About the NIH Pathways to Prevention (P2P) Program
The goal of the Pathways to Prevention (P2P) program is to host workshops that identify research gaps in a selected scientific area, identify methodological and scientific weaknesses in that scientific area, suggest research needs, and move the field forward through an unbiased, evidence-based assessment of a complex public health issue. P2P workshops are designed for topics that have incomplete or underdeveloped research, difficulty producing a report synthesizing published literature, and are generally not controversial. The first P2P workshop was held in December 2012 at the National Institutes of Health (NIH) in Bethesda, Maryland.
The P2P program is strategically located in the NIH Office of Disease Prevention (ODP), which provides the leadership, infrastructure, funding, and coordination necessary to conduct P2P workshops. Previously known as the Evidence-based Methodology Workshop (EbMW) program, the P2P program was renamed in 2013 to better reflect the overarching goal of the program. This program was developed out of a need for a process that (1) could be implemented in approximately a year and (2) addresses topics with methodological weaknesses. A technical brief, which provides an objective description of the state of the science, a summary of ongoing research, and information on research needs, serves as the foundation for each workshop. The technical briefs are prepared by one of the Agency for Healthcare Research and Quality’s (AHRQ) Evidence-based Practice Centers.
Topic Selection Criteria
Topic proposals are submitted online and reviewed by the NIH ODP on a rolling basis. Workshop proposals are typically submitted by an NIH Institute or Center (IC), or Office, and may have multiple co-sponsoring organizations. Other groups, such as other government agencies or trans-agency workgroups, professional societies, and advocacy organizations, may also propose topics with an NIH IC or Office as a sponsor. The following major criteria must be met for a topic to qualify for a P2P workshop:
- Have a primary or secondary disease prevention focus.
- Have broad public health importance—key considerations are the severity of the problem and the feasibility of interventions.
- Have limited published data or incomplete or underdeveloped research.
- Have difficulty completing a systematic review and producing a report synthesizing published literature due to lack of randomized controlled trials.
- Have two or more NIH ICs or Offices committed to addressing the topic by participating in workshop activities (i.e., sponsor, steering committee, post-workshop meetings).
Initial planning for each P2P workshop is done by a Working Group that develops and finalizes the questions that frame the workshop. After the questions have been finalized, a technical brief is prepared by an Evidence-based Practice Center of AHRQ and provided to the speakers and panel members approximately 6 weeks prior to the workshop. The technical brief provides an objective description of the state of the science, a summary of ongoing research, and information on research needs.
Over the 2 days of the workshop, expert speakers directly address workshop questions in their presentations. Workshops feature several discussion sessions, in which open dialogue occurs among speakers, panelists, and attendees from the general public.
Immediately following the workshop, the panel convenes in executive session for 1 day and develops a draft report. Forty-eight hours after the conclusion of the workshop, the draft report is posted on the ODP website for a 15-day public comment period. The final report is released approximately 2 weeks later. During the intervening period, the panel may edit its statement for clarity, correct any factual errors that might be discovered, and revise the draft report according to public comments.
Each P2P workshop results in a technical brief and panel report on the workshop topic. Every panel report reflects an independent panel’s assessment of the medical knowledge available at the time the statement is written; as such, it provides a “snapshot in time” of the state of knowledge on the workshop topic. It is not a policy statement of the NIH or the federal government.
P2P workshop panel reports have robust dissemination:
- Draft and final panel reports are posted online.
- A press telebriefing is held with the release of the final panel report, enabling reporters to question panelists about their findings.
- The final panel report and a summary of the technical brief may appear in a peer-review journal.
Each workshop panel is an unbiased, independent group typically comprised of 8 to 10 members who give balanced, objective, and informed attention to the topic. Panel members:
- Must not be employees of the U.S. federal government.
- May be knowledgeable about the general topic under consideration, but must not have published on or have a publicly-stated opinion on the topic.
- Must not have intellectual conflicts, such as participation in statements by professional societies or participation in advocacy groups on the topic.
- Must not hold financial or career (research) interests in the workshop topic.
- Represent a variety of perspectives, including:
- Practicing and academic health professionals
- Clinical trialists and researchers
- Nonhealth professionals with expertise in fields relevant to the specific topic
(e.g. ethicists, economists, attorneys)
- Individuals representing public-centered values and concerns.
The panelists are recruited with the aim of appropriately reflecting a diverse set of professional and experiential perspectives within the workshop panel. Panel members are not paid a fee or honorarium for their efforts; however, they are reimbursed for travel expenses related to their participation in the conference.
Workshops feature speakers who are experts in the topic at hand, have published on the issue, have conducted research on the issue, and may have strong opinions or beliefs on the topic. These experts present information directly addressing workshop questions. Where multiple viewpoints on a topic exist, every effort is made to include speakers who address all sides of the issue.