Twenty-five years of the National Institutes of Health Office of Behavioral and Social Sciences Research

Abstract

Over its 25 years, the National Institutes of Health (NIH) Office of Behavioral and Social Sciences Research (OBSSR) has played a significant role in a number of behavioral and social science research advances that improve health.

The 10th anniversary of Translational Behavioral Medicine, commemorated by this special issue, coincides with the 25th anniversary of the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH). OBSSR was enacted by Congress in 1993 and established 2 years later in July 1995 to identify projects of behavioral and social sciences research that should be conducted or supported by the national research institutes and develop such projects in cooperation with such institutes and to coordinate research conducted or supported by the agencies of the NIH [1]. Over the past 25 years, OBSSR has worked diligently to fulfill Congress’s charge. Strategically located within the NIH Office of the Director’s Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI), OBSSR is well positioned to facilitate collaboration across the NIH by convening NIH staff and extramural investigators, conducting workshops, developing trans-NIH initiatives, and providing cofunding of meritorious grant applications. In this commentary, we highlight some of the key projects led by OBSSR, in collaboration with our colleagues at the various NIH institutes and centers, to advance behavioral and social sciences research conducted or supported by the NIH. We also consider the opportunities and challenges of OBSSR and the behavioral and social sciences in the next 25 years.

Over the past 25 years, OBSSR has been guided by three strategic plans, each building upon and extending upon former plans. Soon after OBSSR was established, it released its first strategic plan focused on three priorities: (a) enhance behavioral and social science research training, (b) integrate biobehavioral perspectives into biomedical research, and (c) improve communications among behavioral and social science researchers and the public [2]. This initial plan was followed with a strategic prospectus in 2007 that focused on four priorities: next-generation basic science, interdisciplinary research, systems science, and problem-based focus for population impact [3]. The most recent plan, released in 2017, focused on three scientific priorities: (a) improve the synergy of basic and applied behavioral and social sciences research, (b) enhance and promote the research infrastructure, methods, and measures needed to support a more cumulative and integrated approach to behavioral and social sciences research, and (c) facilitate the adoption of behavioral and social sciences research findings in health research and practice [4]. These three strategic plans have guided the activities of OBSSR that have led to many accomplishments. The following highlights a few of these accomplishments within three broad categories of activities that reflect long-standing strategic objectives of OBSSR throughout its history: training the next generation, stimulating emerging research areas, and fostering the integration of behavioral and social sciences within the larger biomedical research enterprise.

TRAINING THE NEXT GENERATION OF RESEARCHERS

Beginning with its initial strategic plan, OBSSR has made the training needs of behavioral and social science researchers a priority. Soon after the office was established, OBSSR issued funding opportunity announcements (FOAs) for the development of short-term educational workshops for social, behavioral, and biomedical researchers in the early stages of their careers [5]. Promoting interdisciplinary approaches, these workshops aimed to help participants develop cross-disciplinary collaborations, consistent with the goal of integrating biomedical, behavioral, and social research, which has been a key priority since the office’s inception [6]. In July 2000, OBSSR and the National Heart, Lung, and Blood Institute (NHLBI) collaborated to hold the first annual Summer Institute on Randomized Behavioral Clinical Trials. Randomized clinical trials (RCTs) were increasingly used as the primary evidence in systematic reviews and practice guidelines, and it was critical that behavioral interventions be evaluated using well-conducted RCTs. Only 4 years earlier, in 1996, the first Consolidated Standards of Reporting Trials (CONSORT) guidelines were published [7], and behavioral intervention researchers needed the skills to conduct RCTs consistent with these guidelines. The Summer Institute on Randomized Behavioral Clinical Trials is now in its 20th year [8]. Extending on this annual training institute model, OBSSR and Centers for Disease Control and Prevention (CDC) collaborated in 2009 to establish the Institute on Systems Science and Health that provided training in the rapidly growing area of system science approaches, such as dynamic systems modeling, agent-based modeling, and social network analyses. Two years later, in 2011, OBSSR, with the National Cancer Institute (NCI), National Institute of Mental Health (NIMH), and other NIH institute partners, established the Training Institute for Dissemination and Implementation Research in Health (TIDIRH) [9] to build capacity in dissemination and implementation science research. These three annual training institutes have trained hundreds of postdoctoral students and early stage investigators, as well as some mid- and senior-level investigators in key, and emerging methodologies necessary to advance the behavioral and social sciences.

