Evidence-based Behavioral Medicine Research Articles

Comments on “evidence-based behavioral medicine: what is it and how do we achieve it?”: the interventionist does not always equal the intervention—the role of therapist competence

Comments on “evidence-based behavioral medicine: what is it and how do we achieve it?”: the interventionist does not always equal the intervention—the role of therapist competence

RE-AIM: evidence-based standards and a Web resource to improve translation of research into practice.

Health services data indicate that under present conditions evidence-based medical and preventive practices are not consistently implemented in clinical practice and affect the quality of care provided to patients. Operating with similar conditions and resources, it is unlikely that evidence-based behavioral medicine (EBBM) practices will be more successfully implemented. In this article we propose ways to help improve the implementation of EBBM practice. This article describes the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework that is available on a free-use Web site (http://www.re-aim.org), which offers practical research translation tools, resources, and support for program planners, community leaders, and researchers. The material located at www.re-aim.org can be used to help anticipate and overcome likely barriers to dissemination and to estimate eventual public health impact. Data on Web site utilization and lessons learned thus far in its implementation are presented. Scientists and public health leaders should devote greater attention to reporting practice-oriented issues such as generalizability, breadth of application, and pragmatic and setting or contextual issues in addition to the current focus on internal validity issues. We hope that this and similar efforts will assist EBBM interventions to have broader applications, be consistently implemented, and be sustained.

Research to practice: international dissemination of evidence-based behavioral medicine.

In recent years, there has been a dramatic rise in the global prevalence of chronic conditions. Cancer, diabetes, cardiovascular diseases chronic lung disorders, and their common behavioral risk factors are escalating rapidly in developing countries, many of which are still struggling with infectious diseases and poor health system infrastructures. This article examines the role that behavioral medicine can play to improve global health. The World Health Organization's Innovative Care for Chronic Conditions Framework provides a model for identifying areas for behavioral medicine influence, including patient-provider interactions, organization of health care, community mobilization, and national policy and financing. Behavioral medicine has a large role to play in international health. Examples from around the world are provided. Because behavior is the product of multilevel, multifactoral determinants, there are many areas of influence for behavioral medicine specialists who want to contribute to global health. By focusing attention internationally, with special attention toward the needs of developing countries, the field of behavioral medicine will be not only responding to its global responsibilities but also repositioning itself to be increasingly relevant for the 21st century.

Evidence-based behavioral medicine: what is it and how do we achieve it?

The goal of evidence-based medicine is ultimately to improve patient outcomes and quality of care. Systematic reviews of the available published evidence are required to identify interventions that lead to improvements in behavior, health, and well-being. Authoritative literature reviews depend on the quality of published research and research reports. The Consolidated Standards for Reporting Trials (CONSORT) Statement (www.consort-statement.org) was developed to improve the design and reporting of interventions involving randomized clinical trials (RCTs) in medical journals. We describe the 22 CONSORT guidelines and explain their application to behavioral medicine research and to evidence-based practice. Additional behavioral medicine-specific guidelines (e.g., treatment adherence) are also presented. Use of these guidelines by clinicians, educators, policymakers, and researchers who design, report, and evaluate or review RCTs will strengthen the research itself and accelerate efforts to apply behavioral medicine research to improve the processes and outcomes of behavioral medicine practice.

The face of 2010: A Delphi poll on the future of psychotherapy.

A panel of 62 psychotherapy experts using Delphi methodology predicted psychotherapy trends in the next decade. The observers forecasted changes in theoretical orientations, therapeutic interventions, psychotherapy providers, treatment formats, and future scenarios. Cognitive-behavior, culture-sensitive, cognitive, and eclectic/integrative theories were predicted to increase the most, whereas classical psychoanalysis, solution-focused theories, and transactional analysis were expected to decline. Directive, self-change, and technological interventions were judged to be in the ascendancy. Master's-level psychotherapists along with virtual therapy services were expected to flourish. Forecast scenarios with the highest likelihood centered on expansion of evidence-based therapy, practice guidelines, behavioral medicine, and pharmacotherapy.