President’s Message: SBM Advances Technology, Public Health, and Prevention
Lisa M. Klesges, PhD, SBM president
Lisa M. Klesges, PhD, SBM president
Since I began my term as the 36th president of the Society of Behavioral Medicine (SBM) during our 2014 Annual Meeting in April, SBM has launched new initiatives, I’ve announced areas of focus for the year, and—believe it or not—planning is well under way for our 2015 Annual Meeting. We’ve been busy!
New Initiatives
The SBM Board of Directors in July approved adding a new Digital Health Council to the society’s cadre of governing councils. The Digital Health Council comes at a pivotal time in behavioral medicine, as technological advances drastically change how we perform research and reach those in need of intervention. Expanding the role of technology is part of SBM’s current strategic plan. The council will help ensure technology remains an SBM focus, and it will help carve out a role for SBM in highlighting the proper use of technology and big data in health care. Special thanks to leaders and members of the Technology Special Interest Group (SIG) for key discussions that led to a Digital Health Council proposal.
The SBM Board in July also welcomed Kevin Masters, PhD, who will be the new editor-in-chief of Annals of Behavioral Medicine, one of SBM’s two journals. Dr. Masters has a great vision for adding to the journal’s already outstanding reputation, which includes a 5-year impact factor of 5.379.
SBM remains dedicated to its traditional print publications, but also continues to grow its online and social media presence to increase engagement with all of our members. A new SBM LinkedIn group is growing steadily, our Facebook page is gaining “likes,” and our several Twitter feeds are bringing the latest behavioral medicine information, opportunities, and news to a growing number of followers. SBM this summer also introduced a new issues blog, SBMConnect.
Presidential Focus
As president, I have created two working groups: one on governance and one on revenue enhancement. The governance working group will look at SBM’s entire structure to see how the charge of each council, committee, and SIG fits into the society’s current strategic plan. The revenue enhancement working group, meanwhile, will identify creative ways to find new society revenue sources. Both groups will make sure SBM remains viable and sustainable. Look for updates on the groups’ progress later this year.
During my year as president, I also hope to keep SBM committed to improving public health. As a public health advocate and professional, this goal is near and dear to me. Obesity rates are troubling, costs of chronic illness are rising, and health disparities remain a constant concern, all while public health funding continues to falter. SBM has a role to play in advancing population health and in getting the right policies enacted to make a difference. Part of that role involves offering a 2015 Annual Meeting that focuses on expanding behavioral medicine’s role in national prevention efforts.
2015 Annual Meeting
The Annual Meeting will be held in San Antonio, TX, from April 22–25, 2015. The meeting’s theme is “Advancing the National Prevention Strategy through Behavioral Medicine Innovation.”
As a guide for the meeting, we’ve adopted the National Prevention Strategy Framework put forth by the National Prevention Council. The framework identifies four strategic directions for improving population health: (1) create and sustain healthy and safe community environments that promote health and prevent disease; (2) provide accessible and integrated clinical and community preventive services; (3) provide the necessary tools and resources to support communities of empowered people; and (4) improve health and quality of life for all through elimination of health disparities. Related priority areas, which will be addressed by meeting speakers, include tobacco-free living; drug abuse prevention; healthy eating; active living; reproductive and sexual health; and mental and emotional well-being. Additional speakers will address cutting-edge strategies for obtaining research funding.
Many thanks to an excellent program committee including Lila Finney Rutten, PhD, MPH, Program Committee chair, and Kate Wolin, ScD, Program Committee co-chair. And thanks also to Elliot Coups, PhD, Board of Directors, who led the submission of our R13 grant application requesting 2015 Annual Meeting funding from the National Institutes of Health (NIH).
Jessie Gruman
Along with many of her friends and colleagues, I would like to pay tribute to one of our members, Jessie Gruman, PhD, who died on July 14.
Dr. Gruman fought tirelessly as a health behavior advocate and, unfortunately, knew all too well the struggles of dealing with serious illnesses. Dr. Gruman battled several cancers during her lifetime and, all the while, stayed committed to describing and bettering the health care experience of patients like herself. She authored several significant books on patients and their engagement, she created useful tools and guidelines for patients, and in 1992 she founded the Center for Advancing Health (CFAH), a nonpartisan, Washington-based research institute that deepened the evidence for patient engagement. Dr. Gruman served as the organization’s president until her death.
Dr. Gruman was an SBM fellow and this year, just before her passing, her colleagues created SBM’s Jessie Gruman Award for Health Engagement to annually recognize an individual who has made a pivotal contribution to research, practices, and policies that have advanced the understanding of patient engagement. Dr. Gruman was presented with the inaugural award during our 2014 Annual Meeting. In subsequent years, other deserving individuals will be honored with the award, and Dr. Gruman’s legacy will live on.
Thanks for Reading
I appreciate your time, and I welcome your input on the 2015 Annual Meeting and other SBM activities. If you’re already an SBM member, please help us engage a new member! If you’re not a member, please consider becoming one. SBM members have access to exclusive job postings, grant-writing courses, and behavioral medicine journals, among other benefits. SBM is a close-knit community and I hope you’ll join us. I look forward to a wonderful and productive year!
Support Student Member Attendance at the 2015 Annual Meeting
Lindsay Bullock, SBM senior media and member communications manager
At the Society of Behavioral Medicine’s (SBM) 2014 Annual Meeting, student member Yaguang Zheng got raw data for research on weight loss behavior and attended a technology-focused session she’d been eagerly looking forward to. Zheng also got to meet Bonnie Spring, whose work she’d long admired.
Zheng had a wonderful time and learned a lot—but that almost didn’t happen. Without SBM’s donor-funded Student Volunteer Program, Zheng would not have been able to afford to come to the Annual Meeting.
The program pays the annual meeting registration fees of student/trainee SBM members like Zheng in exchange for their time; the students must volunteer at the meeting, doing things like working the registration desk and taking tickets from pre-conference session attendees.
Zheng, a PhD student at the University of Pittsburgh, worked the registration desk and said it was incredibly worth it.
“The waived fee…made [meeting attendance] possible,” she said, explaining costs added up even though the meeting was reasonably priced and her school provided some travel funding. “If the conference is in a big city, it costs a lot!”
SBM would like to help more students like Zheng, who know annual meeting attendance can be beneficial to their careers but who lack the necessary funds to make the trip. Unfortunately, the number of Student Volunteer Program applicants often exceeds the funding available. You can change that.
