Prevention Research at the National Institutes of Health · Clinical trials, group- or cluster-randomized trials Less common designs (e.g., stepped wedge, regression discontinuity)

Prevention Research at the National Institutes of Health

David M. Murray, Ph.D. Associate Director for Prevention Director, Office of Disease Prevention

Association for Clinical and Translational Sciences April 14, 2016

Prevention is Part of the NIH Mission

NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability. The NIH provides leadership and direction to programs designed to

improve the health of the Nation by conducting and supporting research in the causes, diagnosis, , and cure of human disease.

prevention

ACTS: April 14, 2016 2

The Office of Disease Prevention Division of Program Coordination, Planning, and Strategic Initiatives

Director NIH

Director DPCPSI

Office of AIDS Research

Office of Research on

Women’s Health

Office of Disease Prevention

Office of Behavioral and Social Sciences

Research

Office of Strategic

Coordination

Office of Research

Infrastructure Programs

Office of Portfolio Analysis

Office of Program

Evaluation & Performance

Sexual & Gender Minority

Research Office

Tribal Health Research Office

Office of Administrative Management &

Communications


Mission of the Office of Disease Prevention

The mission of the ODP is to improve the public health by increasing the scope, quality, dissemination, and impact of prevention research supported by NIH. ODP will fulfill this mission by providing leadership for the

development, coordination, and implementation of prevention research in collaboration with the ICs and other partners.


Awards and Dollars: NIH Total and Prevention

Thou

sand

s

Bill

ions

50 $25

10 15 20 25 30 35

Total Awards Prevention Awards Total Dollars Prevention Dollars

$5

$10

$15

0 $0

$20 40 45

5

2010 2011 2012 2013 2014 2015 Fiscal Year


Prevention


Thou

sand

s

8.0 $5

5.0

6.0

7.0

$3$3$4$4

4.0 $2

1.0

2.0

3.0 Awards Dollars

$0$1$1$2

0.0 2010 2011 2012 2013

Fiscal Year 2014 2015

$0

.0

.0

.5

.0

.5

.5

.5

.0

.5

.0

.0

Bill

ions

Tobacco

Thou

sand

s

8.0 $5.0

5.0

6.0

7.0

$3.0 $3.5 $4.0 $4.5

4.0 $2.5

2.0

3.0 Dollars Awards

$1.0 $1.5 $2.0 B

illio

ns

0.0

1.0

$0.0 $0.5

2010 2011 2012 2013 2014 2015 Fiscal Year


Nutrition

Thou

sand

s

8.0 $5.0

7.0 $4.5

6.0 $3.5 $4.0

5.0 $3.0 4.0 $2.5

3.0 Dollars $2.0

2.0 Awards

$1.0 $1.5

0.0 $0.0 2010 2011 2012 2013 2014 2015

Fiscal Year

Bill

ions

1.0 $0.5


Obesity

2.0

3.0

4.0

5.0

6.0

7.0

8.0

Dollars Awards

$1.0 $1.5 $2.0 $2.5 $3.0 $3.5 $4.0 $4.5 $5.0

0.0 2010 2011 2012 2013


$0.0

Bill

ions

1.0 $0.5

Thou

sand

s


Alcohol

Thou

sand

s

8.0 $5.0

7.0 $4.5

6.0 $3.5 $4.0

5.0 $3.0 4.0 $2.5

3.0 Dollars $2.0

2.0 Awards

$1.0 $1.5

1.0 $0.5

2010 2011 2012 2013 2014 2015 Fiscal Year

Bill

ions

0.0 $0.0

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Infectious Disease – Not HIV/AIDS

2.0

3.0

4.0

5.0

6.0

7.0

8.0

Dollars Awards $1.5

$2.0 $2.5 $3.0 $3.5 $4.0 $4.5 $5.0

0.0 2010 2011 2012 2013


$0.0

Bill

ions

1.0 $0.5 $1.0

Thou

sand

s

ACTS: April 14, 2016 11

HIV/AIDS

Thou

sand

s

2.0

3.0

4.0

5.0

6.0

7.0

8.0

Dollars Awards $1.5

$2.0 $2.5 $3.0 $3.5 $4.0 $4.5 $5.0

0.0 2010 2011 2012 2013


$0.0

Bill

ions

1.0 $0.5 $1.0

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Substance Abuse

Thou

sand

s

8.0 $5.0

7.0 $4.5

6.0 $3.5 $4.0

5.0 $3.0 4.0 $2.5

3.0 Dollars $2.0

2.0 Awards

$1.0 $1.5

0.0 $0.0 2010 2011 2012 2013 2014 2015

Fiscal Year

Bill

ions

1.0 $0.5

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mHealth

Thou

sand

s

8.0 $5.0

5.0

6.0

7.0

$3.0 $3.5 $4.0 $4.5

4.0 $2.5

2.0

3.0 Dollars Awards

$1.0 $1.5 $2.0 B

illio

ns

0.0

1.0

$0.0 $0.5

2010 2011 2012 2013 2014 2015 Fiscal Year

ACTS: April 14, 2016 14

Recent NIH Initiatives Related to Prevention

Enhancing Diversity of the Biomedical Workforce Big Data Rigor and Reproducibility Precision Medicine Initiative (PMI) Environmental Influences on Child Health Outcomes (ECHO)

ACTS: April 14, 2016 15

The Future for Prevention Researchers

Prevention researchers need better training in research design and analytic methods so that results are reproducible and to be sure that they are using current methods. Clinical trials, group- or cluster-randomized trials Less common designs (e.g., stepped wedge, regression discontinuity) Key or new analytic methods (e.g., mixed model regression, methods for

intensive longitudinal data and for big data) This recommendation aligns well with the CTSA’s 2015 ECRPTQ

Competency Domains 1, 4, and 6. This recommendation applies to animal and human studies, to drug

and device interventions, and to behavioral interventions.

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Prevention researchers need better training in the design, operation, and analysis of pragmatic trials, which are often more efficient and can lead to more rapid implementation of newly tested interventions. Pragmatic trials are often run in health care systems. They often rely on electronic health records for most data. They often involve group- or cluster-randomized trial designs, or related

methods (e.g., stepped wedge). Training in the design and analysis is important. Training in operations is also important, because these studies are often

run in existing health care systems rather than in study-specific setting.

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Researchers using behavioral interventions need training in the use of taxonomies and frameworks for behavioral change. These methods contribute to the development of stronger behavioral

interventions. They also set the stage for meta-analyses and other cross-study

analyses.

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ODP’s Contributions

ODP’s Resources for Researchers web pages provide resources for new and experienced investigators interested in prevention research. Prevention research needs and gaps Prevention related programs, offices, divisions, and study sections Applying for NIH funding

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ODP’s Contributions

ODP provides links to Prevention Science Methods webinars, including webinars on topics identified in the previous slides. Group- or cluster randomized trial design and analytic methods Use of taxonomies and frameworks of behavior change Big data and the promise and pitfalls when applied to prevention research Time-varying effect for intensive longitudinal data ODP is seeking opportunities to support training in prevention

science methods

20

prevention.nih.gov

[email protected]

ACTS: April 14, 2016 21

http://prevention.nih.gov/

mailto:[email protected]

Documents

Prevention Research at the National Institutes of Health · Clinical trials, group- or cluster-randomized trials Less common designs (e.g., stepped wedge, regression discontinuity)