Adaptive intervention designs in pediatric psychology: The promise of sequential multiple assignment randomized trials of pediatric interventions.

This article summarizes the utility of multiphase optimization strategy (MOST) and sequential multiple assignment randomized trial (SMART) processes in the development of empirically derived adaptive interventions (AIs). Recent empirical evidence suggests that SMART designs conducted within the context of a MOST framework can be used for building and optimizing AIs and may lead to better clinical care. SMART designs help optimize AIs by determining the best sequencing of decision rules. However, despite their growing relevance, MOSTs and SMARTs are relatively underutilized in the development of pediatric interventions. MOST and SMART designs can be used for developing efficient and cost-effective AIs. Intervention research within the field of pediatric psychology may benefit from incorporating these designs.