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

EXAMPLE. A Multimodal Adaptive Intervention guides the delivery of human coaching and digital messages for adolescents visiting the emergency department.

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.

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.

Related Resources

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

Advances in Methods and Practices in Psychological Science

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

Simulating and analyzing data from a Hybrid Experimental Design

Example code developed in association with the manuscript “Hybrid Experimental Designs for Intervention Development…”

Analysis of proximal and distal effects using data from a hybrid SMART-MRT in which only non-responders are micro-randomized

Use this code as a starting point for analyzing data from your own hybrid SMART-MRT.

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).

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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