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Burgdorf CE, Riley WT, Akbar F, Zuehlke AD, Bibb K, Eshleman HD, Shah A, Belis D, Spittel M, Fearon P. Analysis of the health economics portfolio funded by the National Institutes of Health in response to published guidance. PLoS One 2024; 19:e0284235. [PMID: 38354126 PMCID: PMC10866517 DOI: 10.1371/journal.pone.0284235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
Health services, economics, and outcomes research (referred to as health economics research hereinafter) is one of the interdisciplinary sciences that the National Institutes of Health (NIH) supports in order to pursue its overall mission to improve health. In 2015, NIH guidance was published to clarify the type of health economics research that NIH would continue to fund. This analysis aimed to determine if there were changes in the number of health economics applications received and funded by NIH after the release of the guidance. Health economics applications submitted to NIH both before and after publication of the guidance were identified using a machine learning approach with input from subject matter experts. Application and funding trends were examined by fiscal year, method of application (solicited vs. unsolicited), and activity code. This study found that application and funding rates of health economics research were decreasing prior to guidance. Following publication of this guidance, the application and funding rate of health economics applications increased.
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Affiliation(s)
- Caitlin E. Burgdorf
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - William T. Riley
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Farheen Akbar
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Abbey D. Zuehlke
- Lexical Intelligence, Rockville, Maryland, United States of America
| | - Katrina Bibb
- Lexical Intelligence, Rockville, Maryland, United States of America
| | | | - Ami Shah
- Lexical Intelligence, Rockville, Maryland, United States of America
| | - Deshiree Belis
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michael Spittel
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Paula Fearon
- Lexical Intelligence, Rockville, Maryland, United States of America
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Walton L, Skillen E, Mosites E, Bures RM, Amah-Mbah C, Sandoval M, Thigpen Tart K, Berrigan D, Star C, Godette-Greer D, Kowtha B, Vogt E, Liggins C, Lloyd J. The intersection of health and housing: Analysis of the research portfolios of the National Institutes of Health, Centers for Disease Control and Prevention, and U.S. Department of Housing and Urban Development. PLoS One 2024; 19:e0296996. [PMID: 38285706 PMCID: PMC10824422 DOI: 10.1371/journal.pone.0296996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/20/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Housing is a major social determinant of health that affects health status and outcomes across the lifespan. OBJECTIVES An interagency portfolio analysis assessed the level of funding invested in "health and housing research" from fiscal years (FY) 2016-2020 across the National Institutes of Health (NIH), the United States Department of Housing and Urban Development (HUD), and the Centers for Disease Control and Prevention (CDC) to characterize the existing health and housing portfolio and identify potential areas for additional research and collaboration. METHODS/RESULTS We identified NIH, HUD, and CDC research projects that were relevant to both health and housing and characterized them by housing theme, health topic, population, and study design. We organized the assessment of the individual housing themes by four overarching housing-to-health pathways. From FY 2016-2020, NIH, HUD, and CDC funded 565 health and housing projects combined. The Neighborhood pathway was most common, followed by studies of the Safety and Quality pathway. Studies of the Affordability and Stability pathways were least common. Health topics such as substance use, mental health, and cardiovascular disease were most often studied. Most studies were observational (66%); only a little over one fourth (27%) were intervention studies. DISCUSSION This review of the research grant portfolios of three major federal funders of health and housing research in the United States describes the diversity and substantial investment in research at the intersection between housing and health. Analysis of the combined portfolio points to gaps in studies on causal pathways linking housing to health outcomes. The findings highlight the need for research to better understand the causal pathways from housing to health and prevention intervention research, including rigorous evaluation of housing interventions and policies to improve health and well-being.
