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December 12, 2008
Retreat Refreshes Behavioral, Social Sciences

Dr. Christine Bachrach, acting director of the Office of Behavioral and Social Sciences Research, wanted just one thing out of the first-ever day-long retreat for NIH’s widely dispersed community of behavioral and social scientists, held Nov. 12 at Natcher Bldg.

December 12, 2008
New Hope for Treatment of Addiction

Drug addiction is notoriously tough to treat, but now research is showing a fresh way to tackle the problem. It’s called computer-based training for cognitive-behavioral therapy (CBT4CBT)

OBSSR’s Mabry Wins with Systems Analysis Team

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January 22, 2009, ­ 3:00 PM to 4:00 PM
Sex, Drugs, and Viral Load: Integrating HIV/AIDS Prevention and Treatment

January 28-29, 2009 Dissemination and Implementation Conference

July 12-24, 2009
OBSSR/NIH Summer Training Institute on Randomized Clinical Trials Involving Behavioral Interventions

APPLICATIONS DUE Midnight on Sunday, January 4, 2009
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Behavioral and Social Sciences Research in the 21st Century

Summary of Recommendations from Six National Academy of Sciences Reports

“Approximately half of all causes of mortality in the United States are linked to social and behavioral factors such as smoking, diet, alcohol use, sedentary life-style, and accidents (McGinnis and Foege, 1993). Yet less than 5% of the approximately $1 trillion spent annually on health care in the United States is devoted to reducing risks posed by these preventable conditions (Centers for Disease Control and Prevention, 1992; Health Care Financing Administration, 2000). Behavioral and social interventions therefore offer great promise to reduce disease morbidity and mortality, but as yet their potential to improve the public's health has been relatively poorly tapped.”

         Committee on Capitalizing on Social Science and Behavioral Research to Improve the Public's Health, Institute of Medicine (2000) .

Over the past several years, the National Academy of Sciences convened six committees to address issues relevant to the support of behavioral and social sciences research by the National Institutes of Health (NIH). The overriding conclusion reached by the committees, articulated above, is that the understanding of behavioral and psychosocial processes is fundamental to understanding disease etiology and to promoting health. All six committees recommended that the NIH support interdisciplinary research that integrates the study of social, behavioral, psychological and biological factors in health and disease.

This document presents an integrated summary of ten common recommendations that emerged from six reports (Click here for additional details about the committees):

  • Promoting Health: Intervention Strategies From Social and Behavioral Research (2000)
  • The Aging Mind: Opportunities in Cognitive Research (2000)
  • Bridging the Disciplines in the Brain, Behavioral and Clinical Sciences (2000
  • From Neurons to Neighborhoods: The Science of Early Childhood Development (2000)
  • New Horizons in Health: An Integrative Approach (2001)
  • Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences (2001)
Recommendation 1.
Focus on the factors underlying good health, as well as disease.

Understanding what allows people to maintain good health is critical for both disease prevention and optimal recovery from illness. We know that many behavioral, psychological and social factors contribute to positive health, but have little understanding of how things like good diet and exercise, an optimistic outlook, or strong family and community ties translate at a physiological level -- into resistance to disease, for example. More research into the science of primary prevention is needed, to improve our ability to overcome harmful behaviors such as overeating, excessive alcohol consumption, smoking, and stress. Population-based initiatives need to be explored in order to promote good health by instruction of positive life practices and the provision of environmental supports to sustain them.

Recommendation 2.
Behavioral and social sciences research on issues related to health and disease should adopt a lifespan approach.

Biology and psychology change throughout ones life. Therefore, research into health and disease cannot focus solely on adulthood, but must cover the entire lifespan. Pre-natal factors, many of which can be linked to social, psychological, behavioral or economic status, are enormously important to an individuals health. Maternal nutrition, drug use and infection during pregnancy, for example, will all influence development of her offspring. Infant, childhood and adolescent experiences in different child care settings, schools and peer groups are all incorporated into the developing nervous system, setting patterns for life-long behavioral and physiological function. These need to be understood in order to promote optimal health.

Equally important to address is senescence, the other end of the lifespan continuum. Longitudinal studies of the wear and tear wrought by the stresses of life can help us better manage the physical and cognitive decline that defines the aging process. An understanding of how social and behavioral factors like community support, family involvement or physical activity maintain the health of the body and mind will allow an aging population to live in ways that optimize physical and cognitive function.

Recommendation 3.
Support research on interventions to promote health.

