1 / 37

Strategic Directions for the Office of Behavioral and Social Sciences Research

Strategic Directions for the Office of Behavioral and Social Sciences Research. Robert M. Kaplan 2012 Summer Institute on Social and Behavioral Intervention Research Columbia University July 9, 2012. Poll Question. Less than 10% can identify NIH. About as many people identify Harvard.

lars
Download Presentation

Strategic Directions for the Office of Behavioral and Social Sciences Research

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Strategic Directions for the Office of Behavioral and Social Sciences Research Robert M. Kaplan 2012 Summer Institute on Social and Behavioral Intervention Research Columbia University July 9, 2012

  2. Poll Question • Less than 10% can identify NIH. • About as many people identify Harvard. • More people identify CDC • about 1/3rd of NIH budget • Drug Companies commonly cited • What is the name of the government agency that funds most of the medical research paid for by taxpayers in this country?

  3. We are 27 Institutes and Centers, many offices and programs…..

  4. Small Subset of NHLBI Logos No wonder the pubic is confused

  5. Where are we going? • We are all NIH • Never forget to mention your grant in publications and discussions with the press • Look for clearer branding in the future

  6. NIH: Steward of Medical and Behavioral Research for the Nation “Science in pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.”

  7. DPCPSI –OBSSR, ORWH ODP, OAR

  8. We Cover a lot of Turf Academic Disciplines • Anthropology • Child Development • Cognitive Science • Communication • Criminology • Cultural Studies • Economics • Education • Geography • History • Linguistics • Neuroscience • Law • Philosophy • Political Science • Psychology • Sociology Professional Schools • Clinical Psychology • Gerontology • Medicine • Pediatrics • Family Medicine • General Internal Medicine • Nursing • Social Work • Pubic Health • Public Policy Together these make up the majority of students and faculty at most research intensive universities.

  9. A few behaviors explain almost half of all deaths Mokdad, JAMA 2004 *corrected

  10. Theme 1: The Next Generation of Data and Analysis Methods • mHealth • Electronic Health Records • Systems science • Masses of data • Data Visualization • New methods for analysis

  11. Exposomics (from Kevin Patrick, UCSD) “At it’s most complete, the exposome encompasses life-course environmental exposures (including lifestyle factors), from the prenatal period onwards…” -- Christopher Paul Wild

  12. Genome Exposome Together these lead to whether disease occurs or health is promoted… (from Kevin Patrick, UCSD)

  13. The game is changing! Billions of mobile devices Unprecedented opportunities for population-level sensing + Billions of sensors = + Billions using social networks

  14. Improving Dietary Assessment Methods Using the Cell Phone and Digital Imaging PI: Carol Boushey, Purdue University • Uses a mobile phone as a food record • Image processing to identify food in real time • Supplement with search list • Calculates volume to estimate portion size • Calculates nutrient and food intake

  15. LUCAS- Mobile Microscope LUCAS microscope Problem:Create a low-cost quality microscope to use in low resources settings. Solution:A specially-developed lens fits to a cell phone to create a microscope Field testing: Malawi, Mozambique and Brazil A. OZCAN, 1R21EB009222-01 Computer software automatically interprets images at remote site Cell phone transmits image LUCAS images of CD4+ and CD8+ T cells compared to a regular microscope image.. Photos from Karin Nielsen and Aydogan Ozcan Karin Nielsen, UCLA, FIC, R24TW008811

  16. High-resolution fiber-optic microendoscope Problem:Methods to detect cancer from traditional biopsies are invasive for patients and require lab facilities. Solution:A scientific charge-coupled device camera and a laptop computer for under $4,000 (clinical trials in China, Botswana, Guatemala) Rebecca Richards-Kortum, Rice Univ. NIBIB RO1 EB007594

  17. Adherence Monitoring (Uganda) Problem: Adherence to chronic disease medications is poor. In resource-poor settings, getting people medication is only part of the solution Solution: Wireless medication canisters that signal medication timing, transmit adherence data and allow resources to target the non-compliant Jessica Haberer, Partners Healthcare NIMH K23MH087228

  18. Noika Files New Patent (March 2012) • Haptic tattoos for mobile sensing • Tattoos with ferromagnetic inks, that will vibrate based on commands from your phone • Can receive signals, like vibrations and Morris code like instructions