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Affiliation(s)
- Liberty Walton
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Skillen
- Policy Analysis and Engagement Office, Office of Policy, Performance & Evaluation, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily Mosites
- Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Regina M. Bures
- Population Dynamics Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States of America
| | - Chino Amah-Mbah
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Maggie Sandoval
- Public Health and Epidemiology Practice, Westat, Rockville, Maryland, United States of America
| | - Kimberly Thigpen Tart
- Office of Science Coordination, Planning, and Evaluation, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina, United States of America
| | - David Berrigan
- Health Behaviors Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Carol Star
- Office of Policy Development and Research, Program Evaluation Division, U.S. Department of Housing and Urban Development, Washington, DC, United States of America
| | - Dionne Godette-Greer
- Division of Extramural Science Programs, National Institute of Nursing Research, Rockville, Maryland, United States of America
| | - Bramaramba Kowtha
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Elizabeth Vogt
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Charlene Liggins
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, United States of America
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Ganoza LF, Villani J, Klabunde CN. Investment in Prevention Health Care Delivery Research by the National Institutes of Health. Med Care 2023; 61:75-80. [PMID: 36630558 PMCID: PMC9846585 DOI: 10.1097/mlr.0000000000001809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Research assessing the delivery of preventive health care has considerable potential for improving health outcomes and reducing health care costs for the United States population. OBJECTIVE To characterize the prevention health care delivery research grant portfolio supported by the National Institutes of Health (NIH). MATERIALS AND METHODS A random sample of 14,523 NIH research projects funded during 2012-2019 was selected and coded for various study topics using a structured taxonomy. We analyzed the subset of prevention research projects, for which health care delivery was identified as an independent or dependent variable, including study characteristics and funding trends. RESULTS Overall, 11.2% of NIH-funded prevention research projects were relevant to health care delivery. Of these projects, 68.6% assessed access to care, 53.4% examined quality, and 27.1% assessed costs. Over the study period, the percentage of funded prevention research projects involving health care delivery increased from 10.9%-15.1%. Over half of the projects assessed research related to the prevention of a new health condition, identification of risk factors, or health promotion (55.5%), whereas < half addressed prevention of disease progression/recurrence (40.4%), screening for early disease (20.2%), or screening for risk factors (1.4%). human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use were the most prevalent health topics studied, whereas other topics-such as lung diseases and Alzheimer disease-were less frequently studied. CONCLUSIONS Health care delivery research comprises a modest portion of the NIH prevention research portfolio and is mostly focused on access and quality of care; cost-related analyses are less prevalent.human immunodeficiency virus/acquired immune deficiency syndrome, cancer, and substance use are frequently studied health topics in this portfolio.
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Affiliation(s)
- Luis F. Ganoza
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, 6705 Rockledge Drive, Room 733, MSC 7990, Bethesda, MD 20892
| | - Jennifer Villani
- National Institute on Drug Abuse, National Institutes of Health, Three White Flint North, 11601 Landsdown St, North Bethesda, MD 20852
| | - Carrie N. Klabunde
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, 6705 Rockledge Drive, Room 733, MSC 7990, Bethesda, MD 20892
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Ganoza LF, Alvidrez J, Liggins CA. Assessing National Institutes of Health Prevention Research on Leading Causes of Death Focused on Racial or Ethnic Minority Populations, Fiscal Years 2016-2020. Ethn Dis 2023; 33:44-50. [PMID: 38846263 PMCID: PMC11152156 DOI: 10.18865/1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024] Open
Abstract
Objective To characterize the National Institutes of Health (NIH) prevention research portfolio on leading causes of death focused on racial or ethnic minority populations. Research Design Longitudinal analysis of NIH-funded prevention research projects from FY2016-FY2020. Measures Project characteristics including type of prevention, study design, budget, minority health focus, and causes of death addressed. Results Minority health projects comprised 27.0% of prevention projects and 33.1% of funding across all leading causes of death. Homicide (42.9%), diabetes (36.3%), and stroke (35.5%) had the highest proportion of minority health projects and suicide (20.2%), Alzheimer disease (18.8%), and pneumonia or influenza (8.3%) the lowest. Most minority health projects focused on identifying risk factors or on primary prevention efforts (80.3%). Most projects had an observational design (80.0%), and this predominance was observed for each cause of death. There was a significant correlation between the proportion of minority health projects for cause of death and the ratio of minorities versus non-minorities mortality rate. Conclusions Only about one-fourth of NIH-funded prevention research on leading causes of death focused on racial or ethnic minorities, who currently comprise about 40% of the US population. Only a small fraction of minority health prevention projects included an intervention design, suggesting a limited contribution to the evidence base on effective interventions to address racial or ethnic mortality disparities. Also, we identified that the number of projects increase where mortality rate disparities are higher. This portfolio analysis provides a useful baseline to assess future progress in building the minority health prevention research portfolio, a critical component to promoting health equity in population health.
