Projects Using SMARTs

This page contains several examples of SMART designs in order to illustrate the different design possibilities and questions that SMART can answer. Click on an image to enlarge and show detail. To see a subset of the designs that relate to a specific health problem or design type, select from the dropdown list.

Last updated in 2016. 

Adaptive Treatment for Pregnant Women Who Abuse Drugs

Researchers have developed an intensive relapse-prevention program for pregnant women who abuse drugs. A SMART design is being used to develop an adaptive intervention where the intensity and scope of the relapse-prevention program is adjusted based on the evolving status of the woman.

PIs: Hendrée Jones, Margaret Chisolm
Location: Johns Hopkins University
Funding: NIDA Project R01DA014979

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Adaptive Treatment for Growth Suppression in Children with ADHD

Studies show that the use of stimulants for the control of ADHD in youth leads to a reduction in height gain. This study uses a SMART design to examine the effectiveness of temporary breaks in medicinal treatments and caloric supplementation for the treatment of stimulant-induced weight and growth suppression.

PI: James G. Waxmonsky
Location: Florida International University
Funding: NIMH Project R01MH083692

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Adaptive Intervention for Adolescent Marijuana Use

Researchers in this study are developing an adaptive treatment for adolescent marijuana users. They are studying the use and combination of several efficacious treatments, including behavioral therapy, contingency management, behavioral parent training, and working memory training via a SMART trial.

PI: Alan J. Budney
Location: Dartmouth College
Funding: NIDA Project R01DA015186

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Adaptive Interventions for Children with ADHD

The aim of this SMART is to understand whether to begin with medication or behavioral therapy for children with ADHD, and whether to intensify or augment initial treatment for children who do not respond to treatment.

PI: William Pelham
Location: Florida International University
Funding: U.S. Department of Education-funded, completed project

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Adaptive Treatment for Cocaine Dependence

A SMART design is being implemented to develop an adaptive intervention to increase treatment engagement and decrease cocaine use for patients who are cocaine dependent. The study also examines whether patient choice of care affects patient outcomes.

PI: James R. McKay
Location: University of Pennsylvania
Funding: NIDA Project P01AA016821

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Adaptive Approach to Naltrexone Treatment for Alcoholism

Naltrexone (NTX) is an opioid receptor antagonist used to prevent alcoholism relapse. This trial examines how to define “non-response” to treatment with NTX and what treatments are most effective for those who do or do not respond to the initial treatment.

PI: David Oslin
Location: University of Pennsylvania
Funding: NIAAA Project R01AA017164

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Adaptive Treatment for Adolescent Obesity

This project targets African American adolescents with obesity and their parents. SMARTs are used to develop an adaptive intervention that increases skills in changing dietary, exercise, and sedentary behaviors.

PI: Sylvie Naar-King
Location: Wayne State University
Funding: NHLBI Project U01HL097889 

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Adaptive Treatment Strategies for Children and Adolescents With Obsessive-Compulsive Disorder (OCD)

For youth with OCD, the most common treatments are cognitive-behavioral therapy (CBT), pharmacological treatment, or both. Up to 30% of patients may not benefit from their initial treatments. Researchers will employ a SMART to determine the optimal treatment sequence for participants dependent on whether or not they respond to their initial treatment.

PI: Roseli Shavitt
Location: University of Sao Paulo

 

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Pilot SMART for Adolescent Depression

Adolescents suffering from depression begin treatment with interpersonal psychotherapy. This pilot project employs SMART to help establish treatment rules regarding when and in what way to intensify treatment.

PI: Meredith L. Gunlicks-Stoessel
Location: University of Minnesota, Twin Cities
Funding: NIMH Project K23MH090216 

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This project aims to develop an adaptive intervention for persistent insomnia. Researchers are using SMART to determine the best sequencing of cognitive behavioral therapy and medication for persistent insomnia.

PI: Charles Morin
Location: Laval University
Funding: NIMH Project R01MH091053 

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Patients suffering from bipolar disorder are assigned to one of two mood stabilizers. A SMART design is used to determine the appropriate treatment for patients who develop depression.

PIs: Charles Lee Bowden, Joseph Calabres
Locations: University of Texas Health Science Center at San Antonio, 2nd site: Case Western Reserve University Medical Center
Funding: NIMH Project P30MH08604 

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This pilot project uses a SMART design to develop an adaptive intervention for children with depression. Dr. Eckshtain aims to develop decision rules regarding the use of cognitive behavioral treatment, caregiver–child treatment, or both. The goal is to develop an adaptive treatment protocol for depressed children.

