Precision Health: The Role of the Social and Behavioral Sciences in Advancing the Vision

Abstract

Background In 2015, Collins and Varmus articulated a vision for precision medicine emphasizing molecular characterization of illness to identify actionable biomarkers to support individualized treatment. Researchers have argued for a broader conceptualization, precision health. Precision health is an ambitious conceptualization of health, which includes dynamic linkages between research and practice as well as medicine, population health, and public health. The goal is a unified approach to match a full range of promotion, prevention, diagnostic, and treatment interventions to fundamental and actionable determinants of health; to not just address symptoms, but to directly target genetic, biological, environmental, and social and behavioral determinants of health. Purpose The purpose of this paper is to elucidate the role of social and behavioral sciences within precision health. Main body Recent technologies, research frameworks, and methods are enabling new approaches to measure, intervene, and conduct social and behavioral science research. These approaches support three opportunities in precision health that the social and behavioral sciences could colead including: (a) developing interventions that continuously “tune” to each person’s evolving needs; (b) enhancing and accelerating links between research and practice; and (c) studying mechanisms of change in real-world contexts. There are three challenges for precision health: (a) methods of knowledge organization and curation; (b) ethical conduct of research; and (c) equitable implementation of precision health. Conclusions Precision health requires active coleadership from social and behavioral scientists. Prior work and evidence firmly demonstrate why the social and behavioral sciences should colead with regard to three opportunity and three challenge areas.

The Digital Marshmallow Test (DMT) Diagnostic and Monitoring Mobile Health App for Impulsive Behavior: Development and Validation Study

“…Our study revealed similar results to previous studies that impulsivity is not a unitary construct but is rather composed of qualitatively different constructs, which may or may not have some overlap [ 22 ]. Moreover, the complex relationship between impulsive behaviors and health outcomes within each individual might require an n-of-1 approach to prediction and control of impulsive behaviors [ 37 , 88 , 89 ]. New mHealth methods such as the DMT using multimodal assessment strategies that take trait and state impulsivity into account with contextual variables are needed to further our understanding of how to predict impulsive behavior.…”

“…Future studies should account for contextual factors such as setting, mood, and intentionality to further disentangle the relationship between trait and state impulsivity, and the different dimensions measured by these tools. Contextual factors can also be used to design more precise behavior change and digital health interventions with mobile technology [ 88 , 90 - 93 ].…”

Innovative methods for observing and changing complex health behaviors: four propositions

“…Precision medicine [ 1 ] and precision health [ 2 ] (i.e., diagnostics and treatment strategies that take individual variability into account) have been greatly expanded in the past years through a variety of methods and computational techniques, such as genome sequencing, big data, and wearable technology. These initiatives aim to progressively move beyond approaches focused on average patient responses toward ones that are individualized, contextualized, and timely [ 2 ]. In this article, we aim to provide an overview of key methods and approaches that can help facilitate the transition to precision initiatives in the health behavior change domain.…”

“…The amounting evidence that health behaviors are complex suggests that adaptive and continuous “tuning” interventions are necessary for better supporting healthy behavioral choices over time and across contexts, similar to what a clinician or health coach would do in their practice [ 2 , 69 ]. The idea that tailored interventions are more likely to engender change at the individual level (as opposed to static or generic interventions) is not new; tailoring refers to a category of interventions which aim to “reach one specific individual, based on specific characteristics of that person that have been measured in a formal assessment” [ 70 ].…”

Participants’ enactment of behavior change techniques: a call for increased focus on what people do to manage their motivation and behavior

“…However, in personalized, for example, just-in-time adaptive interventions, where participants are prompted with messages suited to them, based on data (e.g. (35), expectations of enactment are likely to be higher, and monitoring whether participants enact the BCTs tailored precisely to them (36) should become all the more important. These interventions may also offer exciting opportunities to investigate what factors improve uptake of offered BCTs, and inter-individual variation therein.…”