RESEARCH PLAN
The goal of the Health
Maintenance Consortium Resource Center (HMCRC) is to provide direction
to the behavioral health field by bringing together disparate theories
of processes of change, relapse prevention, and ecological/multi-level
contextual approaches to further understand the long-term maintenance of
behavioral change and effective strategies for achieving health
promotion and disease prevention goals through sustained behavior
change. This initiative will expand the Behavioral Change Consortium’s
emphasis on multiple behaviors and multiple theoretical approaches to
include: 1) Consideration of multi-factor associations with long-term
maintenance of a wide array of health-related behavior; 2) Expansion to
more diverse populations and settings; 3) Sustainability at multiple
ecological levels; and 4) Translation and diffusion of theory-based
interventions to practice. These goals will be achieved by working
collaboratively with the funded sites, the NIH program administrators
and designated consultants.
The proposed Resource Center (HMCRC)
will address four interrelated aims to advance and extend the behavioral
change research aims beyond the individual health maintenance consortium
(HMC) studies. Utilizing both internal and external advisors, the HMCRC
will create a scientific and administrative infrastructure to: 1) Foster
ongoing cross-site communications among HMC projects; 2) Provide
technical assistance (TA) to identify common questions, methods and
measures related to maintenance and sustainability as well as to address
crosscutting issues that add synergy to individual HMC projects; 3)
Establish a central clearinghouse for behavioral change concepts,
assessment instruments, intervention protocols, methods and data
emanating from these projects that can be beneficial for other
researchers and practitioners; and 4) Disseminate research findings and
tools via web-based resources and through listservs, workshops, and
symposia to increase availability to both researchers and practitioners.
To
accomplish these goals, HMCRC proposes the following set of objectives
that may be modified in response to the types of studies included in the
HMC:
•
Fostering communication networks and information exchange:
Serve as the communications
hub for project-related activities, including: arranging conference
calls and bi-annual steering group meetings; developing and maintaining
a Web site with interactive features for exchanging information,
resources, instruments, and strategies.
Disseminate results and lessons learned including
research accomplishments and challenges. To accelerate the integration
of research to practice, the HMCRC will provide technical assistance for
enhancing the maintenance, sustainability, and translation of the
projects. To broaden reach and external validity, the HMCRC will create
user-friendly methods to accelerate dissemination into practice.
• Establishing commonalities in questions, methods, and
measurements:
Identify
site-specific research questions, measures and methods that are shared
across the funded projects (e.g. what research questions do funded sites
bring to the table—and how can being part of a collaborative group
provide a forum for asking questions that go beyond what can be learned
in any one study). Unique opportunities exist with this consortium to
extend research findings beyond single studies to compare multiple
behaviors in multiple settings.
Serve as a catalyst for
identifying subgroups of investigators who will come together to work on
common approaches. A description of related experiences of project
staff can be found in the preliminary studies section.
Assess the potential for
common measures, design elements, and analytic strategies. By the end
of the first grant year, the goal is to establish a shared data
protocol. We will start with a small core of common processes and
outcomes (e.g. demographics, key mediators, behavioral outcomes, and
measures of maintenance and sustainability.)
• Providing technical assistance and expert advice on
cross-cutting themes and
frameworks:
Give
technical assistance and content expertise in conceptual frameworks in
order to identify common study aspects and establish working groups and
other study infrastructures to foster cross-site collaborations,
including guidance in understanding: a) The interrelationships between
different settings in which the research occurs; and b) Linkages among
researchers, implementers and community participants.
Identify content experts who
will help the funded sites address cross-cutting issues such as
community collaborations, recruitment and retention in special
populations, common mediators and measurements, best practices for
fostering maintenance of desired behavior, treatment fidelity,
strategies for documenting and maximizing reach, sustainability and
translation, and innovative methods for addressing analyses with shared
data.
• Facilitating a process for data sharing among HMCRC
investigators and others:
Assist
sites in developing a common coding format, designated variables, and
measures as well as a cost-efficient format for transmitting and storing
data that maximizes ease for all study investigators.
Establish
a study-wide presentation and publication policy for utilizing shared
data and advising on cross-cutting rules and regulations regarding
shared data (e.g. provide an interpretation of implications of HIPAA and
other pertinent data sharing and IRB regulations).
Design a feasible
infrastructure and database for shared data sets to be used within the
study period and a method for public access of data within two years
after the end of initial award period. Although HMCRC investigators may
jointly work on research analyses with site investigators and NIH
program representatives, limited funding will not allow individual
consultation with funded sites. Supplemental funding opportunities will
be explored as a way of generating additional funds to support
collaborative efforts. Since HMCRC funding runs concurrently with site
funding, post funding tasks would need to be planned for, but could not
be supported in this initial award.
The following two diagrams provide a graphic presentation
of our conceptual model of the behavioral change process and the flow
across the different HMC components.
Predictors & Mediators of Behavioral Change &
Maintenance Processes Over Life Course
HMC Organizational Structure and Flow
