NIH Record - December 15, 1998  

Prevention Conference Takes Topics From Headlines

A Summary of the Conference "Preventive Intervention Research at the Crossroads: Contributions and Opportunities from the Behavioral and Social Sciences"

By Susan M. Persons

A recent NIH conference jointly sponsored by the Office of Behavioral and Social Sciences Research and the Office of Disease Prevention focused on preventive intervention research and drew a sold-out crowd weeks before its reservation deadline. "'Preventive Intervention Research at the Crossroads: Contributions and Opportunities from the Behavioral and Social Sciences' was one of our most successful conferences," said Dr. Norman Anderson, director of OBSSR.  "Newspaper headlines across the country cry out (the need) for prevention," Anderson said, opening the 2-day conference with examples of periodicals heralding such health threats as AIDS, smoking, obesity, depression, drug abuse, suicide, homicide and child abuse -- all preventable maladies.

Although the conference was designed to showcase individual examples of NIH-supported preventive intervention research strategies, participants commented that it was easy to discern common threads of successful interventions across health issues and age spans. For example, Ken Resnicow, professor at Emory University, said it was clear that "successful interventions have been theory-based. We have had to endure trial and error for a long time, and we now know that disseminating information, scare tactics, and affective education simply don't work. Attention to social influences based on theory and personal and social skills training are the most effective." These findings have ramifications for programs such as Drug Abuse Resistance Education (DARE), which, despite its wide acceptance in many schools across the nation, has been shown to be
ineffective.

A second common thread, according to several speakers, is the huge gap between what researchers know and what practitioners do. There was a strong consensus among the experts for the urgent need to bridge the gap between research and practice. In addition, David Olds, professor of pediatrics at the University of Colorado, expressed concern about the "watering down of programs as they are disseminated." Balancing the need to maintain the integrity of an intervention with the need to target specific populations remains a challenge, researchers agreed.  John Jemmott, professor of psychology at Princeton, gave strong examples from his research illustrating that theory-based, targeted and culturally sensitive interventions can be highly effective in protecting adolescents from HIV/AIDS.

When focusing on children and adolescents, the significance of targeting interventions at early ages was often highlighted by conferees. "The importance of the first grade classroom has been greatly underestimated," said Prof. Sheppard Kellam of Johns Hopkins University. "We are ignoring a major gap in socialization.  Kids who are in chaotic classrooms are reinforced in negative behavior. It is a shame that teachers are not taught to socialize kids properly."

Keynote speaker Dr. Nicole Lurie, principal deputy assistant secretary for health, delivered a message that was reiterated by many subsequent speakers: the need to address the issue of health disparities. "We need a much greater understanding of the behavioral and social underpinnings for the huge differences in the rates of coronary heart disease and stroke, AIDS, infant mortality, diabetes, breast and cervical cancer between Blacks and whites," she said. Lurie also emphasized the need to develop trust among minority populations by getting involved in communities, sharing research and programs. "All health care is local," she said.  "We need to develop both formal and informal health care. There is a notion among academics that once we have written a paper, we are done. That is when the work is just beginning."

Helping bridge the gap between health research and health policy realms, Lisa Layman, legislative aide for Sen. John Chafee (R-R.I.), spoke to conferees about the newly formed bicameral, bipartisan Congressional Prevention Coalition.  Chafee, a cochair and founding member of the coalition, organized it to enhance the communication of science-based information about prevention-related issues in Congress with the goal of focusing on ways to integrate disease prevention and health  promotion into the health care system. Layman urged researchers to "go where the money is and be loud" regarding advocacy for prevention health issues.  "If you want to be successful in the budget process, have a clear message, begin early, and be aggressive." She also suggested that conferees encourage their representatives to join the Congressional Prevention Coalition. "This will help to make sure that prevention research becomes integral to what happens on the Hill," she said.

To obtain a copy of the conference program and research abstracts, call Patricia Evans at (301) 315-9000 ext. 516.