Question

How do I address non-adherence in the design of an adaptive intervention?

Answer

An adaptive intervention is not a research study. Rather, an adaptive intervention is a set of decision rules used to guide sequential, intervention decision making by clinicians. Second, adaptive interventions should be designed to address non-adherence, since this is a common contingency in actual practice settings.

The design of a high-quality adaptive intervention will include a contingency plan for non-adherence. Note that, as with missing data in a tailoring variable that is part of an adaptive intervention, non-adherence is not a statistical challenge; rather, it is a clinical challenge. Thus, non-adherence is not something we fix statistically; rather, non-adherence is something we can expect to happen, and plan for with good adaptive intervention design.

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