introduction to BTM and BTMM designs, reviewing common patterns of moderation emerging in recent research. The next three papers describe the results of BTM and BTMM analyses that focus on single intervention targets. Paper 2 tests BTMM in a trial of a parenting program for military familes targeting emotion socialization related parenting behaviors, finding no moderation for specific parent behavior targets, but significant moderation for baseline levels of general emotion regulation difficulties for fathers, showing compensatory effects on reactive-coercive behavior at one year followup. Paper 3 uses BTMM to test whether the Familias Unidas prevention program for Hispanic families reduced youth internalizing symptoms, finding evidence for compensatory effects on youth internalizing for parent support, but not family functioning or parent stress. Paper 4 reports BTM analyses employing latent baseline factors for a randomized trial of a couples intervention to reduce depression in couples who experienced recent job loss, finding crossover effects (with some benefiting and some worsening) for moderation by baseline levels of job seeker motivation and couples communication. The last two papers use latent profile analysis to study baseline target variation in synthesis datasets that combine data from multiple prevention trials. Paper 5 combines data from four Dutch trials of behavioral parenting interventions to assess whether latent profile analysis can characterize important baseline variation in parenting resources in terms of latent classes consistently across all four trials. Paper 6 combines data from four parent-focused prevention trials, finding evidence for four ordered latent classes of family functioning at baseline.