In January 2014, the ODP released a strategic plan to guide its work through 2018. As we enter the plan’s third year, I am pleased to report on the progress we’ve made with the plan’s six strategic priorities and the Tobacco Regulatory Science Program (TRSP).
Strategic Priority I: Systematically monitor NIH investments in prevention research and assess the progress and results of that research.
To obtain a better understanding of the NIH prevention portfolio, the ODP developed a prevention research taxonomy and an accompanying protocol that allow accurate and standardized classification of grant abstracts. The taxonomy includes nearly 150 non-mutually exclusive topics grouped into eight categories. The ODP also adopted a team-coding approach to apply the taxonomy to research grant abstracts. Custom software, called the Prevention Abstract Classification Tool (PACT), is used to track individual and team coding and to calculate inter-rater reliability. The ODP is also partnering with the NIH Office of Portfolio Analysis to code grants in an automated fashion. A short-term goal is to identify positive and negative examples of prevention studies to train a machine-learning algorithm to objectively characterize the NIH prevention research grant portfolio on the topics and categories in the taxonomy. Such classification will be used to recognize patterns and trends in NIH prevention research funding and to highlight areas for targeted investment. It will help assess how NIH-funded prevention research progresses and changes over time to inform program planning and reporting.
Strategic Priority II: Identify prevention research areas for investment or expanded effort by the NIH.
The ODP is working with colleagues at NIH Institutes and Centers (ICs) to identify currently funded studies that address research areas categorized by the U.S. Preventive Services Task Force (USPSTF) as having insufficient evidence to make a recommendation for or against a clinical preventive service. The goal is to identify research gaps and to coordinate with the ICs on efforts to address them. The ODP and the USPSTF recently published a review in the American Journal of Preventive Medicine discussing their collaboration and the specific areas where NIH research can strengthen USPSTF recommendations. The ODP will take a similar approach with the Community Preventive Services Task Force (CPSTF) to close prevention research gaps in community settings.
The ODP continues to partner with the U.S. Department of Health and Human Services (HHS) Office of Disease Prevention and Health Promotion (ODPHP) to support national health initiatives, including Healthy People 2020. ODP staff serve on the Healthy People Federal Interagency Workgroup and provide NIH input on numerous Healthy People activities.
In December 2015, the ODP held a Pathways to Prevention (P2P) workshop on Total Worker Health® (TWH). TWH aims to improve worker health through policies, programs, and practices that integrate protection from work-related hazards with promotion of injury and illness prevention. The panel’s final report is expected to be released in February 2016. The Pathways to Prevention (P2P) program identifies research gaps and priorities in select scientific areas. An independent panel reviews evidence presented by experts in the field, accepts comments from the public, and examines a scientific evidence report. It then develops suggestions for future research directions.
The final report from the 2014 P2P workshop on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has been published, and the follow-up federal partners meeting is being planned. The attention brought to ME/CFS through the P2P workshop helped catalyze an NIH-wide initiative to bolster research on the disease.
Strategic Priority III: Promote the use of the best available methods in prevention research and support the development of better methods.
To widen the pool of prevention research experts to serve as reviewers of NIH grants, the ODP has developed the Prevention Research Expertise Survey (PRES) that captures scientists’ methodological and content expertise. Survey data will be used to populate a web-based electronic directory that will help NIH Scientific Review Officers (SROs) identify researchers with expertise in specific prevention methods or content areas that are needed on the NIH study sections that review prevention applications. The survey has been approved by the Office of Management and Budget and is expected to be released in early 2016.
The Methods: Mind the Gap webinar series aims to bridge the gap between scientific evidence and clinical practice. As part of the 2015 series, I delivered a webinar on prevention research methods for evaluation of multilevel interventions in public health and medicine. Some of the webinar topics scheduled for 2016 include time-varying effect modeling methods and tools, mediation analysis, intervention taxonomy and opportunities for pooled analysis, big data, and single case designs.
Strategic Priority IV: Promote collaborative prevention research projects and facilitate coordination of such projects across the NIH and with other public and private entities.
The ODP took part in the planning of a number of trans-NIH workshops related to key prevention areas such as obesity, physical activity, and screening. The ODP’s participation also helped strengthen the prevention component of several larger workshops sponsored by the NIH and the HHS, including those related to the prevention of elder abuse, dissemination and implementation research, and injury prevention.
The ODP led the development and the 2015 release of two Funding Opportunity Announcements (FOAs) on the design and testing of the interventions for health-enhancing physical activity and helped compile frequently asked questions (FAQs) addressing issues of research design. More than 70 applications were received, and two have already been funded. ODP staff held discussions with offices across the NIH to identify opportunities for trans-NIH collaborations in other areas and to ensure that the ODP is included in the planning of workshops and other activities aimed at identifying research gaps and topics for new prevention-relevant FOAs.
