Precision Strategies as a Timely and Unifying Framework for Ongoing Prevention Science Advances

Abstract

The purpose of this Special Issue is to encourage prevention scientists to take advantage of the recently actuated precision medicine movement to promote research toward determining what works for whom and under what conditions, also termed treatment matching (Collins and Varmus 2015). This strategy is not new to medicine, behavioral health, or prevention science. Nevertheless, the orchestrated proclamation by President Obama and Director of NIH, Francis Collins, M.D. of the Precision Medicine Initiative (PMI) with its $215M and 1 million participant prospective natural history study reinvigorated these efforts at the NIH and among treatment developers and healthcare providers (Collins and Varmus 2015; PMWC 2018; www.whitehouse.gov/precision-medicine). The 1 million participant prospective study has come to fruition in the form of the ALL OF US Research Program (NIH 2019; Sankar and Parker 2017) which emphasizes genetics, environmental factors, social influences, and lifestyle and is thus highly consistent with underlying theories of prevention science (Meagher et al. 2017). Past medical and behavioral clinical trials directed toward treatment matching have yielded mixed results, but overall such studies have played important roles in advancing their respective fields (Broekhuizen et al. 2012; Project MATCH Research Group 1998; Strecher 1999). August and Gewirtz (2018) discuss recent progress in prevention science targeting internalizing and externalizing outcomes (including substance use) but concluded that the literature Boffered few clues as to alternative interventions that might be effective for those who fail to benefit [from existing interventions]^(pp. 1-2). Generally speaking, attempts at intervention matching in prevention science have not yielded sizable improvements over other prevention programs, but there are exceptions (Broekhuizen et al. 2012; O'Leary-Barrett et al. 2016; Strecher 1999). The more common

Personalized models of psychopathology as contextualized dynamic processes: An example from individuals with borderline personality disorder.

“…We use recently developed statistical methodology that builds individualized models of within-person processes and then identifies shared elements, allowing for heterogeneity in pathology while still locating commonalities between individuals. This is consistent with a broader push toward personalized diagnosis and intervention in medicine, (Collins & Varmus, 2015), prevention science (Ridenour, 2019), education (Reber, Canning, & Harackiewicz, 2018), and psychology (Fisher, 2015; Molenaar, 2004). We provide an empirical illustration of the importance of focusing on the transdiagnostic elements of heterogeneity, variation across time and circumstance, and multiple reciprocal domains of functioning in understanding BPD and psychopathology more broadly.…”

“…To the extent this is occurring, this can accumulate to a large number of false associations across large numbers of participants. Finally, recently there has been concern expressed about the replicability of network models in psychopathology research (e.g., Forbes, Wright, Markon, & Krueger, 2017a, 2017b, 2019van Borkulo et al, 2017). To briefly summarize a technical (and hotly debated) literature, it has been observed that specific edges do not replicate in cross-sectional networks when comparing samples that could arguably be assumed to have the same underlying structure, either due to high similarity or very closely repeated assessments.…”

Moving Toward a Precision-Based, Personalized Framework for Prevention Science: Introduction to the Special Issue

“…Completing the special issue, Ridenour (2018) provides a commentary that briefly describes the PM initiative and its general principles. An argument is presented for bringing these principles into prevention science and discusses how the articles in this special issue align with and advance those principles within a prevention science framework.…”

The Society for Prevention Research 20 Years Later: a Summary of Training Needs

“…The past decade has also seen an explosion in new prevention methodologies and approaches (e.g., ecological momentary assessments, adapted intervention designs, genomic, and neuroimaging data collection methods; Brown et al 2017 ; Brown et al 2014 ; Collins 2018 ; Schuster et al 2016 ; Wiedermann et al 2019 ) and, correspondingly, a need to train individuals at all career levels in these new methods. Technological resources and capabilities have also grown exponentially, enabling innovative data collection and analysis techniques (Mason et al 2015 ; Mohr et al 2017 ; Ridenour 2018 ; Schuster et al 2016 ; Torous et al 2018 ). Clearly, the state of science is rapidly evolving, underscoring the need to re-assess the membership of SPR to gauge training needs with regard to new methods and innovative approaches to keep the field current.…”