Transdisciplinary translational behavioral (TDTB) research: opportunities, barriers, and innovations

The translation of basic behavioral science discoveries into practical strategies represents a promising approach to developing more effective preventive interventions to improve health. Since translational research inevitably involves making use of diverse perspectives from multiple disciplines, it is best conducted as a transdisciplinary enterprise. In this paper, we discuss current strategies used by NIH to support transdisciplinary translational behavioral (TDTB) research, summarize successful efforts, and highlight challenges encountered in conducting such work (ranging from conceptual to organizational to methodological). Using examples from NIH-funded projects we illustrate the potential benefits of, and barriers to, pursuing this type of research and discuss next steps and potential future directions for NIH-supported TDTB research.

A standard for test reliability in group research

Many authors adhere to the rule that test reliabilities should be at least .70 or .80 in group research. This article introduces a new standard according to which reliabilities can be evaluated. This standard is based on the costs or time of the experiment and of administering the test. For example, if test administration costs are 7 % of the total experimental costs, the efficient value of the reliability is .93. If the actual reliability of a test is equal to this efficient reliability, the test size maximizes the statistical power of the experiment, given the costs. As a standard in experimental research, it is proposed that the reliability of the dependent variable be close to the efficient reliability. Adhering to this standard will enhance the statistical power and reduce the costs of experiments.

Addiction treatment outcomes, process and change: Texas Institute of Behavioral Research at Texas Christian University

For more than 40 years the Texas Institute of Behavioral Research (IBR) has given special attention to assessment and evaluation of drug user populations, addiction treatment services and various cognitive and behavioral interventions. Emphasis has been on studies in real-world settings and the use of multivariate methodologies to address evaluation issues within the context of longitudinal natural designs. Historically, its program of addiction treatment research may be divided into three sequential epochs-the first era dealt mainly with client assessment and its role in treatment outcome and evaluation (1969-89), the second focused upon modeling the treatment process and the importance of conceptual frameworks (1989-2009) in explaining the relationships among treatment environment, client attributes, treatment process and outcome, and the third (and current) era has expanded into studying tactical deployment of innovations and implementation. Recent projects focus upon adapting and implementing innovations for improving early engagement in adolescent residential treatment settings and drug-dependent criminal justice populations. Related issues include the spread of human immunodeficiency virus/acquired immune deficiency syndrome and other infectious diseases, organizational and systems functioning, treatment costs and process related to implementation of evidence-based practices.

Federal funding of social work research: high hopes or sour grapes?

Placed in the historical context of government funding ofacademic research, this critical analysis identifies the complexities and implications of schools of social work pursuing federal grants for research. Schools of social work with particular organizational characteristics are better able to compete for federal grants, incurring lower opportunity costs than others. The low probability of grant success for most schools, the organizational adaptations needed for success, and the narrow epistemology of many funding programs call into question whether federal funding of research should be considered the sine qua non for academic social work.

Overview of methods in economic analyses of behavioral interventions to promote oral health

BACKGROUND

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE.

OBJECTIVE

To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health.

METHODS

We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described.

DISCUSSION

Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.

An institutional postdoctoral research training program: predictors of publication rate and federal funding success of its graduates

OBJECTIVE

The National Institute of Mental Health funds institutional National Research Service Awards (NRSA) to provide postdoctoral research training. While peer-reviewed publications are the most common outcome measure utilized, there has been little discussion of how publications should be counted or what factors impact the long-term publication rates of trainees in these programs.

METHODS

The authors reviewed current curricula vitae from 92 graduates of an institutional NRSA and from the faculty mentors of that program to assess publications through 2005. Publications were weighted based on peer versus non-peer-reviewed and authorship position. Trainee and mentor factors were assessed for their impact on publication rates and on becoming principal investigators of larger scale federal grants such as a National Institutes of Health (NIH) R01.

RESULTS

Weighted publication scores correlate with total publication rates at such a high rate that the two scores can be used interchangeably. Forty-three percent of graduates average at least one publication per year after completing the postdoctoral program; 20% were listed as an independent investigator on a larger federal grant. The number of publications published during postdoctoral training and additional funded training beyond that provided by the institutional NRSA are correlated with increased posttraining program publication rates; other factors including gender, terminal degree, number of publications prior to postdoctoral training, and mentor variables had no significant impact. Additional funded training, male gender, and increased time since completion of the training are associated with increased likelihood of larger grant federal funding.