A donation of any dollar amount will help SBM fund more student volunteer slots for deserving student/trainee SBM members. More dollars mean more slots, and that means more student attendance at SBM annual meetings. It also means more students invested in SBM and able to make headway in the field of behavioral medicine.
2015 Call for Award and Fellow Applications
Laura L. Hayman, RN, PhD, FAAN, Awards Committee chair
The Society of Behavioral Medicine (SBM) is now accepting applications for 2015 achievement awards and for new 2015 fellows. The call for applications closes November 14, 2014, at 11:59 p.m. EST. For more detailed information about how to apply or nominate someone, please visit the call for awards or call for fellows pages on the SBM website. Award recipients and fellows will be notified of their selection in February and will then be formally honored at SBM’s 36th Annual Meeting & Scientific Sessions, being held April 22-25, 2015, in San Antonio, TX.
Call for Awards
SBM will offer the following awards in 2015.
- Distinguished Scientist Award
Selection for this award will be based on the nominee’s total career and great scholarly achievements (i.e., made a series of distinguished empirical contributions or contributed substantially to the development of new theories or methods). - Alere Research to Practice Award
Selection for this award is based on the nominee's contributions and exemplary work in translating or extending behavioral medicine from research into practical application, dissemination, or implementation. - Jessie Gruman Award for Health Engagement
This award recognizes the nominee’s pivotal and extensive contributions to research, practice, and/or policies that have advanced the understanding of patient engagement. The award can be given to an individual or an organization. - Early Career Investigator Award
This award recognizes an early-career SBM member’s total career achievements, including the publication of a representative paper. - Outstanding Dissertation Award
Selection for this award is based on the success and excellence of a student/trainee SBM member’s defense of his or her dissertation. - Distinguished Student Awards
These awards will be provided to student SBM members who demonstrate outstanding academic and professional potential in the field of behavioral medicine. Students may apply for the following awards: - Excellence in Research
- Excellence in Service Delivery
- Travel Scholarship
- Distinguished Research and Clinical Mentor Awards
Selection for these awards are focused on nominees’ outstanding service as mentors in clinical or research settings.
- Excellence in Behavioral Medicine Training Program Award
This award recognizes a research- and/or clinically-focused training program. The training program can occur in any discipline, and programs with an interdisciplinary approach will be considered.
Call for Fellows
SBM fellows demonstrate the society’s commitment to advancing the science and practice of behavioral medicine. Fellows serve as role models, offering guidance and support to student/trainee members. The selection of new fellows ensures the continual life and direction of SBM.
To apply for fellow, status a full SBM member must be in good standing with the society for three consecutive years prior to applying and should have received his or her highest academic degree at least 10 years prior. For more information please review SBM’s fellow criteria.
SBM then-President Dawn Wilson (left), PhD, recognizes new 2014 SBM fellows at the 2014 Annual Meeting. Fellows are (from left) Karen M. Basen-Engquist, PhD, MPH; Corrine I. Voils, PhD; Thomas P. Guck, PhD; and Robert W. Motl, PhD. New 2014 SBM Fellows not pictured are Linda M. Collins, PhD; Ryan E. Rhodes, PhD; Jennifer L. Steel, PhD; and Kenneth Tercyak, PhD.
Jessie Gruman Award for Health Engagement Added to 2015 SBM Awards
Laura L. Hayman, RN, PhD, FAAN, Awards Committee chair
The Society of Behavioral Medicine’s (SBM) Awards Committee is honored to open the 2015 call for awards with the addition of the Jessie Gruman Award for Health Engagement.
Jessie Gruman
Jessie Gruman, PhD, was an SBM fellow and this year, just before her passing, her colleagues created SBM’s Jessie Gruman Award for Health Engagement to annually recognize an individual or organization that has made a pivotal contribution to research, practices, and policies that have advanced the understanding of patient engagement. Dr. Gruman was presented with the inaugural award during SBM’s 2014 Annual Meeting.
Dr. Gruman fought tirelessly as a health behavior advocate and, unfortunately, understood all too well the struggles of dealing with serious illnesses. She battled several cancers during her lifetime and, all the while, remained committed to describing and improving the health care experience for patients like herself.
“Gruman moved beyond her individual experiences to search out and categorize lessons learned by others,” Douglas Kamerow, MD, MPH, wrote in The BMJ article, “Lessons from a Fallen Hero.”
Dr. Gruman authored several significant books on patients and their engagement, and she created useful tools and guidelines for patients. In 1992, she founded the Center for Advancing Health (CFAH), a nonpartisan, Washington-based research institute that strengthened the evidence for patient engagement. Dr. Gruman served as the organization’s president until her death.
The Jessie Gruman Award for Health Engagement will carry on Dr. Gruman’s legacy through continual recognition of individuals and organizations working toward the advancement of patient engagement. Recipients of the award will be invited to deliver a master lecture in Dr. Gruman’s honor during future annual meetings.
To apply for the Jessie Gruman Award for Health Engagement please visit SBM’s call for awards Web page.
For further information on Dr. Gruman and her impact on health engagement, please read her biography on the CFAH website.
With the Current Funding Climate, Why Stay in Behavioral Medicine?
Lindsay Bullock, SBM senior media and member communications manager
The Society of Behavioral Medicine (SBM) asked early career members why they’re still determined to pursue a career in behavioral medicine, despite cutbacks in funding from the National Institutes of Health (NIH) and other entities. The members’ responses are below.
Deirdre Dlugonski, PhD, assistant professor in the Department of Kinesiology at East Carolina University
“The main reason I am staying in behavioral medicine is because I believe in the power of our behavioral choices to impact both individual and population level health. Regardless of the funding environment, it is important to understand why and how people make the choices that they make regarding health behaviors.”
Salene M.W. Jones, PhD, post-doctoral fellow at the Group Health Research Institute
“The reason I stay in behavioral medicine is the same reason I got into this field: the people. I got into this field to help people stay and become healthy, both physically and mentally. Decreases in funding may mean we can't do as much research or the same kind of work we could do with better funding, but that doesn't mean the work we can do isn't worthwhile.”
Erica Woekel, PhD, assistant clinical professor and director of the Lifetime Fitness for Health Program at Oregon State University
“Ultimately I am staying in the field because I feel like it's necessary for people to be actively invested in health promotion strategies. I know that NIH funding has decreased and part of my appointment as a faculty [member] at Oregon State University (OSU) is to train undergraduate students to pursue positive health behaviors at multiple levels. My program (Lifetime Fitness for Health) is a graduation requirement at the university, and OSU is also focused on health and well-being as part of their institutional strategic plan. I personally feel like these types of courses help students become more informed of the science (for nutrition, health behavior change, and physical activity promotion) while also teaching them strategies for achieving positive health behaviors.
