In the era of transformation to value-based care, new accountability is placed on health care delivery systems to provide high quality care that improves the health of populations, improves the patient experience of care, and concurrently reduce costs. Many priority conditions for value-based care have associated lifestyle, behavioral, and/or mental health components that contribute to disease outcomes and costs. To address these factors, there is a growing demand for BSSR interventions that are reliable, effective in achieving desired prevention and management outcomes, acceptable to patients, and flexible for integration directly into health care and population health practice. Despite the volume of effective interventions resulting from BSSR funding, adoption of these interventions into care delivery remains rare.
Facilitators of BSSR intervention integration into practice are emerging. To illustrate, diabetes is presented as a priority disease example for value-based care. Diabetes, which affects over 30 million Americans and costs $327 billion annually in direct medical costs and reduced productivity, is a disease with concomitant lifestyle, behavioral, and mental health factors. Three diabetes-related BSSR interventions are used to demonstrate pathways to BSSR integration into health care and population health practice: the Collaborative Care Model; the National Diabetes Prevention Program; and DECIDE, a diabetes self-management program. Features of pathways to integration are discussed. Implications for the design and outcomes reporting of BSSR interventions to facilitate readiness for integration into practice in the current era are identified.
Felicia Hill-Briggs, Ph.D., ABPP
Professor of Medicine and Core Faculty
Welch Center for Prevention, Epidemiology, and Clinical Research
Johns Hopkins University School of Medicine
Felicia Hill-Briggs, PhD, ABPP is Professor of Medicine and Core Faculty of the Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins University School of Medicine. She is Senior Director of Population Health Research and Development for Johns Hopkins HealthCare LLC and Co-Lead of the Behavioral, Social, and Systems Science Translational Research Community for the Johns Hopkins Institute for Clinical and Translational Research (an NIH CTSA). A clinical psychologist, neuropsychologist, and behavioral scientist, Dr. Hill-Briggs conducts clinical trials of individual- and systems-level interventions for the prevention and management of diabetes, cardiovascular disease, and related conditions. A particular emphasis of her research is effective intervention design and adaptation for populations of health inequity. She is developer of the DECIDE program, a problem-solving training approach to chronic disease self-management in high-risk populations, developed through NIH-funded trials. Her dissemination and implementation work extends internationally to governmental and private sector partnerships for population health management and hair heath and improvement in regions with high diabetes burden, including the Caribbean and Middle East.
Dr. Hill-Briggs served as 2018 President of the American Diabetes Association, Health Care and Education. She has served on the NIH Interagency Committee on Diabetes Mellitus and several NIH Special Emphasis Panels. Dr. Hill-Briggs is the recipient of the Rachmiel Levine Medal from ADA, the Nelson Butters Award for Research Contributions to Clinical Neuropsychology from the National Academy of Neuropsychology, and the Tracey Orleans Award from the Society of Behavioral Medicine. In 2017, Dr. Hill-Briggs was elected to the National Academy of Medicine of the National Academies of Science, Engineering, and Medicine (NASEM).