“Let’s not fly blind” has been a frequent call to action at OBSSR in recent years. We are responsible for coordinating the behavioral and social sciences research (BSSR) at the NIH but that is a difficult task without the data and analytics to determine what types of BSSR are being funded or not and why.
To understand the BSSR portfolio, we rely heavily on the Research Condition and Disease Categorization (RCDC) tools available to us. RCDC reports that in Fiscal Year 2017 (FY17), the NIH funded 10649 grants (3124 new or competing) that were coded as BSSR. Because grants have multiple RCDC codes, we can determine how many BSSR grants are also coded as Alzheimer’s (760), Serious Mental Illness (581), Cancer (857) or Heart Disease (256). These RCDC breakdowns are useful for identifying the proportion of BSSR grants focused on specific diseases and conditions and there are several RCDC categories that capture research content areas beyond just diseases and conditions (e.g., cost-effectiveness research, health disparities, biotechnology, clinical research), but OBSSR was looking for more granularity within content areas in the NIH-wide BSSR portfolio.
To address this analysis gap, the Health Science Policy Analysts at OBSSR are working with the NIH Office of Portfolio Analysis to generate subcategories of areas of research within BSSR. Natural Language Processing tools including clustering and topic modeling were used to determine how BSSR grants tend to cluster based on similar words and terms in the grant application. The grants computationally assigned to each of these initial clusters were reviewed and refined by OBSSR staff. Multiple iterations resulted in a repeatable and consistent keyword search approach. FY14 grants were used to develop and test the subcategories with FY17 grants used to validate and refine the subcategories.
This process resulted in 13 content areas of BSSR focused primarily on the processes being studied, clustered based on the use of similar scientific terminology in the grant application, independent of the condition or disease being studied. As with RCDC categorization, there is overlap with multiple codes per grant. The content areas and a short description of each is below (with the number of FY17 grants coded for that content area in parentheses):
- Attention, Learning and Memory (1728) includes the study of the neurobiological and psychological processes and mechanisms that influence attention, learning, and memory. Processes studied by research in this content area include habituation, sensitization, associative learning, operant learning, observational learning, and other processes by which organisms attend to and learn from the environment. This content area includes research on short-term/working and long-term memory of various types (e.g., declarative, procedural, autobiographical, spatial). In addition to basic research on the processes by which learning and memory occur, this content area includes disorders of attention, learning and memory, particularly Alzheimer’s and related dementias as well as interventions to address these cognitive deficits (e.g., cognitive rehabilitation).
- Mental Health (1183) involves research on the neurobiological and social/environmental processes involved in regulating emotion, cognition, and social functions that contribute to mental health and illness. This area includes research on psychopathology and interventions for anxiety, depression, psychosis, and other mental disorders. It also includes research on the influences of these mental disorders on other health conditions as well as the emotional and social impacts of chronic disease.
- Social Processes and Determinants (1159) consists of research that addresses a broad range of social factors that influence health. This research includes social and economic influences, social networks, neighborhood and community influences, cultural factors, and policy impacts. In addition to these macro-level processes, this content area also includes more micro-level basic research on social behaviors, including animal models. Health disparities research is included in this content area, as are studies of population-level and public health approaches. Methodological approaches from ethnography, demography, and epidemiology also are included in this content area.
- Healthcare and Disease Management (1097) consists of a broad range of research studies addressing healthcare access and quality and disease management. The content area includes research using various technologies to improve access. It also includes research on provider-patient interactions, health literacy, decision making, and medical errors. Studies of treatment adherence and other chronic disease management strategies are addressed. A range of healthcare settings and models are studied from hospital-based treatment to home and palliative care as well as end-of-life care. Studies involving counseling in response to testing (e.g., genetics, HIV) also are included in this topic area. Research addressing health economic issues such as health service utilization, benefit design, risk adjustment, and cost-effectiveness are included.
- Developmental Processes and Family Health (1030) includes research on developmental processes from conception to death. Prenatal development, exposures, and stress as well as child and adolescent health and behavior research are included. Maternal health, parental behavior, and family dynamics also are included. Processes involved in healthy aging are included in this content area, as are developmental processes throughout the lifespan. Research on adverse events that negatively impact healthy and normal development and how to prevent or minimize their impact is included.
