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ARRA Investments in Behavior and Social Sciences

Public Health Burden
The personal behavior of patients and care givers, which is influenced by social and cultural factors, contributes a great deal to the quality of health and health care.  Research shows that frequent reminders help people change behaviors, and ultimately improve health, but approaches to provide patient reminders are prohibitively expensive. Thus, new and improved methods are needed to provide patient reminders in an easily accessible and inexpensive manner, and to facilitate rapid and accurate communication between patients and providers.

Behavior Change
Personal behavior contributes to approximately 50% of premature deaths from unintended injuries and chronic diseases. The health of the general population is also influenced by the behavior of health care professionals, for example when they remind patients to take medication or promote the reduction of alcohol or cigarette consumption. Modest changes in behavior have been shown to improve health dramatically, but it is often difficult to initiate and maintain these healthy behaviors. Research is needed to understand the influences on behavior, be they cultural, environmental, or emotional.  In addition, inexpensive and adaptable methods for promoting behavior change are needed. A variety of ARRA funded grants are accelerating research into behavior change including:
  • Developing an adaptable computer system that can interact with hand held devices such as the iPhone so it can be used to study the effectiveness of daily reminders and reporting in monitoring and promoting healthy behaviors in the home and work place.1
  • Testing whether providing nutritional information on groceries promotes the purchase of healthy foods when provided alone or in combination with subsidies for healthy foods and whether cues in the home environment, for example the size of the dinner plate, affect the amount of food children eat.2
Patient Information
Patients provide much of the data used to validate new treatments for disease. New drugs and devices must be tested in thousands of voluntary participants before their safety and efficacy can be determined. These clinical trials must inform participants of the risks involved in participation through a process known as “informed consent”. The informed consent process can be laborious and new methods to facilitate it could increase participation in clinical trials. Patient Reported Outcomes (PROs) provide important information on patient symptoms and responses to treatment. Recently, computer-based PRO questionnaires have been developed that use answers to previous questions to adapt successive questions such that the questionnaire becomes tailored to the individual. This “computer adaptive testing” process has improved the accuracy and reliability of PRO reporting. ARRA funded grants are accelerating the development of new computer tools for tracking informed consent agreements and reporting patient outcomes.
  • Creating a centralized, computerized system that allows individuals the ability to use the Internet to manage their own informed consent agreements, thereby enhancing consumer choice and trust with the long term goal of increasing participation in clinical trials.3
  • Comparing the accuracy of reporting symptoms weekly versus daily to understand the consequences of reducing patient burden by relying on weekly reports.4
  • Developing new standardized measures of pain for reporting by both patients and observers that can be used to test interventions to reduce disability.5
  • Providing expertise in areas including statistics and linguistics to PRO researchers for designing, testing and refining new questionnaires on a variety of chronic health conditions.6

  1. 1RC2AG036592-01 -- Developing interactive technologies to improve research and health behavior -- Asch, David; Volpp, Kevin G (contact) (PA)
  2. 1RC1HD063370-01 -- Nudging nutrition: setting healthier defaults in stores and in homes -- Wansink, Brian (NY)
  3. 1RC2LM010796-01 -- An open source research permissions framework for South Carolina -- Moskowitz, Jay (SC)
  4. 1U01AR057948-01 -- Ecological validity of PROMIS instruments -- Broderick, Joan; Stone, Arthur (contact) (NY)
  5. 1RC1NR011804-01 -- Development and validation of measures of pain behaviors in chronic pain -- Cook, Karon (WA)
  6. 1U54AR057951-01 -- PROMIS statistical center -- Cella, David (IL)

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