Conducting these and other annual training institutes via government contracts became increasingly complex and difficult to scale up; therefore, OBSSR sought to expand these programs via the R25 grant mechanism. In 2013, OBSSR issued the FOA on Short Courses on Innovative Methodologies [10] and awarded eight training grants to conduct annual training in a range of methods and approaches, including community-based participatory research (CBPR), mobile health research, causal inference, mixed methods, multilevel methods, and dynamic systems science. Following from the success of this initial R25 initiative, in 2018, OBSSR revised and reissued this FOA [11] and recently made seven awards. These R25 awards renewed some of the prior R25 trainings, shifted the RCT and TIDIRH trainings from contracts to R25s, and funded new trainings in optimization designs and integrated mental and physical health research. Moving forward, OBSSR intends to continue to revise and reissue the R25 FOA periodically to fund training in new and emerging methods and approaches.

In recent years, OBSSR has sought to expand its training initiatives beyond these annual training institutes that target predominately postdoctoral and early stage investigators. In 2018, OBBSR released a T32 FOA on Predoctoral Training in Advanced Data Analytics for Behavioral and Social Sciences Research [12] to integrate data science training in predoctoral behavioral and social science training. These awards will be made in 2020. OBSSR also recently released a notice encouraging administrative supplements to NIH-funded T32s to develop curricula to integrate better behavioral and social sciences with other health-related sciences [13]. This supplement notice can be used for predominately biomedical T32s to incorporate more behavioral and social science curricula in their training or for predominately behavioral and social science T32s to incorporate more biomedical curricula in their training, consistent with the long-standing priority of OBSSR over the past 25 years to improve the integration of the behavioral and social sciences into the biomedical research enterprise.

At the other end of the training trajectory, OBSSR has issued K18 FOAs, first as part of the NIH Basic Behavioral and Social Science Opportunity Network (OppNet) effort [14] and, more recently, in mobile health training [15]. These 1 year awards are designed to support mid- and senior-level researchers to expand their research capabilities into new and emerging areas of science. With the addition of K18 and T32 FOAs, OBSSR has expanded its training efforts throughout the research career trajectory, from predoctoral to senior-level researchers.

STIMULATING EMERGING BEHAVIORAL AND SOCIAL SCIENCE AREAS RELEVANT TO THE NIH MISSION

Congress enacted OBSSR to identify projects of behavioral and social sciences research that should be conducted or supported by the NIH and develop such projects in cooperation with the NIH institutes and centers. Over its 25 year existence, OBSSR has raised the importance of various behavioral and social science research areas that are highly relevant to the NIH mission. In many cases, OBSSR has served as an incubator for NIH development of behavioral and social science research initiatives that were subsequently incorporated into the mission and objectives of the various NIH institutes and centers as these research areas matured. The list below highlights some of the research areas that OBSSR has helped develop, mature, and incorporate into the NIH Institutes and Centers.

• OBSSR led an FOA establishing the Centers for Mind/Body Interactions and Health in 1999 [16] to encourage and advance interdisciplinary projects—each designed to focus on relationships between the mind and body in disease and health. Around this same time, the Office of Alternative Medicine became the National Center for Complementary and Alternative Medicine (NCCAM, now National Center for Complementary and Integrative Health [NCCIH]). As NCCAM/NCCIH expanded its research portfolio, it supported a range of mind–body research topics and currently serves as the key funder of mind–body integrative approaches for chronic pain and various other disorders.