- Stress, Trauma and Resilience (703) includes research on the effect of exposure to various life stressors and to traumatic events such as violence on health and well-being. This content area includes basic research on fear and stress processes. This content area also includes research on coping and resilience to psychological stress and trauma, and interventions that promote coping and resilience.
- Addictive Behaviors (696) includes research on the processes and mechanisms of addictive behaviors, the prevention and cessation of these behaviors, and substance use as a risk factor for morbidity and mortality. Addictive behaviors include use and abuse of and dependence on tobacco (nicotine), alcohol, cannabis, stimulants, and opioids.
- Food Intake and Physical Activity (480) includes research on various behaviors associated with energy intake and expenditure. Food intake behaviors include the types of foods consumed, food choice, the amount and patterns of food consumption, and the biological, psychological and social influences involved in eating. Feeding behavior research is also included. Physical activity research includes the effects of various forms of activity and inactivity on obesity and a variety of health outcomes (e.g., cardiovascular function and disease) as well as individual, structural, and systems level interventions to increase physical activity. Obesity and weight gain are common outcomes in this research area, but malnutrition is also included.
- Sensation and Perception (473) includes research in the processes and mechanisms involved in the sensations of sight, sound, taste, touch, and smell, as well as interoception, balance, proprioception, time, and temperature and the processes by which we perceive, integrate, interpret, and respond to these sensations.
- Pain, Injury, and Disability (427) includes research on functional impairments that decrease well-being and limit engagement in meaningful activities. These functional limitations may be attributable to intellectual, neurological, sensory, or physical impairments such as chronic pain, physical trauma, stroke, concussion or various neuromuscular disorders. Research in this area includes pathophysiology and management of injured musculoskeletal and neurological systems, and rehabilitation strategies that address the biological, psychological and social condition. This content area also includes the prevention of injury and falls.
- Language and Communication Disorders (407) includes the study of communication processes and impairments in the ability to receive or express verbal and nonverbal communication. Research on interventions to address hearing, speech, and language disorders are also included in this content area.
- Sleep (267) includes research on the neurobiological, psychological, and social processes that regulate sleep and circadian rhythm. Research in this area includes disorders of sleep and circadian rhythm, and related pathophysiology (impaired learning, impulsivity, increase appetite, weaken immune response, and metabolic dysfunction) of sleep and circadian disruption as a health risk factor. This content area includes intervention research for various sleep disorders. Research on infant sleep behavior and sudden infant syndrome also is included in this content area.
- Sexual Behaviors (141) includes research on sexual attitudes and behaviors, and the biological, psychological and social processes that influence these behaviors. This research includes the effects of risky sexual behavior on infectious disease transmission and interventions to reduce risk.
These content areas will allow OBSSR to identify better the areas of research that the NIH funds and the areas that may require additional coordination efforts. We will continue to refine these content areas as we identify misclassifications and as new science emerges, and we will explore further subcategorizations of BSSR grants within these content areas. Along with an updated BSSR definition (stay tuned for an opportunity to provide input on that in the coming months), these enhanced BSSR content areas will provide the basis for reviewing the RCDC BSSR coding and working to ensure that RCDC is an accurate reflection of the BSSR that NIH funds.
These content areas also provide an important step for our next portfolio analysis enhancement effort, mapping the translation of basic to applied BSSR. By creating content areas that include both basic and applied research, we can map more easily the translation of basic findings to applied research within a content area with shared processes of interest. In FY17, four of these content areas (sensation and perception; attention, learning, and memory; stress, trauma and resilience; and mental health) had 49% or more of the grants coded as basic research. In contrast, the sexual behavior and the healthcare and disease management areas have only 19% of the grants in basic research. Do these two content areas have a sufficient basic science foundation to identify new targets and interventions for behavior change, and if so, does that foundation come from basic research in other content areas or from research funded by entities other than the NIH (e.g., NSF)? With this additional lens into the content areas of BSSR research, we will be better able to answer these and other questions that will facilitate our coordination of BSSR at the NIH.