“Oregon State University was just recently granted accreditation as a college of public health and human sciences, and we are the first of its kind in the state of Oregon. We have been working hard to continue our collaborations with our extension faculty, which allows us to see the dissemination of research to practice within 36 counties across the state. We see the difference in people, communities, and health behaviors and therefore this is why I stay in this field—it's essential for the well-being of people.
“Additionally, we have positive qualitative outcomes (and we are working on more quantitative and long-term data) from college students with regards to health behaviors, and due to this I will keep pursuing a career in behavioral medicine.”
Kathrin Milbury, PhD, assistant professor at the University of Texas MD Anderson Cancer Center
“I never went into the field because of job security. I don’t have a high need for certainty. I’m competitive by nature and I like competitive environments. I love my work and I try to work hard while I have funding. In case, I can no longer fund my salary and/or research, it’s time to move on. Right now, I’m fine and I feel called to do this work. I’m not worried. I’m a very spiritual person and I trust God with His plan for me. I’m in the right career today—who knows what other options will come up in the future.”
Membership Council Unveils New Transitional Membership Type for 2015
Monica L. Baskin, PhD, Membership Council chair
Membership Council members know times are tough financially for the Society of Behavioral Medicine’s (SBM) early-career members. That’s why we’re introducing a new transitional membership type for the upcoming 2015 membership year.
Transitional membership provides a discount to recent graduates; the annual transitional membership cost is slightly more than the student rate but not quite as expensive as the full member rate. In the past, traditional membership has been reserved for those in their first year after graduation. Moving forward, transitional membership will be available for those who have graduated within the past two years. Individuals will accordingly be eligible for transitional membership for two years instead of one. There will also be different membership costs for each of those years, to help make the financial jump from student to full membership even more gradual.
If you’ve recently graduated, please consider “transitional year one membership” or “transitional year two membership” when you renew your membership for 2015. Membership renewals will begin this fall with renewal forms sent via postal mail.
2015 SBM new member application
Membership Application Gets a Facelift
The Membership Council has spent the past several months revising and updating the membership applications filled out by new and renewing members. Those revamped applications will be used for the quickly-approaching 2015 membership year.
The application has been strategically shortened to save members time while still collecting pertinent data on professions, behavioral medicine interests, and the like. The format of some questions—like one asking why new members choose to join SBM—has also been changed to collect better data that can be used to drive decisions about SBM’s activities, goals, and member benefits.
Keep an eye out for the new and improved, streamlined applications this fall!
Summer ‘Come Back to Us Campaign’ Sees Success
The Membership Council’s annual Come Back to Us Campaign continues to be a great way to get members to renew their membership. The campaign has Membership Council members and other SBM volunteers personally email non-renewed members to ask that they “come back” to SBM by renewing their membership.
The personal touch works. For one month this summer (between July 20 and August 20), 54 people renewed membership for a 5.4% success rate. The rate was even higher among fellows, who were personally emailed by SBM President Lisa M. Klesges, PhD, as part of the campaign. Of fellows contacted, 29% renewed.
Thanks to all who participated in the campaign or chose to renew membership!
New Annals Editor Kevin Masters Focuses on Honesty, Interventions
Lindsay Bullock, SBM senior media and member communications manager
To say Kevin Masters is a busy man would be an understatement.
Kevin Masters
Masters, PhD, serves as program director for the clinical health psychology doctoral training program at the University of Colorado Denver. He teaches classes there. He does research on how religion and cardiovascular health intersect. He is the immediate past-president of the American Psychological Association’s Division 38. And, in October, he also started work as editor-in-chief of the Society of Behavioral Medicine’s Annals of Behavioral Medicine.
It’s a lot, but Masters said he’ll make plenty of time for Annals because the job is such a critical one.
“Being an editor is a really important job,” he said, “because the lifeblood of our science, in fact the basis of our knowledge, is peer-reviewed publication.”
Masters brings that sense of dedication to the job. He also brings an innate frankness and a desire to publish manuscripts that focus on health interventions.
Masters’ frankness comes out in his dealings with authors. He has no qualms about telling them a piece won’t work, and he makes a point to do so right after the piece is submitted instead of after a lengthy editorial review process. He learned to do that as editor-in-chief of the Journal of Behavioral Medicine, a position he’ll vacate December 31.
“When I first started I was very reluctant to do that with any manuscript,” he said, “but you do get to a point where you can kind of sense [when] a manuscript really won’t make it through the process. And at some point it becomes unfair to the authors if you send it out and take three to four months getting a review on a manuscript you knew wasn’t going to make it. Plus it wears out your reviewers and your editors.”
Masters’ up-front approach has gotten him thank-you emails from authors whose work he rejected. They appreciated his fairness and timeliness, he said.
“It’s better for the authors to move that manuscript forward to another publication more quickly,” he explained.
When Masters considers manuscripts for publication in Annals, he will be especially looking for ones that emphasize potential interventions. He said he’s read more than enough manuscripts about the likelihood of certain people to behave certain ways.
“We’ve seen tons of studies [like that]. We’ve got it. We don’t need to hear it again,” he said. “Instead, show me an intervention. What are you going to do about it?”
Masters tries to follow that prompt in his own work. He started his psychology career with interests in religion and mental health. He studied with Allen E. Bergin at Brigham Young University in Provo, UT, before eventually heading to Duke University in Durham, NC. There, in the Bible Belt, Masters paired his interest in religion with a newer interest in cardiology. Most recently, as program director for the clinical health psychology doctoral training program at the University of Colorado Denver, Masters has been studying religion as a form of culture.
“In that sense, you can study practices within those cultures and see what impacts they have on cardiovascular function,” he said.
For instance, Masters found Christians who took part in Christian prayer rather than secular meditation were less reactive in terms of blood pressure and heart rate when engaged in a subsequent conversation that challenged some of the core beliefs of their faith.
“That suggests to us, if you extrapolate wildly, that maybe you could go into a church and work with that subculture to develop interventions that would help people manage their anger and perhaps help manage cardiovascular activity and health,” he said. “We think this is an important public health issue because, depending on whose stats you believe, anywhere from 20-40% of Americans are in church or synagogue every weekend. That’s a lot of people in a captive situation where they’re prone to believe what’s told to them, and it seems to me we could take better advantage of that than we have.”