• To expand child health research needs into social science areas, OBSSR issued two FOAs, one in 1999 seeking to promote the development of child neglect research programs [17] and another in 2000 supporting intervention research to address violence among youth [18]. These two initiatives highlighted the societal and health impacts of neglect and violence on youth and encouraged the development and evaluation of intervention and prevention programs. These FOAs also fostered partnerships between health researchers and educational and juvenile justice researchers. Since its establishment in 1962, the National Institute of Child Health and Human Development (NICHD) has had a strong behavioral and social sciences research agenda [19] and these initiatives strengthened NICHD’s research support in the area of child maltreatment that has continued through to the present.

• To stimulate research on health disparities in the USA, OBSSR issued an FOA in 2007 [20] focused on this topic, which was renewed in 2010 and 2013. As the National Institute of Minority Health and Health Disparities (NIMHD) transitioned from a center to an institute in 2010 and, later, under the current leadership, expanded its portfolio to fund researcher-initiated grants addressing minority health and health disparities; NIMHD expanded its role in leading and coordinating trans-NIH health disparities initiatives. With this expansion of health disparities efforts and scientific interest at both NIMHD and across the NIH institutes and centers, OBSSR transitioned the leadership of leading this FOA effort to NIMHD.

• To encourage dissemination and implementation research, OBSSR, in partnership with NCI, NIMH, and other NIH institutes, organized the first Annual Conference on the Science of Dissemination and Implementation in Health in 2007. As the conference grew, the organization was transitioned to Academy Health in 2013, with a planning committee representing a broad range of NIH institutes and NCI taking the NIH lead [21]. As dissemination and implementation (D&I) research has matured, NIH institutes and centers, particularly NCI, NIMH, NIDA, and NHLBI, have led various D&I efforts and have integrated this research into their missions and strategic objectives.

• As computational modeling methods such as dynamic systems modeling, agent-based modeling, and social network analyses were increasingly being used in related fields, such as systems biology and computational neuroscience, it became clear that these system science approaches were important to advancing social and behavioral sciences as well. In addition to the system science training described previously, OBSSR led an FOA in 2001 on Systems Science in the Behavioral and Social Sciences [22] that was renewed in 2015. As with many of OBSSR’s methods-based initiatives, maturation of these methods resulted in systems science approaches being included among a broad array of potential methods for answering important research questions (e.g., [23]).

• In 2007, NIH initiated the Gene, Environment and Health Initiative [24] which, along with the release of the iPhone that same year, helped stimulate subsequent NIH initiatives in mHealth, including efforts led by OBSSR in mHealth training, now subsumed under OBSSR’s R25 program, and the Mobilizing Research Initiative, a research resource that allows researchers to more efficiently and rapidly evaluate mobile and wireless (mHealth) technologies, now available to researchers as Eureka [25]. More recently, OBSSR led the Intensive Longitudinal Analysis of Health Behaviors Initiative [26], which integrates advances in mobile and wireless digital technologies with computational modeling approaches to advance our understanding of health behavior change over time within individuals.

These are but a few of the many research efforts of OBSSR for which the office identified an emerging research area, encouraged its growth via workshops, trainings, and funding initiatives, and, then, as the research area matured, assisted in integrating these research areas more fully into the NIH institute and center efforts. Although OBSSR took a lead role in many of these efforts, these efforts were only possible in collaboration with many institute and center partners who worked together to identify these emerging research areas and encourage their growth and integration within the larger NIH research enterprise.

INTEGRATING BEHAVIORAL AND SOCIAL SCIENCES RESEARCH IN THE LARGER NIH BIOMEDICAL RESEARCH ENTERPRISE

Since its inception, OBSSR has made the integration of behavioral and social sciences research within the larger NIH mission a priority [6]. Throughout its existence, OBSSR has attempted to identify opportunities to integrate better the behavioral and social sciences across the various efforts of the NIH, particularly, its larger trans-NIH initiatives. Among a few of the more recent integration efforts are:

• Blueprint and the BRAIN Initiative: in 2004, the NIH Blueprint for Neuroscience Research [27] was established as a collaborative of 13 NIH institutes, centers, and offices (ICOs) to broadly advance the area of neuroscience. OBSSR has been involved in Blueprint since its inception and has helped support the coordination of research, training, tool, and resource development in cross-cutting areas of neuroscience, including behavioral and social science relevant initiatives, such as the NIH Toolbox [28]. A decade later, in 2014, the NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative was launched with a focus on advancing our understanding of brain circuits through the development and application of breakthrough neurotechnologies [29]. As the BRAIN initiative transitions to Phase 2, its focus will turn increasingly to the application of these new neurotechnologies to discover how dynamic patterns of neural activity are transformed into cognition, emotion, perception, and behavior in health and disease. OBSSR has played an important role in this transition and has contributed to upcoming initiatives that will encourage greater integration of these neurotechnologies for better understanding behavior.

