# Using Intervention Mapping and the Multiphase Optimization Strategy to develop multilevel interventions to prevent upper GI bleeding

> **NIH NIH K23** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $194,400

## Abstract

PROJECT SUMMARY/ABSTRACT
Candidate: Jacob E. Kurlander, MD, MSc is a gastroenterologist and early career investigator focused on
reducing the burden of disease associated with upper gastrointestinal bleeding (UGIB). With prior master's-
level training in clinical and health services research, he has been successful in conducting retrospective
research but has little experience with formal interventional studies. This K23 mentored career development
award will provide him with the unique skills necessary to design and evaluate innovative, theory-based,
multilevel interventions aimed at prevention of UGIB. Research Context: Peptic ulcer disease (PUD) is a
prevalent and morbid condition that can result in hemorrhage, intestinal perforation, and death. In high-risk
patients, including many who use antiplatelet therapy or nonsteroidal anti-inflammatory drugs, proton pump
inhibitor (PPI) gastroprotection can dramatically reduce the risk of PUD. However, fewer than half of high-risk
patients receive appropriate gastroprotection. Provider-facing interventions to improve the use of
gastroprotection have shown only marginal success. Multilevel interventions, targeting patients and at least
two other contextual factors (e.g., providers and systems) simultaneously, are increasingly recognized as a
powerful strategy to improve intervention effectiveness. However, the development and evaluation of theory-
based, multilevel interventions are complex because of the multiple interacting components. Research Aims:
Dr. Kurlander will leverage Intervention Mapping (IM), a validated framework for theory-based intervention
development, to: (1) Develop an in-depth understanding of patient-, provider-, and system-level barriers and
facilitators to appropriate PPI gastroprotection by conducting semi-structured interviews with patients,
providers, and other key informants; (2) Design and produce a theory-based multilevel intervention that
targets patients, providers, and the health system; (3) Assess the feasibility, appropriateness, and efficacy of the
multilevel intervention in a single-site pilot study. This pilot will serve as the first step of the Multiphase
Optimization Strategy (MOST), a framework for progressively preparing, optimizing, and evaluating
multicomponent interventions. Training Aims: Dr. Kurlander will develop expertise in: (1) Qualitative
research methods to understand contextual aspects of health care delivery; (2) Theory-based, multilevel
intervention development; and (3) Evaluation and optimization methods for multilevel interventions. He also
will receive specific training in the responsible conduct of research. Dr. Kurlander's training will be supported
by highly experienced, interdisciplinary mentors, advanced didactic coursework, and participation in research
and career development meetings/seminars within an ideal training environment. As a result of the mentored
research training from this award, Dr. Kurlander will become an independent inves...

## Key facts

- **NIH application ID:** 9938545
- **Project number:** 5K23DK118179-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** JACOB ELI KURLANDER
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $194,400
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9938545

## Citation

> US National Institutes of Health, RePORTER application 9938545, Using Intervention Mapping and the Multiphase Optimization Strategy to develop multilevel interventions to prevent upper GI bleeding (5K23DK118179-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9938545. Licensed CC0.

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