Working on that—and editing Annals—is sure to keep Masters busy.
Kevin Masters, the incoming Annals of Behavioral Medicine editor-in-chief, gives the presidential address at the American Psychological Association Division 38 annual convention in August 2014. Masters is now the Division 38 immediate past-president.
Career Development Opportunities Available Year-Round and at 2015 Annual Meeting
Nicole Zarrett, PhD, Education, Training, and Career Development Council chair
The Education, Training, and Career Development (ETCD) Council has been active on a number of fronts to meet the professional development needs of Society of Behavioral Medicine (SBM) members at all stages of their careers. Below are some details regarding the programs offered to SBM members throughout the year, and a preview of sessions planned for the 2015 Annual Meeting in San Antonio, TX.
Year-Round Development
SBM offers a year-round, Web-based Expert Consultation Program that is designed to facilitate the exchange of information and resources between SBM members. Prospective consultees can identify expert consultants on the website and can then contact them with specific questions pertaining to scientific topic areas as well as career development issues. Currently, consultants are available from the Spirituality and Health Special Interest Group (SIG), Physical Activity SIG, Cancer SIG, Integrated Primary Care SIG, Obesity and Eating Disorders SIG, and Child and Family Health SIG, and from the ETCD Council.
Resources will expand as we accrue volunteers spanning even more areas of expertise. Whether you are a postdoc looking for advice on negotiating your first job or a full professor delving into a new area of research, your fellow SBM members may be able to provide the knowledge and guidance you need. To access consultants’ contact information, visit www.sbm.org/membership/members/consultation and log in with your SBM member username and password.
Programs Planned for 2015 Annual Meeting
Every year, the ETCD Council organizes sessions for interactions between junior and senior SBM members. These are great opportunities for trainees and junior members of SBM to network with senior members in an informal setting.
The Graduate Research Panel is offered on an annual basis. The panel is a forum in which faculty with experience in mentoring students in research activities, theses, and dissertations provide advice and answer questions on a variety of topics.
The Poster Mentoring Program will continue during the 2015 meeting, and will offer SBM student/trainee members the chance to interact one-on-one with SBM senior members who will provide supportive conversations and guidance. Selected student/trainee members (picked through a random drawing) will be paired with senior members who will attend their poster presentations and talk with them. It is our hope that an engaging conversation will encourage discussion around research topics, presentation tips, career tracks and goals, and anything else that may come up. SBM strives to engender a unique culture of gracious and personal, one-on-one communication in the interest of member development.
For 2015, we are also planning programs focused on social networking techniques, career development, and funding opportunities. Be sure to look for these sessions in your meeting program. By collaborating with SIGs and identifying new areas of need, the council’s members hope that these new initiatives, coupled with longstanding ones, will offer you multiple chances to increase your professional network and identify your place in the future of behavioral medicine.
Welcome
And, finally, I would like to welcome our newest council members: Zeeshan Butt, PhD, and Jamie Bodenlos, PhD!
SBM and Society for Medical Decision Making Collaborate on Annual Meeting Workshops
Laura D. Scherer, PhD, Society for Medical Decision Making
Historically, the Society for Medical Decision Making (SMDM) and the Society of Behavioral Medicine (SBM) have operated in parallel. Each is interested in similar research questions and has a similar goal of conducting empirical research that broadly addresses behavioral and psychological factors related to health. SMDM has been relatively more focused on the factors that impact individual decisions related to health, while SBM has primarily addressed behavioral factors that relate to health promotion. Despite considerable overlap in perspectives and goals, there is surprisingly little communication between these societies.
To address this issue, over the past few months a group of interested members from SBM (Jada Hamilton, Megan Oser, Christine Rini, Erika Waters) and SMDM (Dana Alden, Laura Scherer) have met monthly with the aim of increasing crosstalk between these two societies. A concrete goal of this “Crosstalk Committee” has been to develop programming for the SBM and SMDM annual meetings that would be of interest and relevance to both societies. Crosstalk Committee discussions led to broad agreement that the topic for these events should be one that both societies have grappled with for years. While several possibilities were listed, we ultimately settled on an issue that is fundamental to our societies’ shared objective of improving the decisions that individuals make relating to their health: What defines a “good” medical decision?
There is currently little consensus on what an optimal medical decision is or how to measure it. Moreover, the criteria will likely vary depending on the perspectives and priorities of different stakeholders. Given the importance of this issue for the collective research interests of SBM and SMDM members, the time is right to have an in-depth intellectual discussion about this issue, in which various perspectives are articulated and shared. Importantly, our goal is to have this discussion in collaboration with members of both SBM and SMDM.
In light of this goal, the Crosstalk Committee is organizing an interactive, cross-disciplinary workshop for the 2015 SBM Annual Meeting. The workshop will feature representatives of key stakeholder groups, including: physicians (Robert Jacobson), patients (Brian Zikmund-Fisher), decision scientists (Ronald Myers), and health insurance providers (John Baleix). Speakers will provide their perspectives on this important topic by reviewing three case studies of difficult decisions and interacting with the audience.
In the coming months, we aim to develop a related seminar for the 2015 SMDM conference. We hope that the committee’s efforts stimulate cross-society discussion of important topics that are of interest and relevance to both groups. This particular issue—what it means to make a “good” decision—is one that psychologists and health professionals have struggled with for years and, as such, begs for conceptual clarity within the context of behavioral medicine research. We look forward to future efforts to generate exciting discussions and collaboration between SMDM and SBM.
Health Decision Making SIG Explores what Makes a 'Good' Health Decision
Christine Rini, PhD, Health Decision Making SIG co-chair and Outlook liaison
Erika A. Waters, PhD, MPH, Health Decision Making SIG chair
Ronald E. Myers, DSW, PhD, Health Decision Making SIG member
People are increasingly faced with the need to become actively involved in making health decisions that are challenging for various reasons. For instance, they may face treatment decisions with no evidence-based “right” choice, decisions about screening tests with the potential to cause harms such as unnecessary treatments, or decisions about whether and how to protect their future health with lifestyle changes. These and other health decisions are of broad interest to Society of Behavioral Medicine (SBM) members within and outside of the society’s Health Decision Making Special Interest Group (HDM SIG).
