The mission of the National Institutes of Health (NIH) is to fund and conduct research that will improve the health of the public. Congress established the Office of Behavioral and Social Sciences Research (OBSSR) at the NIH to facilitate the growth and development of these important fields. The creation of the OBSSR was in part a recognition that behavioral and social factors are not only significant contributors to health and illness, but frequently interact with biological factors to influence health outcomes. In addition, it was recognized that behavioral and social factors represent important avenues for treatment and prevention.

To further the mission of the NIH, four areas of behavioral and social sciences research must be expanded.

1. We need to identify new behavioral and social risk factors for disease. Behavioral and social sciences research funded by the NIH has contributed to the discovery of such well-known risk factors as cigarette smoking, high-fat diets, physical inactivity, substance abuse, low socioeconomic status and many others. Yet, there are unquestionably other behavioral and social potential risk factors for illness that await discovery.

2. We need more research on biological, behavioral, and social interactions as they affect health. It has already been discovered, for example, that psychological stress can impair brain development, elevate blood pressure, suppress immune system functioning, and contribute to coronary occlusion. The hallmark of research on biopsychosocial interactions has been interdisciplinary collaboration, and these efforts must be expanded.

3. We must develop new behavioral and social treatment and prevention approaches. Directing more attention to such approaches will allow us to continue on the remarkable progress that has already occurred in the treatment and prevention of an array of disorders such as depression, heart disease, chronic pain, infant mortality, and AIDS.

4. We need more basic behavioral and social sciences research to accelerate advances in such areas as learning and memory, emotion, motivation, perception, cognition, social class, social relations, family processes, and cultural practices. Such research is the foundation for all other behavioral and social sciences research.

MANDATES AND RESPONSIBILITIES OF THE OBSSR

THE PHILOSOPHY OF, AND A VISION FOR THE OBSSR

The guiding philosophy of OBSSR is that scientific advances in the understanding, treatment, and prevention of disease will be accelerated by greater attention to behavioral and social factors and their interaction with biomedical variables. Figure 1 illustrates the various factors that determine health outcomes, which involve behavioral/sociocultural/environmental, physiological, and genetic factors, and the interactions among these categories. Although the contribution of each category may vary from disease to disease, there is now ample evidence supporting this integrated perspective of causation for most health problems. For example, this conceptualization may be applied to an array of disorders including heart disease, cancer, diabetes, AIDS, depression, substance abuse, stroke, asthma, injuries, anxiety disorders, chronic pain, infant mortality, and dental problems. Furthermore, the categories outlined in figure 1 represent not only risk factors for disease, but identify targets for intervention. Although most of our treatment research efforts have been aimed at the physiological category and associated drug interventions, research clearly demonstrates the efficacy of behavioral and social interventions for a large number of disorders. Therefore, a vision for the OBSSR is that through its work, this broader conceptualization of health will be used to guide the scientific mission of the NIH.

THE STRATEGIC PLANNING PROCESS

In order to fulfill this vision, OBSSR, during its first year, initiated a strategic planning process. The goal of the strategic planning process was to bring together the relevant scientific communities to assist OBSSR in charting its future direction and in establishing its priorities. Two strategic planning meetings were held in February and March of 1996 involving over 70 scientists, science administrators, and representatives of science organizations. These individuals worked to outline the specific goals, strategies, and actions that are summarized in this strategic plan, which will constitute the core activities for OBSSR over the next 3 to 5 years.

As shown in figure 2, the ultimate objective for the NIH is to improve health through the support of scientific research. To achieve this objective, OBSSR will work to enhance the effectiveness of the NIH through greater attention to behavioral and social sciences research (figure 2). The OBSSR strategic plan is organized around goals, strategies, and actions. Three goals were identified for OBSSR and are shown in figure 3. These goals form the core of the OBSSR strategic plan and are described on the following pages.

A major part of the Congressional mandate for OBSSR was for it to work to increase support for behavioral and social sciences research and training at NIH, both in the extramural and intramural programs. To accomplish this, OBSSR must assist NIH in identifying and capitalizing on the numerous scientific opportunities that exist in the behavioral and social sciences. In addition to biobehavioral research (see Goal 2 below), these opportunities exist in such areas as the identification of new risk factors; the development of new treatment and prevention approaches; and research on basic behavioral and social processes relevant to health. The office must also work to increase the pool of scientists who are trained to make discoveries in these areas for the ultimate benefit of the public.

Congress mandated that specific attention be devoted to integrating a biobehavioral perspective into research at NIH. Biobehavioral research, also known as biosocial and biopsychosocial research, combines knowledge and approaches from biomedical, behavioral, and social science disciplines to gain a better understanding of the complex, multifaceted interactions that determine healthy and pathological human functioning. As such, biobehavioral research represents an exciting new frontier for the health sciences and for NIH. Examples of biobehavioral research include such areas as behavioral cardiology, cognitive and behavioral neuroscience, psychoneuroimmunology, and behavioral genetics.

Improved communication among health scientists, and between scientists and the public, is crucial to advancing behavioral and social sciences research and improving health. It was recommended that OBSSR develop a comprehensive communications plan that would involve activities aimed at 1) improving communication and information exchange among behavioral and social scientists; 2) improving communication between sociobehavioral and biomedical scientists; 3) increasing the dissemination of behavioral and social science findings to the public and to health care providers; 4) improving media coverage of behavioral and social sciences research; and 5) ensuring that policymakers are kept abreast of developments in these fields.