Annals of Behavioral Medicine
[ Special Supplement coming in 2004]

Health Behavior Change Research:
A Consortium Approach to Collaborative Science

By stimulating a wide range of cross-project collaborations, the BCC has supported unique efforts for theory-comparison and multiple-behavior research that can better integrate empirical research in our efforts to change health behaviors. This includes finding new ways to enhance recruitment and retention, especially among diverse populations; improving treatment fidelity; developing common metrics across behaviors that can be used to advance the measurement and assessment of behavioral change; and expanding the reach and translation of effective intervention approaches. The BCC has cultivated unprecedented opportunities for cross-site collaboration in order to explore both theoretical and empirical issues important to advancing our understanding of the mechanisms of behavior change. Such work provides a stronger basis for advancing our knowledge of the processes by which people change and maintain health behaviors in an effort to better facilitate those processes.

This supplement issue will present the collective knowledge that has been gained from cross-site initiatives and relationships of the BCC. The content of the issue will include an overview of critical issues in health behavior change research, including behavior-specific measurement issues (i.e., nutrition, physical activity, tobacco dependence), methodological considerations (e.g., recruitment and retention, treatment fidelity), and impact issues (e.g., representativeness and translation).

Proposed Manuscripts

The following workgroups are scheduled to participate in this journal supplement. Specific titles and topics could be subject to change. 

·         Yours, mine and ours: The importance of scientific collaboration in advancing the field of
behavior change research

Brief Description: The inter- and intra-organizational collaboration fostered BCC is unparalleled. In addition to the approximately $8 million annually in funding from NIH, the BCC has received at least $300,000 for cross-site research activities from the Robert Wood Johnson Foundation, approximately $200,000 toward costs of the bi-annual meetings from the American Heart Association, and a further $1.1 million in supplementary funding from various Institutes for workgroup activities. In the four years that the BCC has been operating, it has evolved from a collection of novel research projects to a consortium of investigators whose collaborative infrastructure has multiplied the scientific value of each single intervention at least 15-fold. This paper will describe the various processes involved in the creation and sustainability of the BCC, including internal and external communications, leadership, workgroup roles, private and public partnerships, issues associated with data sharing, joint publication guidelines, and discuss why in the case of the BCC, the whole is far greater than the sum of its parts.
Primary Authors: Patricia J. Jordan, Ph.D., Behavior Change Consortium; Marcia Ory, Ph.D., Texas A & M University System; Tamara Sher, Ph.D., Illinois Institute of Technology

·         Screening for Physical Activity

Brief Description: Although there are current public health recommendations encouraging Americans to become more physically active, little is known about what are the most appropriate screening practices for those entering new activity programs, the impact of screening on individuals initiating exercise programs or the relationship between screening and adverse events, or the adverse events associated with becoming more active. Utilizing data from several BCC sites promoting more physical activity, this paper provides a unique examination of experiences in different types of studies, populations and settings.
Primary Authors: Marcia Ory, Ph.D., Texas A & M University System; Barbara Resnick, Ph.D., University of Maryland; Mace Coday, Ph.D., The University of Tennessee Health Science Center; Deborah Riebe, Ph.D., University of Rhode Island; Leslie Pruitt, Ph.D., Stanford University; Terry Bazzarre, Ph.D., Robert Rood Johnson Foundation; Carol Garber, Ph.D., Brown University; additional authors on behalf of the Physical Activity workgroup TBA

·         Physical Activity Staging Distribution: Establishing a Heuristic Using Multiple Studies

Brief Description: Knowledge of the readiness to change of a population is paramount for maximizing the effectiveness of interventions. This paper, which examines the BCC studies addressing physical activity, allows for an unprecedented establishment of distribution estimates for non-clinical and clinical study samples. In addition, the impact of recruitment methods (reactive versus proactive) on the stage of readiness distribution will be investigated.
Primary Authors: Laurie Hellsten, Ph.D., University of Saskatoon; Claudio R. Nigg, Ph.D., University of Hawaii at Manoa; additional authors on behalf of the Physical Activity workgroup TBA

·         Using Motivational Interviewing in Public Health Research: Training Experiences from the Field

