The future of health behavior change research: What is needed to improve translation of research into health promotion practice?

  • Russell E. Glasgow
  • Lisa M. Klesges
  • David A. Dzewaltowski
  • Sheana S. Bull
  • Paul Estabrooks
Article

Abstract

Background: It is well documented that the results of most behavioral and health promotion studies have not been translated into practice.Purpose: In this article, reasons for this gap, focusing on study design characteristics as a central contributing barrier, are discussed.Methods: Four reviews of recent controlled studies in work sites, health care, school, and community settings are briefly discussed and summarized. Their implications for future research and for closing the gap between research and practice are then discussed.Results: These reviews come to consistent conclusions regarding key internal and external validity factors that have and have not been reported. It is very clear that moderating variables and generalization issues have not been included or reported in the majority of investigations, and that as a consequence little is known about the representatives or the robustness of results from current studies.Conclusions: To significantly improve the current state of affairs, substantial changes will be required on the part of researchers, funding agencies, and review and editorial boards. In conclusion, recommendations for each of these entities are provided.

References

  1. (1).
    National Heart Lung and Blood Institute:You Changed America’s Heart: Framingham Heart Study. Retrieved November 2, 2003, from http://rover.nhlbi.nih.gov/about/framingham/fhsbro.htmGoogle Scholar
  2. (2).
    Glass T: Psychosocial interventions. In Berkman LF, Kawachi I (eds),Social Epidemiology. Oxford, England: Oxford University Press, 2000.Google Scholar
  3. (3).
    Institute of Medicine:Promoting Health: Intervention Strategies From Social and Behavioral Research. Washington, DC: National Academy Press, 2000.Google Scholar
  4. (4).
    Glasgow RE, Lichtenstein E, Marcus AC: Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy to effectiveness transition.American Journal of Public Health. 2003,93:1261–1267.PubMedGoogle Scholar
  5. (5).
    Clarke GN: Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures.Journal of Consulting and Clinical Psychology. 1995,63:718–725.PubMedCrossRefGoogle Scholar
  6. (6).
    Estabrooks PA, Gyurcsik NC: Evaluating the public health impact of physical activity interventions.Psychology of Sport and Exercise. 2003,73:21–28.Google Scholar
  7. (7).
    Collins R, MacMahon S: Reliable assessment of the effects of treatment on mortality and major morbidity: I. Clinical trials.The Lancet. 2001,357:373–380.CrossRefGoogle Scholar
  8. (8).
    Stevens VJ, Glasgow RE, Hollis JF, Lichtenstein E, Vogt TM: A smoking cessation intervention for hospital patients.Medical Care. 1993,31:65–72.PubMedCrossRefGoogle Scholar
  9. (9).
    Stevens VJ, Glasgow RE, Hollis JF, Mount K: Implementation and effectiveness of a brief smoking cessation intervention for hospital patients.Medical Care. 2000,38:451–459.PubMedCrossRefGoogle Scholar
  10. (10).
    Centers for Disease Control and Prevention:The Guide to Community Preventive Services. Retrieved November 2, 2003, from http://www.thecommunityguide.orgGoogle Scholar
  11. (11).
    Truman BI, Smith-Akin CK, Ilinman AR, et al.: Developing the Guide to Community Preventive Services: Overview and rationale.American Journal of Preventive Medicine. 2001,18:18–26.CrossRefGoogle Scholar
  12. (12).
    Cook TD, Campbell DT:Quasi-Experimentation: Design and Analysis Issues for Field Settings. Chicago: Rand McNally, 1979.Google Scholar
  13. (13).
    Basch CE, Sliepcevich EM, Gold RS: Avoiding Type III errors in health education program evaluations.Health Education Quarterly. 1985,12:315–331.PubMedGoogle Scholar
  14. (14).
    National Guideline Clearinghouse:Welcome home page. Retrieved November 2, 2003, from http://www.guideline.gov/Google Scholar
  15. (15).
    Moher D, Schulz KF, Altman DG: The CONSORT statement: Revised recommendations for improving the quality of reports.Journal of the American Medical Association. 2001,285:1987–1991.PubMedCrossRefGoogle Scholar
  16. (16).
    Heller RF, Dobson AJ: Disease impact number and population impact number: Population perspectives to measures of risk and benefits.British Medical Journal. 2000,321:950–953.PubMedCrossRefGoogle Scholar
  17. (17).
    Heller RF, Page J: A population perspective to evidence based medicine: Evidence for population health.Journal of Epidemiology and Community Health. 2002,56:45–47.PubMedCrossRefGoogle Scholar
  18. (18).
    Rychetnik L, Frommer M, Howe P, Shiell A: Criteria for evaluating evidence on public health interventions.Journal of Epidemiology and Community Health. 2002,56:119–127.PubMedCrossRefGoogle Scholar
  19. (19).