Research on interventions to promote health needs to be improved by integration and coordination across multiple levels. These range from the purely biological (e.g., gene therapy, pharmacological) and technological (e.g., improved automobile safety) to regulatory (e.g., anti-smoking laws), economic (e.g., taxes on alcohol), and societal (e.g., community and assisted living centers for seniors, occupational health in the workplace) measures. Research of this type must address cognitive and emotional outcomes, as well as physical health.

Interventions to promote good health must be evaluated to determine their effectiveness. This requires the development of quantitative and qualitative indicators, and assessments of the incremental effects of each component of comprehensive interventions over time. Evaluation research should aim to discover the mechanisms underlying cause-effect relationships between specific interventions and outcomes. Finally, analyses should consider benefits and costs (not only financial) of interventions to target individuals, their families, and their communities and also address dissemination and implementation of such measures. Specifically regarding health care, we need to resolve conflicting findings about whether medical care has high or low returns and for whom, when and how. We also must match measures of care to health outcomes and define the economic and health costs vs. benefits of managed care.

Recommendation 4.
Research on health and disease must be interdisciplinary, encompassing multiple levels of analysis and integrating across levels.

Behavioral and social sciences research is key to this interdisciplinary approach. For example, investigations of how social relationships influence gene expression and activity of the immune system could inform decisions on living conditions that might improve disease resistance. Identification of pathways through which social ties and interacting biological systems influence health practices and behaviors could improve efforts to adopt healthier lifestyles. At the macro-level, multilevel analyses should link population health dynamics to behavioral, psychosocial and environmental factors.

A major issue begging for attention from the research community is the sizeable health disparities that currently exist. In order to eliminate these disparities, the mechanisms by which racial, ethnic, socioeconomic and gender inequality affects health outcomes must be uncovered. How do differences in educational opportunity or status, access to medical care, cultural mores, physical environments, income and/or discrimination influence health? We also need to identify cultural strengths and health-enhancing resources of various racial and ethnic groups and their role in accounting for resilience in the face of inequality in socioeconomic status.

Recommendation 5.
Develop new methodologies and statistical tools.

Incorporating the behavioral and social sciences into more traditional biomedical research efforts will require the development of new methodologies and statistical capabilities. Narratives and other qualitative measures must be added to the more traditional quantitative ones. Methods that are responsive to functioning of complex, dynamic systems that change over time will be needed for the large-scale, longitudinal studies. Derivation of the greatest benefit from the interdisciplinary approach also requires the ability to link across multiple levels of analysis (molecular, genetic, cellular, physiological, cultural, social, community, population). Improved modeling to allow for prediction of outcomes bidirectionally and among all intermediate steps between the molecular and population levels will be essential.

Recommendation 6.
Integrate basic and clinical research.

Basic and clinical research must be integrated so that findings from basic research can be translated to clinicians and others who can design and implement preventative and therapeutic interventions. Information must also flow in the other direction, from the clinic to the research laboratory, as clinicians are in the best position to evaluate the interventions and convey to the basic researchers the needs for translational research. Clinical research also should be expanded beyond the biomedical, to incorporate the social and behavioral sciences.

Recommendation 7. Train investigators in interdisciplinary research.

Successful performance of interdisciplinary research that incorporates basic and clinical, biomedical, behavioral and social sciences will require changes in training of our scientists. Graduate training should be broadened to provide clinical training in PhD programs. Conversely, PhD and postdoctoral training for clinicians (physicians, nurses, dentists, social workers, etc.) should also be supported. To foster cross-fertilization between the biomedical and behavioral/social sciences, the latter should be included in MD/PhD programs.

Established investigators would also benefit from additional training in other disciplines, to broaden their expertise and allow them to do interdisciplinary research. This retraining could be accomplished by sabbaticals or participation in career development programs, workshops, symposia, conferences or summer institutes.

Implementation of an interdisciplinary research approach will require effort by funding agencies and universities. The NIH, for example, could increase its support of consortia and multi-institutional programs that cross traditional, disciplinary boundaries. Grant supplements for funded investigators to add interdisciplinary research efforts to their ongoing projects are another viable option to help established researchers adopt a more interdisciplinary approach. These supplements should require short applications that would undergo expedited review. In order for these efforts to succeed, however, the culture at universities has to be changed. Appropriate credit must be given for interdisciplinary research, by redistribution of overhead and support of shared facilities, for example. Faculty appointment/review processes should be revised so as not to penalize practitioners of interdisciplinary research.

Recommendation 8. Support research on animals, as well as on humans.