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Affiliation(s)
- Luis F. Ganoza
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Jennifer Alvidrez
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
| | - Charlene A. Liggins
- Office of Disease Prevention, Division of Program Coordination, Planning, and Strategic Initiatives, Office of the Director, National Institutes of Health, Bethesda, MD
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Oyedele NK, Ganoza LF, Schully SD, Liggins CA, Murray DM. NIH Primary and Secondary Prevention Research in Humans: a Portfolio Analysis of Study Designs Used in 2012-2019. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:477-487. [PMID: 35064895 DOI: 10.1007/s11121-022-01337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
We can learn a great deal about the research questions being addressed in a field by examining the study designs used in that field. This manuscript examines the research questions being addressed in prevention research by characterizing the distribution and trends of study designs included in primary and secondary prevention research supported by the National Institutes of Health through grants and cooperative agreements, together with the types of prevention research, populations, rationales, exposures, and outcomes associated with each type of design. The Office of Disease Prevention developed a taxonomy to classify new extramural NIH-funded research projects and created a database with a representative sample of 14,523 research projects for fiscal years 2012-2019. The data were weighted to represent the entirety of the extramural research portfolio. Leveraging this dataset, the Office of Disease Prevention characterized the study designs proposed in NIH-funded primary and secondary prevention research applications. The most common study designs proposed in new NIH-supported prevention research applications during FY12-19 were observational designs (63.3%, 95% CI 61.5%-65.0%), analysis of existing data (44.5%, 95% CI: 42.7-46.3), methods research (23.9%, 95% CI: 22.3-25.6), and randomized interventions (17.2%, 95% CI: 16.1%-18.4%). Observational study designs dominated primary prevention research, while intervention designs were more common in secondary prevention research. Observational designs were more common for exposures that would be difficult to manipulate (e.g., genetics, chemical toxin, and infectious disease (not pneumonia/influenza or HIV/AIDS)), while intervention designs were more common for exposures that would be easier to manipulate (e.g., education/counseling, medication/device, diet/nutrition, and healthcare delivery). Intervention designs were not common for outcomes that are rare or have a long latency (e.g., cancer, neurological disease, Alzheimer's disease) and more common for outcomes that are more common or where effects would be expected earlier (e.g., healthcare delivery, health related quality of life, substance use, and medication/device). Observational designs and analyses of existing data dominated, suggesting that much of the prevention research funded by NIH continues to focus on questions of association and on questions of identification of risk and protective factors. Randomized and non-randomized intervention designs were included far less often, suggesting that a much smaller fraction of the NIH prevention research portfolio is focused on questions of whether interventions can be used to modify risk or protective factors or to change some other health-related biomedical or behavioral outcome. The much heavier focus on observational studies is surprising given how much we know already about the leading risk factors for death and disability in the USA, because those risk factors account for 74% of the county-level mortality in the USA, and because they play such a vital role in the development of clinical and public health guidelines, whose developers often weigh results from randomized trials much more heavily than results from observational studies. Improvements in death and disability nationwide are more likely to derive from guidelines based on intervention research to address the leading risk factors than from additional observational studies.