• • All of Us and Other Trans-NIH Longitudinal Cohort Initiatives: in 2015, President Obama launched the Precision Medicine Initiative (PMI), one part of which is a longitudinal cohort of over 1 million individuals, now called All of Us, to understand better the role of genetic and environmental influences on health and disease. OBSSR played an important role in the initial formation of this effort [30], including the OBSSR Director serving as interim deputy director of PMI during its formation, and continues to work with this initiative to integrate key social, behavioral, and environmental influences into the protocol. About the same time as the All of Us initiative launched, NIH also launched the Environmental Influences on Child Health Outcomes (ECHO) initiative, and NIDA led a multi-IC cohort initiative on Adolescent Brain and Cognitive Development (ABCD). OBSSR has contributed staff time and financial resources to both of these efforts to assist in the integration of behavioral and social science research within these and large, longitudinal cohort efforts.

• Helping End Addiction Long-Term (HEAL): in the face of a rapidly growing opioid epidemic, NIH received considerable funding from Congress to double its funding on opioid use disorder (OUD) and chronic pain. To shape future research initiatives, NIH held three workshops in the summer of 2017 focused on medication development for OUD, nonaddictive pain treatments, and neurobiological mechanisms of pain. Given the limited focus on social and behavioral influences in these initial workshops, OBSSR worked with the HEAL initiative and held a workshop on the contributions of behavioral and social sciences to address the opioid crisis [31]. This workshop and subsequent efforts of a trans-NIH behavioral and social sciences opioid working group contributed to the shaping of HEAL Initiatives, resulting in a substantial proportion of the FY19 HEAL funding addressing social and behavioral influences of the opioid epidemic [32].

THE NEXT 25 YEARS

The behavioral and social sciences have made significant progress during the 25 years of OBSSR’s existence. Within the NIH, funding for behavioral and social sciences research continues to experience slow but steady growth proportional to the growth of the overall NIH budget. Compared to the period of time when OBSSR was established, most of the NIH institutes and centers now have substantial research portfolios in the behavioral and social sciences and all recognize the importance of this research to the public health of the nation and the world. Behavioral and social sciences have become a more integral component of the overall NIH research enterprise. In the most recent OBSSR Strategic Plan, we envisioned a time when the integration of behavioral and social sciences within the NIH research enterprise becomes so pervasive that the office may no longer be needed. We are not there yet, and there is much work remaining, much of it in line with the OBSSR strategic plan.

The overarching theme of the current OBSSR strategic plan is the need to encourage a more cumulative and integrated behavioral and social sciences research enterprise that extends from basic science through the adoption of evidence-based approaches to improve the nation’s health [4]. It is through that translational, cumulative science lens that we consider future challenges and opportunities over the next 25 years, cognizant that it would have been quite challenging 25 years ago to imagine many of the advances that have transformed the current state of the behavioral and social sciences [33].

Building a stronger connection between basic science findings and intervention development is crucial for improving behavior change capabilities. Earlier generations of behavioral and social scientists developed innovative interventions from basic science findings. Much of the social and behavioral intervention research that NIH currently funds are based on many of the same behavior change principles from a generation ago, often loosely grounded to a health behavior theory and seldom testing a novel intervention strategy or component. A more cumulative and innovative science needs to draw more extensively from basic research and translate and test new approaches to change behavior and social systems. The Science of Behavior Change (SOBC) Common Fund Initiative [34] is an important demonstration project to reconnect applied innovation with the translation of basic science mechanisms and processes. To encourage a more cumulative science, OBSSR continues to encourage intervention research that is better grounded in basic research findings and basic science that is more attuned to the foundational questions applied researchers need answered.