SBM members are learning about how people make health decisions, and they are developing new methods for helping patients make good decisions. The goal of this ambitious endeavor is deceptively simple: Determine how best to engage patients in making satisfying health care choices that increase the likelihood that they will realize meaningful outcomes. However, in reality, embracing this mission requires us to consider or influence a complex set of intrapersonal, interpersonal, and contextual factors. It also requires us to address some fundamental questions: What is a good decision making process? What is a good decision making outcome? How can you tell when your efforts have “succeeded” in helping someone make a good decision? SBM’s HDM SIG is planning events that will tackle these questions and related aspects of health decision making at the upcoming SBM Annual Meeting & Scientific Sessions to be held in San Antonio, TX, from April 22-25, 2015.
In any health decision, the individuals who are involved have their own perspectives on what constitutes the best choice. Practitioners are typically interested in promoting empirically- or clinically-tested options that are most likely to lead to the best clinical outcomes for their patients. Policy professionals must balance the potential for societal benefit against the potential for chosen treatments to strain an already over-burdened health system. Behavioral decision scientists investigate factors that influence the extent to which people made preference-sensitive decisions that were consistent with their personal values and were based on accurate information. Scientists also investigate whether such decisions were difficult to make (e.g., due to decisional conflict), and if—once made and acted upon—they caused decision regret, poor quality of life, impaired ability to pursue valued life goals, or other adverse outcomes. Less often, scientists consider outcomes beyond individual patients, such as effects on the family system. In real life, patients’ health decisions are often far more complex than current theories help us to understand and predict. Furthermore, too often patients must make decisions despite having poor access to high-quality information, or they have difficulty understanding, remembering, and applying the information they get.
These complexities are just some of the reasons SBM members and the HDM SIG are drawn to research on this fascinating topic. In fact, we would like to highlight an interactive, cross-disciplinary workshop organized for our San Antonio meeting by a committee made up of SBM and Society of Medical Decision Making (SMDM) members (Dana Alden, Jada Hamilton, Megan Oser, Christine Rini, Laura Scherer, and Erika Waters). This workshop will feature representatives of key stakeholder groups with differing perspectives of health decision making, including: physicians (Robert Jacobson), patients (Brian Zikmund-Fisher), decision scientists (Ronald Myers), and health insurance providers (John Baleix). They will describe their perspectives on “good” health decisions in the context of three case studies of difficult decisions, interacting with the audience. The HDM SIG will soon be announcing other health decision making events for the upcoming Annual Meeting, as well. We look forward to seeing you in San Antonio!
Noted Social Network Researcher Amanda Graham Talks about her Work and the Future
Arlen C. Moller, PhD, TTBCI SIG senior co-chair
Gina Merchant, TTBCI SIG junior co-chair
Amanda Graham
In anticipation of the Theories and Techniques of Behavior Change Interventions Special Interest Group (TTBCI SIG) sponsoring 2015 Society of Behavioral Medicine (SBM) Annual Meeting sessions on the topic of social networks and behavioral medicine, we contacted noted social network and behavioral health researcher Amanda Graham, PhD, to ask her about how she was introduced to social network research. We also asked her to weigh in on some important issues related to this emerging research area.
Dr. Graham is the director of research development at the Schroeder Institute for Tobacco Research and Policy Studies, a research institute in Washington, DC, established by Legacy in 2008, with formal academic ties to the Johns Hopkins Bloomberg School of Public Health and Georgetown University’s Lombardi Comprehensive Cancer Center.
TTBCI SIG: To get started, can you tell us a little bit about how you got interested in using social network analysis to understand health behavior change?
Graham: My interest in the links between social support/social ties and health started in graduate school; both my master’s thesis and dissertation involved the study of social support in relation to cardiovascular health. When I began studying Web-based interventions for smoking cessation in early 2000s, the critical role of online social networks in promoting abstinence seemed intuitive: getting involved in an online network and directly receiving or being exposed to support from others online should increase the chances of a successful quit attempt. However, the literature on smoking cessation interventions aimed at promoting abstinence by changing the availability of support at the dyadic or small group level had shown mixed and largely underwhelming results. …
Online social networks—and the massive amount of data they generate—provide an exciting opportunity to revisit the mechanisms through which social networks influence behavior. … The entire social network can be characterized dynamically over time at weekly, daily, and even hourly intervals. Individual users can be located within the network and their social position, social roles, and social influence to or from other members can be gleaned from fine-grained content analyses of the communications they read/write. The availability of detailed tracking data—combined with social network metrics, the content of all communications, and changing sentiments over time—presents unique opportunities to examine mechanisms of behavior change.
You are one of only a few researchers to have published research exploring online social support networks in two different health behavior domains: smoking cessation and weight loss (i.e., using data from the QuitNet community in collaboration with Nathan Cobb et al., and with SparkPeople data in collaboration with Kevin Hwang et al.). Can you comment on some of the similarities or difference you observed related to how these two social support networks operate?
Functional online social networks have their own unique “flavor.” They establish particular norms, patterns of behavior, and even dialects based on the unique composition of members. For example, in one social network, reaching out to a new member through a private message may be an accepted custom, whereas in another social network, an initial private message may be perceived as aggressive or overly intimate. Having said that, there are qualities that seem to cut across health behaviors and health conditions that characterize well-established, dynamic online social networks like QuitNet, SparkPeople, and BecomeAnEx (the online social network for smoking cessation that is the subject of my current research). One of these qualities is the persistence of members [who] have attained their behavior change goal and stay involved in the network largely due to a desire to “pay it forward.” Many of these individuals are “key players” or “glue” that maintains the integrity of online networks despite the continual flux of members. A second quality shared by the social networks that I have researched is the predominance of women. Women are more likely to seek health information online for themselves or others, which may explain their greater representation in online social networks.
What excites you and/or what issues do you foresee as this research paradigm grows?
I’m very excited about a new R01 that I just received from the National Cancer Institute titled “Social Dynamics of Substance Use in Online Social Networks for Smoking Cessation.” … Millions of smokers turn to the Internet each year for cessation assistance, and hundreds of thousands seek advice and support in online social networks for smoking cessation, but we still know very little about the ways in which online social networks impact tobacco use. This study will involve an in-depth examination of the 6-year longitudinal dataset from BecomeAnEx, Legacy’s online social network for smoking cessation. … One of the major goals of this study is to construct metrics of the dynamic topology of the network of 650,000 users and examine these metrics as predictors of abstinence in the two subsets where we have known smoking status. The study also involves a series of sentiment analyses and the use of fine-grained text analytics to explore the vast amount of user-generated content from within the network.
