Performance Improvement 2008. Goal 4 - Advance Scientific and Biomedical Research and Development Related to Health and Human Services



Basic science is the foundation for improved health and human services. However, once a basic discovery is made, the findings must be applied and translated into practices for health and human service improvement to result. This continuum from basic and applied research to practice is a significant emphasis of HHS´ scientific research and development enterprise. [5]

Strengthen the Pool of Qualified Health and Behavioral Science Researchers.

A study of the feasibility to evaluate health training and career development programs was conducted. The study resulted in a process-evaluation design for examining outputs from selected National Institute of Arthritis and Musculoskeletal and Skin Diseases research training and career development award programs. The advisory group for the study agreed that the proposed design and approach for developing the evaluation was feasible and recommended that it proceed.

Evaluators assessed implementation and outcomes of the Extramural Associates Research Development Award Program, established to provide grant support to minority and women educational institutions seeking to increase their involvement in biomedical and behavioral research and research training. Based on findings from the Web-based survey, interviews with extramural associates, and grantee file review, the program was being implemented as planned. Associates expressed satisfaction with the grant application process.

Increase Basic Scientific Knowledge to Improve Human Health and Human Development.

Researchers assessed the effectiveness of the Edward R. Roybal Centers Program for Translational Research on Aging. The assessment panel recommended that the program continue and recommended that future published requests for applications articulate more clearly the program´s focus, intent, and desired impact and how it would be measured.

A study explored whether an outcome evaluation of the In Vivo Cellular and Molecular Imaging Centers Program was warranted and feasible, and, if so, to recommend an outcome evaluation design. The program was found to be ripe for an outcome evaluation; its activities, outcomes and impacts are sufficiently varied and complex that in-depth analysis would be worthwhile. Researchers recommended that future outcome evaluations be quasi-experimental.

Conduct and Oversee Applied Research to Improve Health and Well-Being.

Cancer clinical trial participants were surveyed to determine whether they were concerned about possible financial conflicts of interest between researchers, medical centers, and drug companies whose drugs are being tested, as well as potential safeguards. Patients found these financial ties ethically acceptable. They preferred that an oversight system be in place to protect against conflicts of interest rather than to have the detailed financial disclosure statements of researchers or the institution provided to them personally.

Patients in several focus groups provided their views of the Food and Drug Administration´s Early Risk Information on Drug Products and overall usefulness of patient information handouts. Focus group members indicated they believed that many consumers stopped taking drugs, due to adverse events, before talking to their physicians. Participants considered physicians and pharmacists to be the most trustworthy sources. Some suggested that FDA safety news should be sent out through TV and newspapers.

Communicate and Transfer Research Results into Clinical, Public Health, and Human Service Practice.

An assessment was conducted of both customer satisfaction and the value of the American Customer Satisfaction Index, in the context of 60 different NIH Web sites. The Index has been used widely by the private sector and other government agencies. Two-thirds of the assessment teams indicated overall satisfaction with their use of the Index for site evaluation. The Index provided Web site teams with a convenient way to measure customer satisfaction. It allowed continuous qualitative data collection at a lower cost than such options as a one-time user survey.

Researchers identified the reasons that families do not return for essential follow-up for early hearing and intervention screening for their newborns. Although overall completion rates to follow-up and diagnosis were quite high among the women surveyed, a number of barriers to follow-up need to be addressed. These include the shortage of hearing specialists in rural areas and those trained to work with infants, inadequate private and Medicaid coverage, physician knowledge and attitudes about early hearing screening, too little information and communication with the family, and a lack of systematic health care system links from screening through intervention.

A study was conducted to determine how successful a Fire-Fighter Fatality Investigation and Prevention Program was in affecting safety knowledge, attitudes, and behavior. Key implications from the evaluation: small, volunteer departments have the greatest challenges to following safety guidelines; existing resources limit safety practices; gaps in knowledge and attitudes limit safety; firefighters and fire departments need information presented in additional formats; and increasing awareness would likely improve safety practices.

Pharmacists were asked to share their attitudes, beliefs, feelings, and experiences regarding drug product emerging risk communications from the Food and Drug Administration. The study concluded that it would be useful for pharmacists to have a single, credible source they could rely on for timely and accurate information about serious emerging drug risks.

A wide ranging series of studies provided a picture of the numbers of substance abuse and mental health episodes taking place nationally. One study found that the alcohol admission rate had declined by 28 percent and that the admission rate for methamphetamine/amphetamine use increased 127 percent between 1995 and 2005. Another study found that, in 2005, five substances accounted for 95 percent of all reported admissions: alcohol (39 percent), opiates and cocaine (31 percent), marijuana (16 percent), and stimulants (9 percent; primarily methamphetamine). In 2004-2005, it is estimated that use of illicit drugs ranged from a low of 5.9 percent in Iowa to a high of 12.2 percent in Alaska. Approximately 8 percent of full-time workers were illicit drug users. The highest rates illicit drug use was found among the food and hotel (17 percent) and construction (14 percent) industries. In 2006, marijuana use among youths aged 12 to 17 had decreased to 6.7 percent, underage drinking was 28.3 percent, and cigarette smoking had declined among young adults. In 2006, there were about 14,000 substance abuse treatment facilities treating approximately 1.1 million clients at any one time. With regard to mental illness, the percentage of 12-to-17-year-olds who had experienced a major depressive episode in the previous year decreased to 7.9 percent in 2006 from 8.8 percent in 2005.

Researchers assessed whether the Bench-to-Bedside Program sped the translation of promising laboratory discoveries into new medical treatments. Over two-thirds of responding project investigators indicated that collaboration between bench and clinical scientists was enhanced by the project and that it would not have been initiated without funds. Three-quarters of the project investigators said they achieved major milestones; 89 percent indicated that new collaborations between intramural and extramural investigators were established as a result of their project and 95 percent of the responding investigators indicated the partnership was critical to their success.


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