Society Of Behavioral Medicine Research Articles

Prioritize "Food is Medicine" initiatives in the 2024 Farm Bill for human and planetary health.

The Society of Behavioral Medicine (SBM) supports increased funding for policies in the 2024 Farm Bill that align with a Food is Medicine (FIM) framework and address multiple dimensions of human and planetary health.

Ethical, legal, and social implications of digital health: A needs assessment from the Society of Behavioral Medicine to inform capacity building for behavioral scientists.

The ethical, legal, and social implications (ELSIs) of digital health are important when researchers and practitioners are using technology to collect, process, or store personal health data. Evidence underscores a strong need for digital health ELSI training, yet little is known about the specific ELSI topic areas that researchers and practitioners would most benefit from learning. To identify ELSI educational needs, a needs assessment survey was administered to the members of the Society of Behavioral Medicine (SBM). We sought to identify areas of ELSI proficiency and training need, and also evaluate interest and expertise in ELSI topics by career level and prior ELSI training history. The 14-item survey distributed to SBM members utilized the Digital Health Checklist tool (see recode.health/tools) and included items drawn from the four-domain framework: data management, access and usability, privacy and risk to benefit assessment. Respondents (N = 66) were majority faculty (74.2%) from psychology or public health. Only 39.4% reported receiving "formal" ELSI training. ELSI topics of greatest interest included practices that supported participant engagement, and dissemination and implementation of digital tools beyond the research setting. Respondents were least experienced in managing "bystander" data, having discussions about ELSIs, and reviewing terms of service agreements and privacy policies with participants and patients. There is opportunity for formalized ELSI training across career levels. Findings serve as an evidence base for continuous and ongoing evaluation of ELSI training needs to support scientists in conducting ethical and impactful digital health research.

Behavioral Medicine Research Council (BMRC) Statement Papers: A New Approach to Consensus Building in Behavioral Medicine Science.

In his departing remarks, outgoing NIH Director Dr. Francis Collins lamented that he should have engaged more with behavioral science to develop COVID-19 mitigation strategies [1]. Behavioral medicine can contribute unique value to public health efforts to achieve optimal health for all. Yet, we continue to see gaps in the dissemination of behavioral medicine research and gaps in the effective translation of science into public health practice and policy. The Behavioral Medicine Research Council (BMRC) ­addresses these gaps by building a strong collaborative foundation for behavioral medicine. The BMRC is an autonomous, joint committee made up of representatives from the four leading U.S.-based behavioral medicine organizations: the Academy of Behavioral Medicine Research (ABMR); the American Psychosomatic Society (APS); the Society of Behavioral Medicine (SBM); and the Society for Health Psychology (SfHP) [2]. The goal of the BMRC is to identify strategic behavioral medicine research goals and promote systematic, interdisciplinary approaches to achieve them. The efforts of the BMRC include but are not limited to identifying specific research targets, prescribing best practices, cultivating a field-level culture, and building coalitions and joint advocacy to improve the influence of behavioral science in the broader research community, and the public, and policymakers. The BMRC comprises two distinguished senior scientists to represent each of the member societies for 3-year terms. In addition, the editors-in-chief of the three major journals—Annals of Behavioral Medicine, Health Psychology, and Psychosomatic Medicine—also engage in coordinating and facilitating dissemination. This coalition represents a new effort to harness the field’s collective strength and lead toward a more remarkable impact on population health assertively.

Equity and behavioral digital health interventions: Strategies to improve benefit and reach.

Behavioral digital health interventions (e.g., mobile apps, websites, wearables) have been applied widely to improve health outcomes. However, many groups (e.g., people with low income levels, people who are geographically isolated, older adults) may face obstacles to technology access and use. In addition, research has found that biases and stereotypes can be embedded within digital health interventions. As such, behavioral digital health interventions that intend to improve overall population health may unintentionally widen health-related inequities. This commentary offers guidance and strategies to mitigate these risks when using technology as a means for delivering a behavioral health intervention. A collaborative working group from Society of Behavioral Medicine's Health Equity Special Interest Group developed a framework to center equity in the development, testing and dissemination of behavioral digital health interventions. We introduce Partner, Identify, Demonstrate, Access, Report (PIDAR), a 5-point framework to avoid the creation, perpetuation, and/or widening of health inequities in behavioral digital health work. It is critically important to prioritize equity when conducting digital health research. The PIDAR framework can serve as a guide for behavioral scientists, clinicians and developers.