Theories and Techniques of Behavior Change Interventions SIG Seeks Input on Social Event
Heather L. Gainforth, PhD, Theories and Techniques of Behavior Change Interventions SIG junior co-chair
The chairs of the Theories and Techniques of Behavior Change Interventions Special Interest Group (TTBCI SIG) have been busily planning for the 36th Annual Meeting & Scientific Sessions of the Society of Behavioral Medicine (SBM) to be held in San Antonio, TX, from April 22–25, 2015. In September, the TTBCI SIG submitted one pre-conference workshop, two symposia, one midday meeting, and a breakfast meeting that we think will be of great interest to our membership. We are also looking for your advice as to where a TTBCI SIG social event should be held.
Symposia
This year we have sponsored two symposia submissions that may be of interest to our membership. The first, titled How Social Network Data can Help us Understand Health Behavior Change and Health Promotion, will feature speakers Tom Valente, PhD (University of Southern California); Gina Merchant (University of California, San Diego); Heather Gainforth, PhD (University College London, UK); and Holly Shakya, PhD (University of California, San Diego). The second, titled Toward an Ontology of Behavior Change: An Innovative Approach to Intervention Development, will feature speakers Larry An, MD (University of Michigan): Kai Larsen, PhD (University of Colorado), and Susan Michie, DPhil, CPsych, FBPS (University College London, UK); and William Riley, PhD (National Institutes of Health).
Midday Meeting: The Debate
Last year the TTBCI SIG in partnership with the Multiple Health Behavior Change SIG, Obesity and Eating Disorders SIG, and Physical Activity SIG hosted an inaugural debate. The debate received positive reviews and was standing room only. Given its success, these SIGs are partnering to host a second debate. The topic of the 2015 debate will be, Investing in Epidemiology Without Theory is a Waste of Resources. Speakers will include Noel Brewer, PhD (University of North Carolina); Carlo DiClemente, PhD (University of Maryland, Baltimore County); Karina Davidson, PhD, (Columbia University); and Robert West, PhD (University College London, UK).
Pre-Conference Workshop
The TTBCI SIG is sponsoring a pre-conference workshop titled The ABC's of Social Network Methods and Analysis. The instructors for this workshop will be Holly Shakya, PhD (University of California, San Diego) and Heather Gainforth, PhD (University College London, UK). This workshop will provide an introduction to social network methods and analyses. Participants will learn ways to measure individual and network level variables with special attention paid to how to plan for measuring network effects. Ways to leverage social networks to change behavior across several health contexts will be presented.
Morning Meeting
This year’s TTBCI SIG morning meeting will contain a fast-paced data blitz showcasing abstracts being presented at SBM that are relevant to the SIG's focus!
Social Event: We Need Your Help
The SIG is planning to a host a social event on Friday, April 24, 2015, and we need your feedback regarding where it should be held. Have you attended a conference in San Antonio before and know a great place? Do you live in San Antonio and know of a fantastic location? Email heathergainforth@gmail.com with your feedback and ideas! Please note that this event is not covered by the SBM Annual Meeting liability insurance and therefore cannot be considered an official SBM programmatic event.
Interpersonal Job Search Do’s and Don’ts for Early Career Multiple Health Behavior Researchers
Marcella H. Boynton, PhD, Multiple Health Behavior Change chair
Much ink has been spilled in various professional publications on ways to navigate the highly competitive job market. Although many candidates are advised on the more formal aspects of the job search, what is often less discussed are the interpersonal elements of establishing an excellent professional reputation and a rapport with professional contacts. Listed below are some do’s and don’ts for being a more interpersonally skilled job candidate, especially as relevant to multiple health behavior researchers.
DO participate in as many professional development opportunities as possible. Local networking events, courses on grantsmanship, and professional mentorships all fit the bill. If your local institution does not offer coursework or seminars on professional development topics, professional conferences—like the Society of Behavioral Medicine (SBM) Annual Meeting— usually offer several such pre-conference sessions or panels. If you are a multiple health behavior researcher, try to seek out opportunities that address your specific professional development issues (e.g., how to build and communicate a coherent research identity when doing research in multiple areas). DO NOT participate in professional development opportunities to the exclusion of your primary training or research activities. Learning skills such as how to put together a well-structured curriculum vitae is a laudable goal; however, if you have meager accomplishments to detail, you may struggle to make the cut come job-search time.
DO develop your professional network. Means of doing this include organizing a symposium, reviewing articles, participating in grant panels, and contributing your time and skills to professional organizations like SBM. Attending professional organization social events are also an excellent means of extending your professional network. If you are a multiple health behavior researcher, try to develop professional connections in all of your research domains. DO NOT pester, vacuously glad-hand, or otherwise attempt to make a non-genuine contact with someone in your field just to extend your “network.” Contacting someone you don’t know with a genuine query or striking up a conversation with a colleague at a professional mixer is perfectly legitimate and even desirable—just remember to use a light touch. If there is someone you are particularly eager to make a professional connection with, ask a mentor or colleague to make an introduction. It will be your authentic relationships that will help you establish a strong professional reputation as well as make you a more desirable job candidate.
DO keep your professional interactions collegial and positive. Never underestimate the interconnectedness of your professional world or the visibility of your behavior toward others. No one wants to hire a toxic personality, and you can bet that if your name makes it onto a short list of job candidates, the individuals involved in the hiring process will be asking around about the kind of person you are. Moreover, inconsiderate or socially inept behavior at a job interview can play a major role as to whether a candidate is offered a position. DO NOT make it your mission to have close personal relationships will all of your colleagues. Becoming overly involved in your colleague’s personal lives can have serious pitfalls, including a reputation for being intrusive or inappropriate.
DO try to gather job search stories and suggestions from as many colleagues as possible. Everyone has a tale to tell, and much wisdom can be gained from hearing what those before you have experienced. Additionally, letting your colleagues know that you are on the job market may lead to unexpected job opportunities. DO NOT however, believe all of the advice that you receive. As you go through the job search process, many people will give you well-meaning suggestions, some of which may be off the mark. So ask questions, but take all answers (even those presented here!) with a hearty grain of salt.
Ethnic, Minority, and Multicultural Health SIG Busy Planning Annual Meeting Events
Jamilia Sly, PhD, Ethnic, Minority, and Multicultural Health SIG co-chair
Clement Gwede, PhD Ethnic, Minority, and Multicultural Health SIG co-chair
Many exciting things are happening for the Society of Behavioral Medicine’s (SBM) Ethnic, Minority, and Multicultural Health Special Interest Group (EMMH SIG) this year. Leadership has recently changed and sessions are already being planned for SBM’s 2015 Annual Meeting & Scientific Sessions.