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Affiliation(s)
- Natasha K Oyedele
- Office of Disease Prevention, Division of Program Coordination Planning and Strategic Initiatives, Office of the Director, NIH, Bethesda, MD, USA.
| | - Luis F Ganoza
- Office of Disease Prevention, Division of Program Coordination Planning and Strategic Initiatives, Office of the Director, NIH, Bethesda, MD, USA
| | - Sheri D Schully
- All of Us Research Program, Office of the Director, NIH, Bethesda, MD, USA
| | - Charlene A Liggins
- Office of Disease Prevention, Division of Program Coordination Planning and Strategic Initiatives, Office of the Director, NIH, Bethesda, MD, USA
| | - David M Murray
- Office of Disease Prevention, Division of Program Coordination Planning and Strategic Initiatives, Office of the Director, NIH, Bethesda, MD, USA
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Murray DM, Ganoza LF, Vargas AJ, Ellis EM, Oyedele NK, Schully SD, Liggins CA. New NIH Primary and Secondary Prevention Research During 2012-2019. Am J Prev Med 2021; 60:e261-e268. [PMID: 33745818 DOI: 10.1016/j.amepre.2021.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This manuscript characterizes primary and secondary prevention research in humans and related methods research funded by NIH in 2012‒2019. METHODS The NIH Office of Disease Prevention updated its prevention research taxonomy in 2019‒2020 and applied it to a sample of 14,523 new extramural projects awarded in 2012-2019. All projects were coded manually for rationale, exposures, outcomes, population focus, study design, and type of prevention research. All results are based on that manual coding. RESULTS Taxonomy updates resulted in a slight increase, from an average of 16.7% to 17.6%, in the proportion of prevention research awards for 2012‒2017; there was a further increase to 20.7% in 2019. Most of the leading risk factors for death and disability in the U.S. were observed as an exposure or outcome in <5% of prevention research projects in 2019 (e.g., diet, 3.7%; tobacco, 3.9%; blood pressure, 2.8%; obesity, 4.4%). Analysis of existing data became more common (from 36% to 46.5%), whereas randomized interventions became less common (from 20.5% to 12.3%). Randomized interventions addressing a leading risk factor in a minority health or health disparities population were uncommon. CONCLUSIONS The number of new NIH awards classified as prevention research increased to 20.7% in 2019. New projects continued to focus on observational studies and secondary data analysis in 2018 and 2019. Additional research is needed to develop and test new interventions or develop methods for the dissemination of existing interventions, which address the leading risk factors, particularly in minority health and health disparities populations.
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Affiliation(s)
- David M Murray
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland.
| | - Luis F Ganoza
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Ashley J Vargas
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Erin M Ellis
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Natasha K Oyedele
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
| | - Sheri D Schully
- All of Us Research Program, Office of the Director, NIH, Bethesda, Maryland
| | - Charlene A Liggins
- Office of Disease Prevention, Division of Program Coordination Planning, and Strategic Initiatives, Office of the Director, NIH, Bethesda, Maryland
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Gallo C, Abram K, Hannah N, Caton L, Cimaglio B, McGovern M, Brown CH. Sustainability planning in the US response to the opioid crisis: An examination using expert and text mining approaches. PLoS One 2021; 16:e0245920. [PMID: 33507985 PMCID: PMC7842889 DOI: 10.1371/journal.pone.0245920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/08/2021] [Indexed: 02/07/2023] Open
Abstract
Between January 2016 and June 2020, the Substance Abuse and Mental Health Services Administration rapidly distributed $7.5 billion in response to the U.S. opioid crisis. These funds are designed to increase access to medications for addiction treatment, reduce unmet treatment need, reduce overdose death rates, and provide and sustain effective prevention, treatment and recovery activities. It is unclear whether or not the services developed using these funds will be sustained beyond the start-up period. Based on 34 (64%) State Opioid Response (SOR) applications, we assessed the states' sustainability plans focusing on potential funding sources, policies, and quality monitoring. We found variable commitment to sustainability across response plans with less than half the states adequately describing sustainability plans. States with higher proportions of opioid prescribing, opioid misuse, and poverty had somewhat higher scores on sustainment. A text mining/machine learning approach automatically rated sustainability in SOR applications with an 82% accuracy compared to human ratings. Because life saving evidence-based programs and services may be lost, intentional commitment to sustainment beyond the bolus of start-up funding is essential.
