The NIH Science of Behavior Change Program: Transforming the science through a focus on mechanisms of change

Abstract

The goal of the NIH Science of Behavior Change (SOBC) Common Fund Program is to provide the basis for an experimental medicine approach to behavior change that focuses on identifying and measuring the mechanisms that underlie behavioral patterns we are trying to change. This paper frames the development of the program within a discussion of the substantial disease burden in the U.S. attributable to behavioral factors, and details our strategies for breaking down the disease- and condition-focused silos in the behavior change field to accelerate discovery and translation. These principles serve as the foundation for our vision for a unified science of behavior change at the NIH and in the broader research community.

Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol

“…The current randomized control trial proposes to test whether the AIMS-T1D behavioral intervention can improve adolescents' SR and treatment regimen adherence. The study takes an experimental medicine approach to behavior change by testing the impact of an intervention targeting SR as a primary outcome [72]. As prior work using similar interventions suggests that these aspects of SR are malleable [52,54,59], the next step in a systematic experimental medicine approach to building and testing better interventions is to test whether these early findings can generalize to a new population, specifically adolescents with T1D.…”

A model for cognitively-based compassion training: theoretical underpinnings and proposed mechanisms

“…The CBCT integrative model proposes a framework for how key skills developed in each module may lead to three principal outcomes of interest: resilience, compassion, and wellbeing. The NIH Science of Behavior Change Program identified three target classes that are central to behavior change: self-regulation, stress resilience and stress reactivity, and interpersonal and social processes (Nielsen et al 2018). The proposed CBCT mechanisms of change include skills relevant to each identified class.…”

“…While CBCT has been previously shown to be an effective intervention to reduce depression and other negative health symptoms (Desbordes et al 2012;Mascaro et al 2016), there is a lack of empirical research addressing the mechanisms of change in a CBCT intervention. Here, we adopt the National Institute of Health (NIH) Science of Behavior Change definition which refers to mechanisms of behavior change as "malleable targets that play a role in initiating or maintaining behavior change" (Nielsen et al 2018). Mechanisms of behavior change could take place at different levels of analysis including the psychological, social, cultural or structural.…”

“…In the case of the CBCT integrative model, 'mechanisms of change' refer to the relationships among psychosocial skills developed through participation in CBCT that are expected to lead to the outcomes of interest: resilience, compassion, and wellbeing. The National Institute of Health (NIH) Science of Behavior Change Program emphasizes the importance of utilizing mechanism-focused methods to understand how and why interventions work to effectively optimize and personalize behavioral interventions for specific populations (Nielsen et al 2018). In keeping with that approach, this paper has two aims: (1) to provide a comprehensive overview of the theoretical underpinnings and practices of CBCT and (2) to propose a conceptual model that identifies the psychosocial constructs that influence change mechanisms in CBCT training.…”

It's About Time: Answering the Call for Greater Precision in Research and Practice

“…Yet, despite an ever‐growing research literature, there is lingering frustration with what can be gleaned from the evidence available. In response to this state of affairs, there have been calls to improve the connections between theory and interventions (Hekler et al., ; Rothman, ), initiatives have emerged that delineate how to translate basic principles into intervention strategies (Czajkowski et al., ; Nielsen, Riddle, & King, ; Sheeran, Klein, & Rothman, ), resources have been developed to help investigators specify the intervention techniques being utilised and how they might work (Carey et al., in press; Michie et al., ), and guidance is available, within domains, regarding what constructs to measure and how best to measure them (e.g. weight loss; MacLean et al., ).…”