    Glasgow RE, Vogt TM, Boles SM: Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health. 1999,89:1322–1327.PubMedCrossRefGoogle Scholar
  20. (20).
    Glasgow RE, McKay HG, Piette JD, Reynolds KD: The RE-AIM framework for evaluating interventions: What can it tell us about approaches to chronic illness management?Patient Education and Counseling. 2001,44:119–127.PubMedCrossRefGoogle Scholar
  21. (21).
    Glasgow RE: Evaluation of theory-based interventions: The RE-AIM model. In Glanz K, Lewis FM, Rimer BK (eds),Health Behavior and Health Education (3rd Ed.). San Francisco: Wiley, 2002, 531–544.Google Scholar
  22. (22).
    Lando HA, Valanis BG, Lichtenstein EL, et al.: Promoting smoking abstinence in pregnant and postpartum patients: A comparison of 2 approaches.American Journal of Managed Care. 2001,7:685–693.PubMedGoogle Scholar
  23. (23).
    Eakin EG, Glasgow RE, Riley KM: Counseling patients to increase physical activity: A review of the effectiveness of current strategies.Journal of Family Practice. 2000,49:158–168.PubMedGoogle Scholar
  24. (24).
    France EK, Glasgow RE, Marcus AC: Smoking cessation interventions among hospitalized patients: What have we learned?Preventive Medicine. 2001,32:376–388.PubMedCrossRefGoogle Scholar
  25. (25).
    Bull SS, Gillette C, Glasgow RE, Estabrooks P: Worksite health promotion research: To what extent can we generalize the results and what is needed to translate research to practice?Health Education and Behavior. 2003,30:537–549.PubMedCrossRefGoogle Scholar
  26. (26).
    Glasgow RE, Bull SS, Gillette C, Klesges LM, Dzewaltowski DA: Behavior change intervention research in health care settings: A review of recent reports with emphasis on external validity.American Journal of Preventive Medicine. 2002,23:62–69.PubMedCrossRefGoogle Scholar
  27. (27).
    Estabrooks PA, Dzewaltowski DA, Glasgow RE, Klesges LM: How well has recent literature reported on important issues related to translating school-based health promotion research into practice?Journal of School Health. 2003,73:21–28.PubMedCrossRefGoogle Scholar
  28. (28).
    Dzewaltowski DA, Estabrooks PA, Klesges LM, Bull SS, Glasgow RE: Behavior change intervention research in community settings: How generalizable are the results? Health Promotion International (in press).Google Scholar
  29. (29).
    Ory MG, Jordan PJ, Bazzare T: The Behavior Change Consortium: Setting the stage for a new century of health behavior change research.Health Education Research. 2002,17:696–699.CrossRefGoogle Scholar
  30. (30).
    Flay BR: Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs.Preventive Medicine. 1986,15:451–474.PubMedCrossRefGoogle Scholar
  31. (31).
    Greenwald P, Cullen JW: The new emphasis in cancer control.Journal of the National Cancer Institute. 1985,74:543–551.PubMedGoogle Scholar
  32. (32).
    Mook DG: In defense of external invalidity.American Psychologist. 1983,38:379–387.CrossRefGoogle Scholar
  33. (33).
    Brewer MB: Research design and issues of validity. In Reis HT, Judd CM (eds),Handbook of Research Methods in Social and Personality Psychology. New York: Cambridge University Press, 2000, 3–39.Google Scholar
  34. (34).
    Oldenburg B, Ffrench BF, Sallis JF: Health behavior research: The quality of the evidence base.American Journal of Health Promotion. 2000,14:253–257.PubMedGoogle Scholar
  35. (35).
    Oldenburg BF, Sallis JF, Ffrench ML, Owen N: Health promotion research and the diffusion and institutionalization of interventions.Health Education Research. 1999,14:121–130.PubMedCrossRefGoogle Scholar
  36. (36).
    Lomas J: Improving research dissemination and uptake in the health sector: Beyond the sound of one hand clapping. C97-1 (November, 1997). 1997. McMaster University Centre for Health Economics and Policy Analysis/Policy Commentary.Google Scholar
  37. (37).
    Trudeau KJ, Davidson K, for the Evidence-based Behavioral Medicine Committee: A CONSORT Primer.Outlook: A Quarterly Newsletter of the Society of Behavioral Medicine. 2002,Winter:5–8.Google Scholar
  38. (38).
    Elbourne DR, Campbell MK: Extending the CONSORT statement to cluster randomized trials:For discussion. Statistics in Medicine. 2001,20:489–496.CrossRefGoogle Scholar
  39. (39).
    Davidson K, Goldstein M, Kaplan R, et al.: Evidence-based behavioral medicine: What is it and how do we achieve it?Annals of Behavioral Medicine. 2003,26:161–171.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2004

Authors and Affiliations

  • Russell E. Glasgow
    • 1
  • Lisa M. Klesges
    • 2
  • David A. Dzewaltowski
    • 3
  • Sheana S. Bull
    • 4
  • Paul Estabrooks
    • 3
  1. 1.Kaiser Permanente Colorado and AMC Cancer Research CenterDenver
  2. 2.University of Tennessee Health Science CenterUSA
  3. 3.Kansas State UniversityUSA
  4. 4.University of Colorado Health Sciences Center and AMC Cancer Research CenterDenver

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