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Iterative quality improvement can occur faster than one element at a time.

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Responds to the comments by S. Hamby and J. Grych (see record 2013-31242-011) on the current authors' original article, "Disruptive innovations for designing and diffusing evidence-based interventions" (see record 2012-10813-001). Hamby and Grych implied that the careful and systematic testing of one element at a time is a prerequisite to its application in service contexts. This is certainly one valid approach to generating such evidence and follows the dominant paradigm of current scientific norms. In fact, it would partially contribute to a more molecular and theory-based understanding of intervention efficacy than we currently have; however, we believe that the choice to apply elements of an intervention or to study them first is a false dichotomy given the real-world complexities of behavioral interventions, ongoing need for interventions to impact families currently in need, and funding environments.

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