CONCLUSION

Weighting publications by whether they were peer-reviewed and by authorship position appears to have little benefit over a simple counting of the number of publications. Publication during research training and the pursuit of funding for additional individual research training may be appropriate short-term goals within an institutional research training program.

Drug pricing: No cure, no cost

A drug company is set to refund the NHS if its new drug doesn't work. As pressure on healthcare budgets grows, Andrew Jack investigates the worldwide movement towards value based pricing

Incentive program decreases no-shows in nontreatment substance abuse research

This study examined the use of a low-cost incentive program to decrease the rate of unanticipated no-shows in a nontreatment study of the genetics of substance dependence. Low-cost retail items (such as calling cards or gift certificates) were offered contingent on attendance at the first scheduled research appointment. Although the intervention did not result in an increase in the rate of attendance at appointments, it reduced the likelihood of unanticipated no-shows by almost 50%. This reduction was accompanied by a significant increase in advance cancellations. Despite limitations due to the study's A-B design, this research demonstrates that it may be possible to use modest incentives to increase the efficiency of research enrollment and increase service provision for substance abusers.

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

The Behavior Change Consortium (BCC) has provided a unique opportunity to combine and explore resources, data, processes, and knowledge as a means of strengthening the validity, reliability, and outcomes that compose the field of behavioral science. The workgroups of the BCC were able to transcend disciplinary boundaries by developing a collaborative framework that fused scholarship and creativity to explore research problems in the area of health behavior change theory and intervention. We have identified seven common elements that emerged from each workgroup and fostered inclusion, progress, and ultimately results. These elements were (a) establishing communication channels, (b) identifying objectives, (c) utilizing common measures, (d) obtaining financial support, (e) seeking outside feedback, (f) engaging "big picture" thinking, and (g) bridging theory to practice. In this article we 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, and issues associated with data sharing. We also discuss why, in the case of the BCC, the whole is far greater than the sum of its parts. We present this example of unparalleled multibehavioral research collaboration as a model to other collaborative efforts that will be spawned by the new National Institutes of Health Roadmap initiative.

Methodologically sound, cost-effective research on the outcome of couple therapy

Because of its potential to answer pressing applied questions about what treatments to use with which couples as well as its potential to answer basic questions about couple functioning, outcome research on couple therapy is vital to the field. This article describes the primary methodological issues that an investigator faces in conducting outcome research during treatment development, efficacy testing, and effectiveness evaluation. Descriptions of what has been done in the past are integrated with recommendations about what should be done in the future. Mindful of the potential expense of outcome research, the authors suggest ways in which questions can be investigated cost effectively.

Who should fund and control the direction of human behavior genetics? Review of Nuffield Council on Bioethics 2002 report, genetics and human behaviour: the ethical context

In this (Nuffield Council on Bioethics 2002), the third in its series on ethics and related issues in genetics (see also Nuffield Council on Bioethics 1993 and Nuffield Council on Bioethics 1998), the Nuffield Council has focused on four'normal' behaviors; intelligence, personality, antisocial behavior and sexual orientation. This is a narrow range of behaviors and one where their discussion of the potential impact of predictive genetic testing is probably inappropriate. They also take an unduly narrow view of the purposes of behavior genetics in the 21st century. It is not simply to estimate heritability but to understand more about the structure of behavior and the processes which underlie it. Their narrow focus and their negative approach to the history and achievements of genetics is reflected in their less than positive support for future behavior genetic research. Behavior geneticists need to do more to publicize what their field has achieved in order to counter the very extensive antibehavior genetics initiatives which are almost unique in science. At the same time, organizations such as the Nuffield Council need to consider carefully the impact their deliberations may have on research funding.

Research Centers in Minority Institutions (RCMI)

The Research Centers in Minority Institutions (RCMI) Program was initiated in the United States of America in 1985 as a congressionally mandated program. The mission of the RCMI Program is to expand the national capacity for the conduct of biomedical and behavioral research by developing the research infrastructure at institutions granting doctoral degrees in health or health-related sciences, that have 50% or greater enrollment of minorities (African Americans, Hispanics, Native Hawaiians and Pacific Islanders, Native Americans and Alaska Natives) that are underrepresented in the biomedical sciences. The program administration is based in the National Center for Research Resources (NCRR), at the National Institutes of Health (NIH), an agency of the Department of Health and Human Services (DHHS). Since its inception, the program has provided critical resources (core research laboratories, equipment, personnel, supplies, etc.) at each of the RCMI-funded institutions. This article is intended to provide an overview of the RCMI Program, outline the research areas and list contact persons for additional information on research and core resources at each of the current RCMI sites.