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Affiliation(s)
- Carlos Gallo
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Karen Abram
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Nanette Hannah
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Lauren Caton
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Barbara Cimaglio
- Illinois Department of Human Services, Division of Substance Use Prevention and Recovery, Chicago, Illinois, United States of America
| | - Mark McGovern
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, United States of America
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - C. Hendricks Brown
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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Vargas AJ, Sprow K, Lerman JL, Villani J, Regan KS, Ballard RM. Diet and Physical Activity Prevention Research Supported by the U.S. NIH From 2012-2017. Am J Prev Med 2019; 57:818-825. [PMID: 31753263 PMCID: PMC6894494 DOI: 10.1016/j.amepre.2019.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Poor diet and inadequate physical activity are common contributors to preventable death in the U.S. This paper provides a summary of the NIH-sponsored research on disease prevention that underlies public health and clinical recommendations to improve diet and physical activity. METHODS A representative sample (n=11,082) of research grants and cooperative agreements (research projects) representing the NIH prevention research portfolio between 2012 and 2017 were hand coded by trained analysts in 2017-2018. This manuscript describes the rationale(s), exposure(s), outcome(s), population(s), and study design(s) in prevention research focused on diet and physical activity and compares this research to identified research gaps in the field. RESULTS A relatively stable 7.8% (95% CI=7.0%, 8.8%) and 5.0% (95% CI=4.4%, 5.7%) of the NIH prevention research projects were focused on diet and physical activity, respectively, during 2012-2017. These projects often explored diet and physical activity together in the context of obesity, included observational studies, and focused on a general adult population. Few of these projects focused on development of improved assessment methods. Approximately 50% of these studies were related to research gaps identified by the 2015 Dietary or 2018 Physical Activity Guidelines Advisory Committee Scientific Reports. CONCLUSIONS Opportunities exist for more engagement by NIH and scientific investigators in diet- and physical activity-focused prevention research, particularly around assessment and known research gaps.
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Affiliation(s)
| | - Kyle Sprow
- National Cancer Institute, NIH, Rockville, Maryland
| | - Jennifer L Lerman
- National Cancer Institute, NIH, Rockville, Maryland; ICF International, Fairfax, Virginia
| | | | - Karen S Regan
- National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, Maryland; Office of Dietary Supplements, NIH, Rockville, Maryland
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Vargas AJ, Schully SD, Villani J, Ganoza Caballero L, Murray DM. Assessment of Prevention Research Measuring Leading Risk Factors and Causes of Mortality and Disability Supported by the US National Institutes of Health. JAMA Netw Open 2019; 2:e1914718. [PMID: 31702797 PMCID: PMC6902772 DOI: 10.1001/jamanetworkopen.2019.14718] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE No studies to date have examined support by the National Institutes of Health (NIH) for primary and secondary prevention research in humans and related methods research that measures the leading risk factors or causes of death or disability as outcomes or exposures. OBJECTIVE To characterize NIH support for such research. DESIGN AND SETTING This serial cross-sectional study randomly sampled NIH grants and cooperative agreements funded during fiscal years 2012 through 2017. For awards with multiple subprojects, each was treated as a separate project. Study characteristics, outcomes, and exposures were coded from October 2015 through February 2019. Analyses weighted to reflect the sampling scheme were completed in March through June 2019. Using 2017 data from the Centers for Disease Control and Prevention and 2016 data from the Global Burden of Disease project, the leading risk factors and causes of death and disability in the United States were identified. MAIN OUTCOMES AND MEASURES The main outcome was the percentage of the NIH prevention research portfolio measuring a leading risk factor or cause of death or disability as an outcome or exposure. RESULTS A