New Co-Chairs
We would like to announce a transition of leadership. Hayley S. Thompson, PhD, and Frank L. Sotelo, MS, served as EMMH SIG co-chairs for the past two years, and we are grateful for their contributions. The new co-chairs are Clement Gwede, PhD, and Jamilia Sly, PhD. Gwede is an associate member of the Moffitt Cancer Center. His research spans the continuum of cancer care with a focus on reducing cancer disparities through community-based interventions. Sly is an instructor at the Icahn School of Medicine at Mount Sinai, and her research is focused on reducing cancer disparities in minority and underserved populations. The co-chairs are both very enthusiastic about future plans for the EMMH SIG, especially at the upcoming 2015 SBM meeting in San Antonio, TX.
Annual Meeting Events
As part of the EMMH SIG mission, we have proposed an exciting slate of events that should be of interest to all SBM members. With the help of the wonderful EMMH SIG planning committee, the SIG has submitted five exciting and timely abstracts for the upcoming meeting. The EMMH SIG Planning Committee includes Heather Honore Goltz, PhD, LMSW; Jean C. Yi, PhD; John S. Wiebe, PhD; Sabrina Ford, PhD; Sarah Miller, PsyD; Cathy D. Meade, PhD, RN, FAAN; Qian Lu, PhD, MD; Yendelela L. Cuffee, PhD, MPH; Stacy N. Davis, PhD, MPH; Hayley S. Thompson, PhD; Linda g. Fleisher, PhD, MPH; Linton Cuff; Robert L. Newton Jr., PhD; Rosalie A. Torres Stone, PhD; Shawna V. Hudson, PhD; Usha Menon, PhD, RN, FAAN; Frank L. Sotelo, MS; and Kimlin Ashing-Giwa, PhD; and SIG Co-Chairs Gwede and Sly.
Under the leadership of Drs. Menon, Ford, and Meade, our SIG has proposed a timely pre-conference day course titled, Promoting Health Equity through Dissemination and Implementation Research. In this workshop, we will define dissemination and implementation terminology, and will discuss strategies for the adaptation of interventions for dissemination and implementation with emphasis on culture, literacy, and race/ethnicity. We will also present frameworks of implementation and evaluation, and will explicate these further with two case studies that address health disparities.
Two exciting symposia have been proposed for the 2015 SBM meeting. The first symposium is titled, Cultural Adaptations of Behavioral Interventions for Lifestyle Change for Minority Women. This symposium will present research findings from studies that aimed to culturally adapt and evaluate the efficacy of behavioral interventions for lifestyle change (healthy eating and physical activity) and weight loss for overweight and obese Latina and African American women. The second symposium is titled, Culturally Competent Interventions Across the Cancer Continuum. The purpose of this symposium will be to provide insight and lessons learned on how to overcome challenges and effectively develop and evaluate culturally sensitive interventions for cancer patients and survivors from ethnic minority populations.
Research training and mentoring is also a priority for the EMMH SIG. Thus, we have proposed to host a midday meeting titled, Developing a Successful Research Career: The Importance of Mentoring. The proposed roundtable discussion will focus on strategies to develop and maximize mentoring relationships/collaborations for career development awards and research funding opportunities from various national research entities.
Finally, the EMMH SIG will hold a breakfast business meeting. We will continue our tradition of presenting abstract awards to a student/trainee and an early investigator. We will also present an award recognizing excellence in mentoring to a senior faculty member who is also an SBM member.
We hope that SBM members are as excited about these activities as we are. See you in San Antonio!
Integrated Primary Care Professionals Can Direct Future of Health Care
Integrated Primary Care SIG Outlook Liaison Kristine M. Diaz, PsyD
Integrated Primary Care SIG Outlook Liaison Stacy Ogbeide, PsyD
Integrated Primary Care SIG Outlook Liaison Danielle Arigo, PhD
The Integrated Primary Care Special Interest Group (IPC SIG) is committed to the promotion and enhancement of the delivery of evidence-based behavioral health care in primary care settings. In this update on IPC SIG news, we will focus on interprofessionalism in integrated primary care, which is likely to be of value to all Society of Behavioral Medicine (SBM) members.
National medical regulatory bodies have called for the preparation of health care professionals to function collaboratively on health care teams that include health professionals from various disciplines. Interprofessional education (IPE) provides learner-centered education and clinical simulation to health care professionals in the development of these team-based skills. At the same time, the Affordable Care Act’s aim to reduce patient costs by improving patient outcomes and reducing hospitalization rates has led health care professionals to embrace collaborative teamwork across various health professions. The primary care physician workforce shortage has also led various health care professions to work collectively to address patient care. This movement toward interdisciplinary health care teams provides integrated primary care professionals an opportunity to highlight our expertise and strength in interprofessional collaborative practice in order to serve as leaders in the future of health care.
For many patients, integrated primary care providers serve as the "primary health care provider" and/or offer an invaluable liaison for coordinating care with other health care specialists. The Patient-Centered Medical Home (PCMH) model has further reinforced the interdisciplinary team-based approach in patient care in integrated primary care. In fact, patient-centered care and an interdisciplinary team-based approach have actually been encouraged nationwide for more than 40 years. The Institute of Medicine’s first conference, Interrelationships of Educational Programs for Health Professionals(1970), and related-report, Educating for the Health Team (1972), promoted collaborative, team-based education and practice as an efficient model for improving health outcomes, patient care, and patient safety while also decreasing health care costs. Additionally, the World Health Organization released the Framework for Action on Interprofessional Education and Collaborative Practice (2010) to address the global shortage of the health care workforce in primary care.
With our expertise and clinical experience, integrated primary care health care professionals can identify themselves as leaders in interdisciplinary team-based health care through the publication of their work in MedEdPORTAL and through presentations at conferences in their health specialty area. The attendance of conferences and events held by the Interprofessional Education Collaborative, National Center for Interprofessional Practice and Education, and Collaborative Family Healthcare Association may assist with the advancement of interdisciplinary collaborative practice in one’s clinic setting as well as identify strategies to conduct research in IPE. Please consider submitting your scholarly activity in interprofessionalism in integrated primary care as a rapid communication poster submission for SBM’s 2015 Annual Meeting in San Antonio, TX. Rapid communication poster submissions open Thursday, November 13, 2014.
Please email IPC SIG Co-Chairs Mark E. Vogel, PhD, and James E. Aikens, PhD, if you are interested in joining the IPC SIG.