The ODP provided co-funding for a wide range of prevention research efforts across the NIH, the Centers for Disease Control and Prevention (CDC), and HHS. The ODP supported meetings, workshops, and conferences on various topics including neurocognitive influences on teen driving, Alzheimer’s Disease-related dementias, self-regulation of appetite, multilevel interventions for hard-to-reach populations, and an Institute of Medicine Forum on Promoting Children’s Cognitive, Affective, and Behavioral Health. We also provided co-funding for three projects for Healthy People 2020, including data projects on Health Disparities and Heart Disease and Stroke. Four projects on physical activity and childhood obesity, including the Coordinating Center for the National Collaborative on Childhood Obesity Research and an intramural research project on the metabolic and cognitive outcomes of interrupting sedentary behavior in children, also received co-funding from the ODP.
The ODP played a key role in the effort to develop and edit the National Nutrition Research Roadmap, which identifies research gaps and opportunities in nutrition science across the federal government. ODP staff participated in discussions on the development of the 2015 Dietary Guidelines for Americans and provided input on the NIH strategic planning process.
Strategic Priority V: Identify and promote the use of evidence-based interventions and promote the conduct of implementation and dissemination research in prevention.
The ODP added to its website a section on community resources that provides information geared toward community planners, health care and public health professionals, policymakers, and the general public. This section includes a list of evidence-based programs and practices sponsored by government agencies, nonprofit groups, and private-sector organizations, which have the potential to impact public health. The Community Resources section also includes news and announcements, upcoming events, educational materials, and resources from the NIH and its federal partners.
The ODP signed on to three FOAs (R01, R03, R21) focusing on Dissemination and Implementation Research in Health. The purpose of these FOAs is to support innovative approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of evidence-based interventions, tools, policies, and guidelines.
Staff from the ODP served on the planning committee and presented at the 8th Annual Conference on the Science of Dissemination and Implementation, ensuring that prevention science was well represented at this important meeting.
Strategic Priority VI: Increase the visibility of prevention research at the NIH and across the country.
To assist prevention researchers with designing and conducting their studies, the ODP created Resources for Researchers—a web portal that combines prevention-related information across various NIH websites with newly developed tools and resources in one online repository tailored to the needs of the prevention research community. It includes instructions for finding NIH-funded research projects; directions for applying for NIH funding; a listing of prevention-related study sections; a summary of prevention research needs and gaps, and a database of recent, high-quality peer-reviewed publications testing prevention interventions across a range of health conditions.
To round out its tobacco regulatory science portfolio, TRSP recently announced several new funding opportunities, including requests for applications on Abuse Liability Associated with Reduced Nicotine Content and Chemistry, Toxicology, and Addiction Research on Waterpipe Tobacco. In fiscal year 2015, $16.5 million in funding was awarded in 35 new grants, resulting in over $110 million in extramural research support distributed through the program.
TRSP supports the Tobacco Centers of Regulatory Science (TCORS) program that encourages research collaboration through integrated program center grants. Centers’ discretionary funds allow participants to conduct timely, quick-turnaround pilot research. Currently, TCORS investigators are pursuing 116 such collaborative pilot projects.
TRSP is participating in the PhenX project (“consensus measures for Phenotypes and eXposures”) an ongoing NIH effort to identify expert-recommended, standardized, high-priority measures across a variety of scientific disciplines that can be accessed and downloaded through the PhenX Toolkit. TSRP has contributed several collections of recommended measures for Tobacco Regulatory Research (TRR). TRR collections include measures related to tobacco products, product user or potential user, and industry and retailer activities. These measures provide a useful standard for data collection across different studies and a framework for cross-study comparisons and collaborative analyses.
Under the “deeming rule” provision of the Family Smoking Prevention and Tobacco Control Act, the FDA recently sought to extend its regulatory authority over a broader range of tobacco products, such as electronic cigarettes, cigars, pipes, and hookahs. TRSP-funded research provides crucial evidence to inform this important regulatory measure.
In 2015, the ODP made real progress in portfolio analysis, identification of research gaps, improving research methodology, fostering trans-NIH collaborations, dissemination and promotion of prevention research results, and tobacco regulatory science. Sustaining this momentum in the coming years will help realize the promise of prevention as a cornerstone of public health.
David M. Murray, Ph.D.
Associate Director for Prevention
Director of the Office of Disease Prevention