PI: Dikla Eckshtain
Location: Judge Baker Children’s Center at Harvard Medical School
Funding: NIMH Project K23MH093491

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Characterizing Cognition in Nonverbal Individuals With Autism

In order to develop communication skills among school-aged children who are nonverbal, this project employs a SMART design to test a novel intervention. The intervention includes components that focus on spoken language and the use of a speech-generating device (e.g., iPad). The SMART design provides the data needed to define response and nonresponse to the intervention and identify the best treatment sequence.

PI: Connie Kasari
Location: Center for Autism Research and Treatment, University of California, Los Angeles
Funding: Funded by Autism Speaks

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Adaptive Interventions for Minimally Verbal Children With Autism Spectrum Disorder in the Community

This study will compare two types of intensive, daily instruction for children with autism spectrum disorder (ASD) who use only minimal verbal communication. Earlier research has shown that even after early language-skills training, about one-third of school-aged children with ASD remain minimally verbal. Researchers plan to enroll 200 children in four cities: Los Angeles, Nashville, New York City, and Rochester, N.Y.

PI: Connie Kasari
Location: Center for Autism Research and Treatment, University of California, Los Angeles
Funding: NICHD Project R01HD073975

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Adaptive Intervention Strategies in Conduct Problem Prevention: Pilot Study

This study compares two types of interventions for youth (ages 10-15) with conduct disorders. Participants received either a teen-focused or parent-focused intervention. The appropriate intensity of the interventions was also studied.

PI: Gerald August
Location: University of Minnesota
Funding: NIMH Project R34MH097832

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SMART Design for Attendance-Based Prize Contingency Management (CM) for Cocaine Abuse

Contingency management (CM) is a treatment used in substance abuse where patients are rewarded for following treatment guidelines. In this study, researchers are comparing CM to treatment without incentives using a SMART design. They are also testing the timing and the length of the CM.

PI: Nancy Petry
Location: University of Connecticut Health Center
Funding: NIDA Project R01AA021446

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Adaptive Treatment for Smoking Among People With HIV

Between 50% and 70% of people living with HIV are nicotine dependent. This SMART examines how and when to apply contingency management and standard treatment to promote smoking cessation in this population. 

PI: David Ledgerwood
Location: Wayne State
Funding: NIMH Project R01DA034537

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Pilot SMART for Treating ADHD in Families

This project aims to develop an adaptive intervention for families where the mother has ADHD and the child is at genetic and environmental risk for ADHD. Researchers are using SMART to determine how to use behavioral training or medication for mothers separately, in sequence, or in combination, to improve the quality of parenting and prevent the progression of ADHD in children.

PIs: Mark Stein and Andrea Chronis-Tuscano
Location: Seattle Children’s Hospital
Funding: NIMH Project R34MH99208

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Improving Mental Health Outcomes: Building an Adaptive Implementation Strategy

This SMART is cluster-randomized. Randomization occurs at the clinic level. The aim of the study is to develop an adaptive quality improvement strategy designed to enhance the implementation of an evidence-based mental health intervention. Outcomes are measured at the patient level. 

PI: Amy Kilbourne
Location: University of Michigan
Funding: NIMH Project R01MH099898

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Adaptive Intervention for Suicide Prevention Among College Students

Researchers in this study are developing an adaptive treatment to address suicidality in college students seeking services at college counseling centers. They are developing the first empirically validated approach to sequence treatments for students seeking services.

PI: Jacqueline Pistorello
Location: University of Nevada, Reno
Funding: NIMH Project R34MH104714

 

 

 

Pilot SMART for Elementary Students With Autism Spectrum Disorder

This project will develop an adaptive intervention to improve social connectedness, academic engagement, and other skills among school-aged children with autism spectrum disorder. Treatment for each participant includes some combination of a playground-based intervention, a classroom-based intervention, a peer-mediated intervention, and a parent-assisted intervention.​ This pilot project will address feasibility and acceptability concerns and will provide preliminary data for a full-scale SMART.

PI: Connie Kasari
Location: Center for Autism Research and Treatment, University of California, Los Angeles
Funding: Funded by Institute of Educational Sciences 

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Adolescent Substance Abuse: Progressive Treatment for Adolescent Who Use Drugs

Because the history of adolescent substance abuse interventions shows that individuals respond differently to treatment, this study uses a pair of SMART designs to examine when and how to treat adolescent drug users.

PI: Holly Barrett Waldron
Location: Oregon Research Institute
Funding: NIDA-funded, completed project