Pathways for translating behavioral medicine research to practice and policy

Research to law: A qualitative study of Massachusetts' 2018 Care Act expanding emergency department initiation of medication for opioid use disorder

BACKGROUND

Initiating medication for opioid use disorder (MOUD) during emergency department (ED) visits is an important innovation to engage individuals in addiction treatment. In 2018, Massachusetts passed the CARE Act, becoming the first state to legislate that hospitals with EDs must be able to offer MOUD. We performed a qualitative study to explore factors influencing policy enactment.

METHODS

Semi-structured interviews were conducted in 2019 with ten key stakeholders involved in the policymaking process representing state government, hospitals, physician professional societies, and recovery/behavioral health organizations. Data were analyzed in 2020-2021 using a hybrid inductive-deductive approach.

RESULTS

The first key theme stakeholders expressed was the importance of research and public health consensus; they described consensus building within existing coalitions regarding the pressing need for action, and supporting expansion of treatment with this evidence-based strategy. Second, stakeholders discussed overcoming financing and feasibility concerns by passing budget-neutral legislation and ensuring flexibility for diverse hospital types. Lastly, stakeholders looked towards implementation, describing the implementation guide development process and ensuring capacity for continuing treatment existed throughout the state.

CONCLUSIONS

This study suggests that research supporting the effectiveness of ED MOUD induction drove the passage of this state legislation. Long-term collaboration between diverse stakeholders towards a common goal of increasing access to evidence-based treatment to address the opioid epidemic was also perceived as facilitating the law's passage. Policymakers and advocates in other states may look towards Massachusetts's legislative process as a model for implementing similar legislation as part of their strategies to address the drug overdose crisis.

What informs oral health and chronic disease policy development in Australia: a citation analysis

Improvement of health services and patient outcomes depends on the translation of health research into health policy. Oral health research can inform policies to manage chronic diseases and improve quality of life of affected individuals. To determine if translation of this research into policy is occurring, we identify where policymakers obtain evidence to inform the development of Australian health policy. We conducted a citation analysis of oral health, cardiovascular disease, diabetes and cognitive impairment National policies to determine if current oral health research has informed oral health and chronic disease policy. We analysed five National policies with 268 individual references to policy or organizational documents (n = 179), peer-reviewed research (n = 74), grey literature (n = 12), or unidentifiable (n = 3). Although we found oral health references listed in the National policies (92), we did not find this information to have been translated into the oral health and chronic disease policies we analysed.

What Is Slowing Us Down? Six Challenges to Accelerating Advances in Health Behavior Change

BACKGROUND

Accelerating advances in health behavior change requires releasing the brake, as well as applying the throttle. This paper discusses six challenges or "brakes" that have slowed progress.

PURPOSE/METHODS/RESULTS

We engage with six issues that limit investigators' ability to delineate and test the strategy-target and target-behavior relations that underlie effective interventions according to the experimental medicine approach. We discuss the need for guidance on how to identify the relevant mechanism of action (target) in an intervention and whether a periodic table of health behavior constructs might aid investigators. Experimental and correlational analyses (prospective surveys and behavior change techniques) have been used to test the validity of targets, and we present evidence that there is little agreement among the findings from different research designs. Whereas target engagement is typically analyzed in terms of increasing scores on constructs that impel behavior change, we discuss the role of impeding targets and the benefits of adopting a broader construal of potential targets and approaches to engagement. There is presently a paucity of competitive tests regarding which strategies best engage targets and we discuss empirical criteria and conceptual developments that could enhance the evidence base. Finally, we highlight the need to take "context" or conditional intervention effects more seriously by leveraging the interplay between questions about why interventions work and questions about when and for whom they work.

CONCLUSION

Candid appraisal of the challenges facing research on health behavior change can generate new opportunities for theoretical development and offer direction and cumulative impetus for empirical work.

Examining the Role of Anxiety and Depression in Dietary Choices among College Students

This study examines the role of anxiety and depression symptoms in predicting dietary choices in emerging adults while accounting for sex differences in these relationships. Participants were 225 English speaking undergraduates enrolled in a university in southeastern United States. Participants were recruited through an online research recruitment application utilized by the university. Participants volunteered for a two-phased anonymous survey monitoring the effects of eating habits and gastrointestinal health in young adults. As part of this effort, participants completed self-reporting measures related to anxiety and depression, as well as an automated, self-administered 24-h diet recall. Multigroup path analysis was used to test primary hypotheses. Overall, a decrease in total caloric intake and an increase in sugar consumption were found as self-reported symptoms of anxiety and depression increased. In addition, there were sex differences in the relationship between depression and food choices. Men consumed more saturated fat as well as less fruits and vegetables as self-reported symptoms of depression increased. Results suggest symptoms of depression are a greater risk factor for poor nutrition in male college students than females. The findings provide another justification to screen for psychological distress in student health services given the implications on behavioral lifestyle and health.

Early Career Professionals’ (Researchers, Practitioners, and Policymakers) Role in Advocating, Disseminating, and Implementing the Global Action Plan on Physical Activity: ISPAH Early Career Network View

Increasing population levels of physical activity (PA) can assist in achieving the United Nations sustainable development goals, benefiting multiple sectors and contributing to global prosperity. Practices and policies to increase PA levels exist at the subnational, national, and international levels. In 2018, the World Health Organization launched the first Global Action Plan on Physical Activity (GAPPA). The GAPPA provides guidance through a framework of effective and feasible policy actions for increasing PA, and requires engagement and advocacy from a wide spectrum of stakeholders for successful implementation of the proposed actions. Early career professionals, including researchers, practitioners, and policymakers, can play a major role with helping “all people being regularly active” by contributing to 4 overarching areas: (1) generation—of evidence, (2) dissemination—of key messages and evidence, (3) implementation—of the evidence-based actions proposed in the GAPPA, and (4) contributing to advocacy for robust national action plans on PA. The contribution of early career professionals can be achieved through 5 pathways: (1) research, (2) workplace/practice, (3) business, (4) policy, and (5) professional and public opinion. Recommendations of how early career professionals can contribute to the generation, dissemination, and implementation of the evidence and actions proposed by the GAPPA are provided.