Over the past 25 years, the field has developed and evaluated many effective social and behavioral interventions to prevent illness, treat various mental and physical disorders, and manage chronic disease. The translation of these effective interventions into practice, however, remains a significant challenge for the field. This anniversary of Translational Behavioral Medicine is a testament to the increasing priority that the field has placed on dissemination, implementation, and adoption of these interventions over the past decade. NIH has and will continue to support training and research in implementation science, but we must do more than study the problem [35]. To see these effective interventions adopted in practice, we must work to change the current incentive structure of practice and policy, which currently offers few rewards for adopting effective treatments and few negative consequences for failing to do so. With appropriate structural incentives, the next 25 years of intervention research should continue to transition from academic settings to policy and practice settings that generate the intervention questions and evaluate the effectiveness of interventions in these settings.

Technological advances have and will continue to change how we conduct behavioral and social sciences research and deliver interventions. When OBSSR was created, nobody could have predicted the current pervasiveness of the Internet, smartphones, and social media in our lives, and it is equally difficult to imagine what technological advances of the next 25 years will transform our lives and our research paradigms. What we do know is that it has been crucial for advancing the behavioral and social sciences that, as these technologies are being developed and released to the public, we leverage them to assess, understand, and change behavior and social systems. In addition to leveraging the technological progress of our engineering and computer science colleagues, we also need to work closely with them in transdisciplinary teams to create new technologies that specifically address the research and practice needs of the behavioral and social sciences.

The combination of these technological advances, NIH’s continued efforts to encourage data sharing [36], and the increasing access to administrative data [37] have and will continue to transform the behavioral and social sciences into a data-rich research enterprise in which big data management and analytic skills increasingly will be required. In addition to the increasing efforts in computational modeling in the behavioral and social sciences that OBSSR helped facilitate, the NIH has increasingly prioritized AI and other machine-learning approaches [38], and OBSSR continues to work to integrate better behavioral and social sciences in these NIH data science initiatives. One clear limiting factor to data sharing and emerging data science approaches is the relative lack of behavioral ontologies and controlled vocabularies that adequately standardize scientific terminologies in the behavioral and social sciences and the relations among these terms. OBSSR has begun an effort to advance behavioral ontologies, consistent with the vision of a cumulative science that leverages standard vocabularies of its interventions/manipulations, mechanisms/mediators, and outcomes to share data more efficiently and accelerate scientific advances.

These and other advances over the next 25 years will require a rethinking of graduate training in the behavioral and social sciences. As noted in a recent National Academies workshop report [39], current graduate training has not kept pace with the skill sets needed by graduates who must function in an increasingly diverse, transdisciplinary, and data-rich environment. Some of the training that OBSSR has provided over the last 25 years is partly remedial, providing training in common research methodologies like RCTs for which all graduates should be well trained. In the near future, specialized trainings supported by OBSSR in areas such as computational modeling and mHealth will become more mainstream and ready for incorporation as a core competency of all behavioral and social science graduates. OBSSR will continue to support training in advanced, cutting-edge areas of research. Some will remain niche or specialized skills, but others will become more mainstream skills that should be incorporated into increasingly flexible graduate training curricula.

OBSSR has played a role in a number of behavioral and social science research advances in the past 25 years, but we have not done this alone. We have been fortunate to have committed behavioral and social science colleagues across the NIH institutes and centers who have worked with OBSSR to advance the science. An excellent working relationship among the behavioral and social scientists in NIH program, scientific review, and administration has been crucial to the successes of the past 25 years and will be crucial to the 25 years to come. We have also been fortunate to have a dedicated research community that has helped shape the behavioral and social science directions of the NIH and responded to new NIH initiatives with rigorous research grant proposals. Bold, rigorous research that seeks to answer important questions relevant to public health has and will continue to be the primary driver for the continued success of the behavioral and social sciences funded by the NIH.