New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine
SBM's two journals, Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research (TBM), continuously publish online articles, many of which become available before issues are printed. Three recently published Annals and TBM online articles are listed below.
SBM members who have paid their 2014 membership dues are able to access the full text of all Annals and TBM online articles via the SBM website by following the steps below.
- Go to the Members Only section of the SBM website (https://www.sbm.org/membership/members).
- Log in with your username and password.
- Click on the Journals link (listed third in the list of member benefits).
- Click on the title of the journal which you would like to electronically access.
To check if you are a current SBM member, or if you are having trouble accessing the journals online, please contact the SBM national office at info@sbm.org or (414) 918-3156.
Annals of Behavioral Medicine
The Challenge of Stimulus Control: a Comment on Poelman et al.
Authors: Sherry Pagoto, PhD, and Brad M. Appelhans, PhD
Excerpt: Stimulus control interventions attempt to reduce unhealthy behavior (or increase healthy behavior) by identifying and modifying environmental factors that repeatedly trigger that behavior [1]. In the context of weight management, modifying the food environment has been a focus given the omnipresence of energy-dense foods in the home, workplace, and marketplace. Poelman and colleagues conducted a randomized trial of an intervention that aimed to reduce BMI by educating participants about portion control and the environmental triggers that lead to overconsumption [2]. Unfortunately, their intervention showed a very modest and short-lived effect on body mass index.
Advancing Research on Engagement in Internet Interventions: a Comment on Owen et al.
Author: Mark S. Salzer, PhD
Excerpt: The issue of engagement, also discussed as exposure, to internet-based interventions and content has increased dramatically over the last decade. Any enthusiasm about the possible public health benefits of online interventions with varied populations to achieve outcomes such as smoking cessation, weight loss, skills acquisition, or address mental health disorders or distress is tempered by robust findings of widespread non-engagement with such interventions. Users are not logging in, log-in only once, view a webpage for short periods of time (i.e., seconds), or quickly taper off in their participation, a phenomenon described as “nonusage attrition” [1]. Efficacy is clearly hard to determine with such behavior. The result has been a resounding call for the development of a “science of user engagement” [2].
Individual and Household Predictors of Adolescents’ Adherence to a Web-Based Intervention
Authors: Louise C. Mâsse, PhD; Allison W. Watts, MSc; Susan I. Barr, PhD; Andrew W. Tu, MSc; Constadina Panagiotopoulos, MD; Josie Geller, PhD; and Jean-Pierre Chanoine, MD
Abstract: Adherence to e-health obesity interventions is a significant challenge. We examined the individual and household predictors of adolescents’ adherence to a Web-based lifestyle intervention. One hundred sixty overweight/obese adolescents and one of their parents enrolled in the 8-month e-health intervention. Structural equation modeling was used to examine individual factors from the theory of planned behavior and self-determination theory and household factors (food/soda availability, parenting, environment) that predict adolescents’ adherence to components of the intervention. We explained 10.8 to 36.9 % of the total variance in adherence to components of the intervention. Intrinsic motivation and parenting practices and styles directly predicted adherence. Relatedness and autonomy support indirectly predicted adherence via intrinsic motivation. Finally, household income modulated these effects. Taking a self-regulatory perspective (i.e., accounting for intrinsic motivation) contributes to our understanding of intervention adherence, but the household environment may play a greater role in facilitating adolescent behavior change.
Translational Behavioral Medicine
It takes a (virtual) village: crowdsourcing measurement consensus to advance survivorship care planning
Authors: Carla Parry, PhD, MSW, MA; Ellen Beckjord, PhD, MPH; Richard P. Moser, PhD; Sana N. Vieux, MPH; Lynne S. Padgett, PhD; and Bradford W. Hesse, PhD
Abstract: We report results from the use of an innovative tool (the Grid-Enabled Measures (GEM) database) to drive consensus on the use of measures evaluating the efficacy and implementation of survivorship care plans. The goal of this initiative was to increase the use of publicly available shared measures to enable comparability across studies. Between February and August 2012, research and practice communities populated the GEM platform with constructs and measures relevant to survivorship care planning, rated the measures, and provided qualitative feedback on the quality of the measures. Fifty-one constructs and 124 measures were entered into the GEM-Care Planning workspace by participants. The greatest number of measures appeared in the domains of Health and Psychosocial Outcomes, Health Behaviors, and Coordination of Care/Transitional Care. Using technology-mediated social participation, GEM presents a novel approach to how we measure and improve the quality of survivorship care.
The window of opportunity for indoor tanning legislation
Author: Jonathan E. Mayer, BA
Abstract: As of August 2014, 11 states in the USA have passed under-age-18 bans on indoor tanning. The Society of Behavioral Medicine, the American Academy of Dermatology, and the American Academy of Pediatrics have all issued statements in support of an under-age-18 ban. The World Health Organization and the Food and Drug Administration have both declared indoor tanning devices as carcinogenic, and this year, the Surgeon General for the first time issued a warning on the dangers of UV radiation and indoor tanning. This essay highlights how the awareness of the risks of indoor tanning, effective policies, and a conducive political atmosphere have aligned to create a window of opportunity for further under-age-18 indoor tanning legislation. The rising number of preventable skin cancers and mortalities is an issue that transcends political party lines, and now, there is a need for support from health professionals and advocates to motivate legislators to push new under-age-18 bills past their sticking points.
A brief primary care intervention to reduce fear of movement in chronic low back pain patients
Authors: Thomas P. Guck, PhD; Raymond V. Burke, PhD; Christopher Rainville, MD; Dreylana Hill-Taylor, MD; and Dustin P. Wallace, PhD
Abstract: Fear avoidance model of chronic pain-based interventions are effective, but have not been successfully implemented into primary care. It was hypothesized that speed walking times and key measures of the fear avoidance model would improve following the brief intervention delivered in primary care. A brief primary care-based intervention (PCB) that included a single educational session, speed walking (an in vivo desensitization exposure task), and visual performance feedback was designed to reduce fear avoidance beliefs and improve function in 4 patients with chronic low back pain. A multiple baseline across subjects with a changing criterion design indicated that speed walking times improved from baseline only after the PCB intervention was delivered. Six fear avoidance model outcome measures improved from baseline to end of study and five of six outcome measures improved from end of study to follow-up. This study provides evidence for the efficacy of a brief PCB fear avoidance intervention that was successfully implemented into a busy clinic for the treatment of chronic pain.
