The Future of Behavioral Randomized Clinical Trials

The chapter aims to predict the future of behavioral randomized trials in four key areas. The emergence of a meta-science for behavioral clinical trials will replace the “one-size-fits all” approach to behavioral trial design with designs that feature a progression of questions, a progression of methods, and the use of guidelines to facilitate decision-making. Behavioral treatments will produce stronger effects with the emergence of precision lifestyle medicine that targets precisely those most likely to benefit and tailors precisely to diverse persons, settings, and time, and with multilevel trials that simultaneously intervene on more than one level of ecologic risk. Behavioral trials will be easier to implement using networks that collaborate on multi-site behavioral trials, leveraging data routinely collected in the healthcare system, and enhancing accessibility to trials using digital technology. The gap between trial results and implementation in practice will be narrowed by strategic planning for dissemination featuring outcomes in trials that are meaningful to clinicians and third-party payers, commitment to refine treatments that have failed, and a push toward influencing clinical practice guidelines with Phase III efficacy trials.