Brief Description: Motivational interviewing (MI), initially developed for addiction counseling, has increasingly been applied in a number of health promotion settings. This paper will describe the methods used to train and supervise intervention staff to deliver a MI intervention in various public health settings, and will provide examples of training strategies from a number of BCC projects intervening on a variety of health behaviors. The authors will compare the various approaches required to train staff to conduct public health interventions with those needed to deliver clinical treatment, and will contrast the ideals of providing high-quality MI training with the limitations of conducting field research and offer recommendations for future studies.
Primary Authors: Ken Resnicow, Ph.D., Emory University; Jacki Hecht, R.N., M.S.N., Brown Medical School/The Miriam Hospital; Rosemary Breger, M.P.H., Oregon Health & Science University; Belinda Borrelli, Ph.D., Brown Medical School; and Denise Ernst, M.A., Kaiser Permanente Center for Health Research

·         Measuring tobacco use and abstinence outcomes in clinical trials: 
The Behavior Change Consortium experience supports reporting prolonged abstinence

Brief Description: Measuring tobacco use and abstinence outcomes in the 15 Behavior Change Consortium (BCC) studies presented many challenges that are common to studies of health related behavior change. Study designs varied between observational (10), cessation induction (3), aid to cessation (2), and reducing exposure to environmental smoke (1), and the interventions varied in strength from web-based to intensive individual counseling. Considerations given for how recommendations for assessing how tobacco use and outcomes were made will be discussed. Empirical support from a BCC study will be presented and discussed supporting current Society for Research on Nicotine and Tobacco’s recommendations for reporting prolonged abstinence primarily, and seven day point prevalence secondarily, in all clinical trials.
Primary Authors: Geoffrey C. Williams, M.D., Ph.D., University of Rochester; Holly McGregor, Ph.D., University of Rochester; Belinda Borrelli, Ph.D., Brown University Medical School; Patricia J. Jordan, Ph.D., Behavior Change Consortium; Claudio R. Nigg, Ph.D., University of Hawaii at Manoa; Vic Strecher, Ph.D., University of Michigan; Cathy Backinger, Ph.D., National Cancer Institute

·         Research in the Real World: When Behavioral Trials Meet with Life’s Realities
and its Impact on Attrition

Brief Description: The strength of behavior change trials lies in the extent to which intervention results can be generalized to broader populations. In this context, much data has emerged on recruiting adequate numbers of representative participants into clinical trials. Conversely, retaining study participants in behavioral trials, an equally formidable task, has received far less attention and systematic study by investigators. This paper attempts to identify life course events occurring from middle childhood through older age adulthood that may make it difficult for participants to remain in a clinical trial from randomization through study close out. The paper will also describe and rate the effectiveness of the retention strategies employed by 15 behavior modification trials in combating study attrition as evidenced by follow up retention rates across diverse populations.
Primary Authors: Carla Boutin-Foster, M.D., M.S., Weill Cornell Medical College; Mace Coday, Ph.D., The University of Tennessee Health Science Center; Tamara Sher, Ph.D., Illinois Institute of Technology; Jennifer Tennant, R.N., Rush-Presbyterian-St. Luke’s Medical Center; Judy Salkeld, Ph.D., Harvard School of Public Health; Molly Greaney, Ph.D., University of Rhode Island; Sandra Saunders, M.P.H., University of Rhode Island

·         Beginning with the Application in Mind: Designing and Planning Health Behavior Change
Interventions to Enhance Translation & Dissemination

Brief Description: It is well known that improvements are needed in the translation and dissemination of behavior change interventions to achieve national population health goals.  Designing and planning interventions with the “end-user” in mind can improve the generalizability and applicability of programs and enhance their translation. This paper uses the RE-AIM framework of reach, efficacy/effectiveness, adoption, implementation and maintenance to organize significant planning questions and describe key study features that can strengthen the potential translation of behavioral change research.  Implementing these recommendations will also enhance linkages between researchers, program adopters, delivery agents, and communities in improving population health.  
Primary Authors: Lisa Klesges, Ph.D., University of Tennessee, Memphis; Russ Glasgow, Ph.D., Kaiser Permanente, Colorado; Paul Estabrooks, Ph.D., Kansas State University; David Dzewaltowski, Ph.D., Kansas State University

 For more information about the upcoming special issue, please contact the BCC's Communications Coordinator at beatles@etal.uri.edu.