Integrating human-delivered and digital interventions

Advances in mobile and wireless technologies offer tremendous opportunities for extending the reach of psychological interventions and adapting interventions to the unique and changing needs of individuals.

Human delivery is essential to engagement, but it is both expensive and burdensome.

The integration of digital and human-delivered components is critical to building effective and scalable interventions.

Multimodal Adaptive Interventions

A Multimodal Adaptive Intervention (MADIs) is an intervention design that guides the provision of a combination of services that are sequenced and adapted by different modalities (e.g., human delivered, digital) on different time scales.

Slow Timescale

Delivered every few weeks or months

* Standard adaptive interventions operate on this timescale

Fast Timescale

Delivered every few days or hours

* Just-in-time adaptive interventions operate on this timescale

Hybrid Experimental Designs for optimizing MADIs

Hybrid Experimental Designs (HED) can be used to answer scientific questions about the integration of human-delivered and digital components and their adaptation at multiple timescales. Researchers can use HEDs to design effective Multimodal Adaptive Interventions (MADI).

Various hybrid experimental designs are possible, such as hybrids of a standard factorial design with a SMART or an MRT, or a hybrid combining a SMART and an MRT.

Diagram titled "Example Hybrid Experimental Design," showing participants randomized to App or App + Coaching at program entry, re-randomized upon non-response at weeks 2, 4, or 8 to modest or vigorous step-up interventions, with daily micro-randomization to message or no message from day 15 through week 12.
EXAMPLE. This SMART-MRT hybrid was devised to answer scientific questions key to the development of the multimodality adaptive intervention above. Learn more about this study.
EXAMPLE. This SMART-MRT hybrid was devised to answer scientific questions key to the development of the multimodality adaptive intervention above. Learn more about this study.
Diagram titled "Example Hybrid Experimental Design," showing participants randomized to App or App + Coaching at program entry, re-randomized upon non-response at weeks 2, 4, or 8 to modest or vigorous step-up interventions, with daily micro-randomization to message or no message from day 15 through week 12.

Tap to enlarge.

Featured Resources

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Hybrid Experimental Designs for Intervention Development: What, Why, and How

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Design of Experiments with Sequential Randomizations on Multiple Timescales: The Hybrid Experimental Design

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Software for Analyzing Data from Hybrid Experimental Designs

Code Library

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Data Analysis for Three Kinds of Hybrid Experimental Designs

Featured Code

Nahum-Shani, I., Dziak, J.J., Venera, H. et al. Design of experiments with sequential randomizations on multiple timescales: the hybrid experimental design. Behav Res (2023). https://doi.org/10.3758/s13428-023-02119-z

Nahum-Shani I, Dziak JJ, Walton MA, Dempsey W. Hybrid Experimental Designs for Intervention Development: What, Why, and How. Advances in Methods and Practices in Psychological Science. 2022;5(3). doi:10.1177/25152459221114279

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