Public health practitioners combine proven interventions to tackle complex health challenges using new framework

December 1, 2025-- Vast resources have gone into developing and testing medical and public health interventions so they can be used confidently as evidence-based practices. Yet many interventions are deployed in isolation—even when the people they aim to help often face multiple, overlapping health challenges.

A new study led by researchers at Columbia University Mailman School of Public Health introduces an innovative method designed to increase the use and impact of evidence-based practices by combining them into stronger, multi-component programs. The findings are published in Annals of Epidemiology.

The COllaborative Method for Building INterventions from Existing Evidence-Based Interventions—known as COMBINE-EBIs—is a rigorous five-step process that helps public health practitioners and researchers merge existing, proven interventions into a single, streamlined program.

“COMBINE-EBIs is a thorough, systematic, and efficient approach for building multi-component, multi-modal interventions to address multiple, co-occurring health behaviors simultaneously,” said Justin Knox, PhD, associate professor of Clinical Implementation Science and Intervention in Psychiatry and Sociomedical Sciences.

In this particular study, the research team applied COMBINE-EBIs to develop a multi-component intervention for people with HIV who drink heavily. The resulting program leverages existing social support that they people already have from their friends and family along with smartphone technology and is designed to help them reduce their alcohol use and do well in HIV care.

“Many people experience health issues that are complex and interconnected. Multi-component interventions—especially those that bundle multiple proven strategies—offer a promising way to address real-world needs more holistically and efficiently,” said Knox.

The Five Steps of COMBINE-EBIs:

1. Identify and Select Relevant EBIs
2. Develop a Shared Conceptual Model
3. Evaluate and Align the Model
4. Create a Single Combined Protocol
5. Refine Through Further Input and Stakeholder Feedback

This structured process helps teams bring together existing interventions, minimize redundancy, improve coordination, and better respond to the needs of populations facing overlapping health challenges.

“As more frameworks call for interventions to be bundled or staged, we saw a clear need for a practical, evidence-based process for combining them,” Knox said. “COMBINE-EBIs offers a resource-efficient pathway for developing new multi-component interventions that address co-occurring health conditions synergistically.”

Knox and his colleagues suggest that by building on interventions with proven efficacy and emphasizing community engagement, COMBINE-EBIs provides a practical framework for accelerating public health gains. It offers a pathway for developing interventions that reflect the complexity of people’s lives—and the need for integrated, whole-person care.

See the paper for the full list of co-authors and their institutions.

The study was supported by the National Institute on Alcohol Abuse and Alcoholism, K01AA028199, and the National Institute on Mental Health P30MH043520.

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.