Prevention Science, Vol. 5, No. 3, September 2004 (
A Conceptual Framework for Adaptive
Linda M. Collins,
Susan A. Murphy,
and Karen L. Bierman
Recently, adaptive interventions have emerged as a new perspective on prevention and treat-
ment. Adaptive interventions resemble clinical practice in that different dosages of certain
prevention or treatment components are assigned to different individuals, and/or within indi-
viduals across time, with dosage varying in response to the intervention needs of individuals.
To determine intervention need and thus assign dosage, adaptive interventions use prespec-
iﬁed decision rules based on each participant’s values on key characteristics, called tailoring
variables. In this paper, we offer a conceptual framework for adaptive interventions, discuss
principles underlying the design and evaluation of such interventions, and review some areas
where additional research is needed.
KEY WORDS: adaptive interventions; prevention; research design.
For most of the history of research-based in-
terventions aimed at prevention and treatment, the
composition and dosage of these interventions have
been ﬁxed, in other words, a single composition and
dosage has been offered to all program participants.
For example, a school-based drug abuse prevention
curriculum might be delivered to all sixth graders.
Every component of the intervention that may be
necessary for any particular participant is included
in the curriculum, and each child is given the same
intervention. Although it is recognized that individ-
uals may have different intervention needs, it is ex-
pected that the intervention is in no way diluted or
made counterproductive if components that are par-
ticularly relevant for an individual are combined with
components that may have less, or even no, relevance
for that individual.
The Methodology Center and Department of Human Develop-
ment and Family Studies, The Pennsylvania State University, Uni-
versity Park, Pennsylvania.
Institute for Social Research and Department of Statistics, Uni-
versity of Michigan, Ann Arbor, Michigan.
Department of Psychology, The Pennsylvania State University,
University Park, Pennsylvania.
Correspondence should be directed to Linda M. Collins, 159
S. Henderson, University Park, Pennsylvania 16802; e-mail:
Recently, adaptive interventions have emerged
as a new perspective on research-based preven-
tion and treatment. According to this perspec-
tive, the varying intervention needs of individuals
may not be met optimally by using a single uni-
form composition and dosage. For this reason,
an adaptive intervention assigns different dosages
of certain program components across individu-
als, and/or within individuals across time. Dosage
varies in response to the intervention needs of in-
dividuals, and dosages are assigned based on de-
cision rules linking characteristics of the individual
with speciﬁc levels and types of program compo-
nents. In some adaptive interventions a dosage of
zero is possible on a given component. This im-
plies that there may be individuals who do not
receive certain components at all, and that dif-
ferent types or versions of program components
may be assigned to different individuals. Part of
the conceptual appeal of the adaptive approach
is its clear resemblance to clinical practice. How-
ever, in order to maintain replicability (see be-
low), adaptive interventions entail the use of explicit
decision rules, thus differing from most clinical
Adaptive interventions are becoming more com-
mon, as prevention programs move in the direction
2004 Society for Prevention Research