total of 11 082 research projects were coded. Only 25.9% (95% CI, 24.0%-27.8%) of prevention research projects measured a leading cause of death as an outcome or exposure, although these leading causes were associated with 74.0% of US mortality. Only 34.0% (95% CI, 32.2%-35.9%) measured a leading risk factor for death, although these risk factors were associated with 57.3% of mortality. Only 31.4% (95% CI, 29.6%-33.3%) measured a leading risk factor for disability-adjusted life-years lost, although these risk factors were associated with 42.1% of disability-adjusted life-years lost. Relatively few projects included a randomized clinical trial (24.6%; 95% CI, 22.5%-26.9%) or involved more than 1 leading cause (3.3%; 95% CI, 2.6%-4.1%) or risk factor (8.8%; 95% CI, 7.9%-9.8%). CONCLUSIONS AND RELEVANCE In this cross-sectional study, the leading risk factors and causes of death and disability were underrepresented in the NIH prevention research portfolio relative to their burden. Because so much is already known about these risk factors and causes, and because randomized interventions play such a vital role in the development of clinical and public health guidelines, it appears that greater attention should be given to develop and test interventions that address these risk factors and causes, addressing multiple risk factors or causes when possible.
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Affiliation(s)
- Ashley J. Vargas
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Sheri D. Schully
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Jennifer Villani
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
| | - Luis Ganoza Caballero
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
- Scientific Consulting Group, Inc, Gaithersburg, Maryland
| | - David M. Murray
- Office of Disease Prevention, National Institutes of Health, North Bethesda, Maryland
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Murray DM, Villani J, Vargas AJ, Lee JA, Myles RL, Wu JY, Mabry PL, Schully SD. NIH Primary and Secondary Prevention Research in Humans During 2012-2017. Am J Prev Med 2018; 55:915-925. [PMID: 30458950 PMCID: PMC6251492 DOI: 10.1016/j.amepre.2018.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/30/2018] [Accepted: 08/08/2018] [Indexed: 12/19/2022]
Abstract
INTRODUCTION This paper provides the first detailed analysis of the NIH prevention research portfolio for primary and secondary prevention research in humans and related methods research. METHODS The Office of Disease Prevention developed a taxonomy of 128 topics and applied it to 11,082 projects representing 91.7% of all new projects and 84.1% of all dollars used for new projects awarded using grant and cooperative agreement activity codes that supported research in fiscal years 2012-2017. Projects were coded in 2016-2018 and analyzed in 2018. RESULTS Only 16.7% of projects and 22.6% of dollars were used for primary and secondary prevention research in humans or related methods research. Most of the leading risk factors for death and disability in the U.S. were selected as an outcome in <5% of the projects. Many more projects included an observational study, or an analysis of existing data, than a randomized intervention. These patterns were consistent over time. CONCLUSIONS The appropriate level of support for primary and secondary prevention research in humans from NIH will differ by field and stage of research. The estimates reported here may be overestimates, as credit was given for a project even if only a portion of that project addressed prevention research. Given that 74% of the variability in county-level life expectancy across the U.S. is explained by established risk factors, it seems appropriate to devote additional resources to developing and testing interventions to address those risk factors.
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Affiliation(s)
| | | | | | - Jocelyn A Lee
- Office of Disease Prevention, NIH, Rockville, Maryland
| | | | - Jessica Y Wu
- University of California Research Initiatives, University of California, Office of the President, Oakland, California
| | - Patricia L Mabry
- Indiana University Network Science Institute and School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
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Wallace RB. Machine Learning to Identify Prevention-Related Research Grants. Am J Prev Med 2018; 55:913-914. [PMID: 30454640 DOI: 10.1016/j.amepre.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Robert B Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
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