  19. THEME 2 Behavioral and Social Science in an Evolving Health Care System

  20. The Second Era (Today) The Third Era (Tomorrow) From Neal Halfon, 2012 The First Era (Yesterday) Breslow, L. "A Life in Public Health.”2004 Springer Publishing Co. NY, NY Dr. Breslow passed away April 10, 2012 at age 97 The Evolving Health Care System • Focused on acute and infectious disease • Germ Theory • Short time frames • Medical Care • Insurance-based financing • Industrial Model • Reducing Deaths • Increasing focus on chronic disease • Multiple Risk Factors • Longer time frames • Chronic Disease Mgmt & Prevention • Pre-paid benefits • Corporate Model • Prolonging Disability free Life • Increasing focus on achieving optimal health • Complex Systems - Life Course Pathways • Lifespan/ generational • Investing in population-based prevention • Network Model • Producing Optimal Health for All Health System 2.0 Health System 3.0 Health System 1.0

  21. Howard K. Koh, M.D., M.P.H. & Kathleen G. Sebelius, M.P.A.: Promoting Prevention through the Affordable Care Act nnejm.org september 30, 2010 ) • Americans receive only about half of the preventive services that are recommended • Many of the 10 major titles in the Affordable Care Act advance a prevention theme through a wide array of new initiatives and funding. Theme 3: Advancing Translational Science

  22. FDR: A Preventable Death?Blood Pressure Readings 1944-1945 Theme 3: Advancing Translational Science

  23. The initial findings from the Framingham heart study were published 50 years ago. By 1961, we knew that the major risk factors for CHD included: • Tobacco smoking • High blood pressure • High serum cholesterol • Diabetes Theme 3: Advancing Translational Science

  24. Theme 3: Advancing Translational Science Source: New York Times, April 24, 2009 Public Health Impact: From NHLBI Annual U.S. Deaths Per 100,000 People Of All Ages Over Time 600 • Death rates from heart disease have fallen since 1950 • ~30% reduction for all cardiovascular diseases combined • Nearly ½ of decline due to prevention & treatment of CV risk factors (smoking, high BP, cholesterol) 500 Heart Disease 400 300 Cancer 200 Stroke 100 Accidental Injuries Alzheimer’s 0 1960 1970 1980 1990 2000 2005

  25. Awareness, Treatment, and Control of Hypertension in 2004 NHANES Theme 3: Advancing Translational Science

  26. Even at Current Levels…. • Awareness: 80% • Treatment: 70% • Control: 50% .8X .7X .5 =.28 Only 28% of people with high blood pressure are being successfully treated. Theme 3: Advancing Translational Science

  27. Theme 3: Advancing Translational Science Source: Woolf & Johnson 2006 Non-Technical Solutions Behavioral reminders for cholesterol treatments are estimated to prevent 7X more deaths than replacing older cholesterol-lowering drugs with more potent medicines vs.

  28. U.S. Coronary Bypass Rates Theme 3: Advancing Translational Science (Primary Care)

  29. Is Informed Consent “Real”? • In a survey of consecutive patients scheduled for an elective coronary revascularization procedure at Yale New Haven Hospital in 1997-1998: • 75% believed PCI would help prevent an MI • 71% believed PCI would help them live longer Source: Holmboe ES. JGIM 2000; 15:632 Theme 3: Advancing Translational Science (Primary Care)

  30. Theme 3: Advancing Translational Science (Primary Care) Source: Trikalinos TA. Lancet 2009; 373:911) Is Informed Consent “Real”? While in the latest meta-analysis in 2009 (61 trials, 25,388 patients): “Sequential innovations in catheter-based treatment for non-acute coronary artery disease showed no evidence of an effecton death or myocardial infarction when compared to medical therapy.”

  31. Is Informed Consent “Real”? • In a survey of consecutive patients consented for an elective coronary angiogram and possible percutaneous coronary intervention at Baystate Medical Center in 2007-2008 • 88% believed PCI would help prevent an MI • 76% believed PCI would help them live longer Source: Rothberg MB. Annals Intern Med 2010; 153:307) Theme 3: Advancing Translational Science (Primary Care)

  32. Office of Behavioral and Social Sciences Research (OBSSR) Based on trans-NIH need → new funding opportunity announcements: Practical Interventions to Improve Medication Adherence in Primary Care (R01, R21) Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (R01) Systems Science and Health in the Behavioral and Social Sciences (R01, R21)

  33. Theme 3: Training the Next Generation of Behavioral and Social Scientists K-12 The undergraduate curriculum The PhD program of the future The 2011 AAMC report of the future of the medical school curriculum The 2015 MCAT

  34. Training Programs and Meetings

  35. What do we want: When do we want it?

  36. THANK YOU. Questions and Suggestions?

More Related