Animal models are invaluable for the delineation of the mechanisms underlying health and disease. It is beneficial to study animals both in the laboratory, where the investigator can control environmental factors, and in more natural settings, which better mimic the real world. Several state-of-the-art molecular and genetic technologies are especially well-suited to animal studies. DNA microarray technology allows investigators to determine how the environment alters the expression of multiple genes and ensuing behavioral responses. Transgenic animals, in which specific genes are deleted or expressed in a tissue- and/or time-dependent manner are enormously valuable in understanding the role of particular gene products in normal physiological function, thus allowing for the design of effective therapies to treat pathological conditions. For example, investigators are currently using transgenic mice to investigate how specific proteins produced in particular brain cells influence drug addiction.

Recommendation 9.
Build infrastructure.

An investment in a certain amount of infrastructure is necessary to sustain these interdisciplinary research efforts. Populations of animal models in the laboratory and in more naturalistic settings -- will have to be maintained. Transgenic animals will have to be produced and the colonies sustained. For the recommended lifespan perspective, these populations will have to be maintained through senescence. In addition, standardized behavioral testing paradigms related to human behavior will have to be developed in order for data from these new animal models to be applicable to humans. For brain/behavior studies, a monkey brain-imaging facility is recommended.

As described above, in order to most effectively study health and disease, long-term, longitudinal studies of human populations in social contexts (e.g., communities and populations) should be supported. General-use databases from these large-scale, longitudinal studies, measuring many variables should be established. Studies should cover the range of variation in the population and should support research aimed at understanding the relationships among neural, cognitive, behavioral, sensory-motor, health and life experience variables. The research community should be engaged in discussions of the problems involved in using such resources effectively to create a broadly useful longitudinal database. Also specifically recommended is a common database for human brain imaging data linked to behavioral characteristics.

Recommendation 10.
Collaboration among institutes/divisions at the NIH, other government agencies and the private sector will advance these research goals.
Interdisciplinary research crosses traditional boundaries within and between federal funding agencies and the private sector. Performance of true interdisciplinary research incorporating behavioral, social and biomedical sciences related to health and disease will require collaboration and cooperation among many different institutes and divisions within and between these entities.

National Academy of Sciences Reports

National Research Council (2000) The Aging Mind: Opportunities in Cognitive Research. Committee on Future Directions for Cognitive Research on Aging. PC Stern and LL Carstensen, eds. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

         The Committee identified promising opportunities in behavioral science, cognitive science and neuroscience and at the          conjunctions of these fields, relevant to changes in cognitive function during the aging process.

Institute of Medicine (2000) Bridging the Disciplines in the Brain, Behavioral and Clinical Sciences. Committee on Building Bridges in the Brain, Behavioral and Clinical Sciences. TC Pellmar and L Eisenberg, eds. Division of Neuroscience and Behavioral Health. Washington, DC: National Academy Press.

         The Committee examined needs/strategies for interdisciplinary training in the brain, behavioral, social and clinical          sciences in order to enhance translation of brain/behavior research to clinical settings and vice versa.

Institute of Medicine (2000) Promoting Health: Intervention Strategies From Social and Behavioral Research. Committee on Capitalizing on Social Science and Behavioral Research to Improve the Public's Health. BD Smedley and SL Syme, eds. Division of Health Promotion and Disease Prevention. Washington, DC: National Academy Press.

         The Committee identified promising areas of social science and behavioral research that may address public health          needs.

National Research Council and Institute of Medicine (2000) From Neurons to Neighborhoods: The Science of Early Childhood Development. Committee on Integrating the Science of Early Childhood Development. JP Shonkoff and DH Phillips, eds. Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

         The Committee reviewed scientific knowledge about the nature of early development and the role of early experiences, and          discussed the implications of this knowledge base for early childhood policy, practice, professional development, and          research.

National Research Council (2001) New Horizons in Health: An Integrative Approach. Committee on Future Directions for Behavioral and Social Sciences Research at the National Institutes of Health. BH Singer and CD Ryff, eds. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

         The Committee identified questions at the interface of social, behavioral and biomedical sciences, whose resolution could          lead to ;major improvements in health of the U.S. population.

Institute of Medicine (2001) Health and Behavior: The Interplay of Biological, Behavioral, and Societal Influences. Committee on Health and Behavior: Research, Practice and Policy, Board on Neuroscience and Behavioral Health. Washington, DC: National Academy Press.

         The Committee examined recent scientific advances about the biological, psychological, and social determinants of health          and about the nature of the interactions between health and behavior.