The full translational spectrum of prevention science: facilitating the transfer of knowledge to practices and policies that prevent behavioral health problems

Abstract

A broad-span, six-stage translational prevention model is presented, extending from the basic sciences-taking a multi-level systems approach, including the neurobiological sciences-through to globalization. The application of a very wide perspective of translation research from basic scientific discovery to international policy change promises to elicit sustainable, populationlevel reductions in behavioral health disorders. To illustrate the conceptualization and actualization of a program of translational prevention research, we walk through each stage of research to practice and policy using an exemplar, callous-unemotional (CU) traits. Basic science has identified neurobiological, psychophysiological, behavioral, contextual, and experiential differences in this subgroup, and yet, these findings have not been applied to the development of more targeted intervention. As a result, there are currently no programs considered especially effective for CU traits, likely because they do not specifically target underlying mechanisms. To prevent/reduce the prevalence of conduct disorder, it is critical that we transfer existing knowledge to subsequent translational stages, including intervention development, implementation, and scaling. And eventually, once resulting programs have been rigorously evaluated, replicated, and adapted across cultural, ethnic, and gender groups, there is potential to institutionalize them as well as call attention to the special needs of this population. In this paper, we begin to consider what resources and changes in research perspectives are needed to move along this translational spectrum. INTRODUCTIONDespite exciting advances in our knowledge of the biological, social, and environmental underpinnings of behavioral health problems, the translation of original research to routine public or mental health practice takes at least one or two decades, sometimes longer. The reasons for this protracted gap between research findings and the implementation of evidence-based strategies and practices are complex, related to difficulties in

A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics

“…Decision aids have been tested with good success in the oncology field [8], but are relatively new to mental health. This research exemplifies a translational perspective such as the five-stage typology highlighted in this issue [9].…”

Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks

“…Many challenges present themselves throughout the translational process, protracting its effectuation. For example, changes in environment, policy, or prevention implementation systems often require old interventions to be updated [6]. If expected efficacy cannot be established, foundational science and intervention design should be revisited.…”

“…If expected efficacy cannot be established, foundational science and intervention design should be revisited. And if negative real-world reactions to intervention undermine its potential impact (effectiveness), implementation plans need to be altered or a new intervention developed [6]. Another challenge stems from the need for collaboration both within and across all translational stages between teams of basic and social scientists, intervention developers, organizational and community leaders, cross-sector agency staff, frontline service providers, dissemination and implementation scientists, funders, policymakers, and individuals whose behaviors are targeted for change.…”

Transdisciplinary translational behavioral (TDTB) research: opportunities, barriers, and innovations

“…A translational approach to identifying, optimizing, and implementing preventive behavioral interventions is consistent with the mission of the National Institutes of Health (NIH), which is to seek Bfundamental 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.T ranslational research is defined by the NIH as: (1) Bthe process of applying discoveries generated during research in the laboratory, and in preclinical studies, to the development of trials and studies in humans,^and (2) Bresearch aimed at enhancing the adoption of best practices in the community.^The first area is often referred to as T1 and the second as T2 research. The translational spectrum applied to prevention research can be further broken down into additional categories, resulting in an interactive and dynamic set of research phases as illustrated in Table 1 [1]. As depicted in Table 1, the translational spectrum in prevention research begins with Btype zero^or T0, characterized by basic discovery science and the movement of basic science findings to the next logical step along the translational continuum (e.g., findings on basic principles, mechanisms, and processes in animal models validated with human subjects in field or laboratory settings); continues through T1 (bench to bedside), which involves early stage intervention development and testing; to efficacy and effectiveness (T2) testing; and culminates in the dissemination, adoption and implementation of proven interventions in clinical and community settings (T4), and ultimately at a global level (T3-T5).…”