Advocacy to support climate and health policies: recommended actions for the Society of Behavioral Medicine.

Climate change poses serious threats to public health and is exacerbating health inequities. Policy changes are essential to mitigate climate change impacts on human and planetary health. The purpose was to describe recommendations by the Policy and Advocacy Subgroup of the Society of Behavioral Medicine (SBM) Climate Change, Behavior Change and Health Presidential Working Group (PWG). The Policy and Advocacy subgroup was comprised of experts in public health, climate policy, and health behavior change, who worked together to identify priorities and develop recommendations. We worked under the premise that building political will for climate policy action is the most urgent goal, and we recommended promotion of citizen advocacy for this purpose. Because citizen advocacy is a set of behaviors, SBM members can use behavioral science to identify and scale up interventions, working collaboratively with communities targeted for marginalization. Recommendations for SBM included establishing an organizational home for climate and health work, providing training and resources, engaging in climate advocacy as an organization, and networking with other organizations. Recommendations for a proposed SBM Climate and Health Committee, Council, or Special Interest Group included developing trainings and resources, seeking opportunities for networking and collaborations, and identifying a research agenda. Individual behavior changes are insufficient to address climate change; policy actions are needed. SBM and similar organizations can support their members to work in developing, evaluating, and scaling up advocacy interventions for action on climate policy to magnify the power of the health and medical sectors to protect planetary and human health.

Mindfulness-based cognitive theory on cancer pain management: comments on the outcomes of the Aarhus University Hospital research protocol

Over the last 20 years a branch of ‘Mindfulness-Based Interventions’ (MBIs) has been strongly introduced against anxiety and depression. In between, practitioners perform ‘Mindfulness-Based Cognitive Therapy’ (MBCT) to cancer patients in order to assist them manage the intensity of cancer pain. The World Health Organization (WHO) and the Society of Behavioral Medicine (SBM) communicated very recently that MBIs should be used against cancer pain to compliment the effect of medical drugs. However, the scientific community is still quite skeptical regarding the efficacy of MBCT on cancer pain management, since there is a lack of proper scientific evidence in clinical trials. This article makes comments on the outcomes that were obtained by a single research protocol in Denmark. The published studies tested the efficacy and cost effectiveness of MBCT. What is more, the findings are reflected, as well as further considerations and suggestions are communicated throughout this article.

Emerging digital technologies in cancer treatment, prevention, and control.

The very first issue of the journal of Translational Behavioral Medicine (TBM) was dedicated, in part, to the theme of Health Information Technology as a platform for evidence implementation. The topic was timely: legislation in the USA was passed with the intent of stimulating the adoption of electronic health records; mobile smartphones, tablets, and other devices were gaining traction in the consumer market, while members within the Society of Behavioral Medicine were gaining scientific understanding on how to use these tools to effect healthy behavior change. For the anniversary issue of TBM, we evaluated the progress and problems associated with deploying digital health technologies to support cancer treatment, prevention, and control over the last decade. We conducted a narrative review of published literature to identify the role that emerging digital technologies may take in achieving national and international objectives in the decade to come. We tracked our evaluation of the literature across three phases in the cancer control continuum: (a) prevention, (b) early detection/screening, and (c) treatment/survivorship. From our targeted review and analyses, we noted that significant progress had been made in the adoption of digital health technologies in the cancer space over the past decade but that significant work remains to be done to integrate these technologies effectively into the cancer control systems needed to improve outcomes equitably across populations. The challenge for the next 10 years is inherently translational.

Society of Behavioral Medicine (SBM) Position Statement: increase access to mental health services due to COVID-19-related parent and family stress.

COVID-19 has caused drastic increases in family stress contributing to deleterious social and emotional ramifications. Before COVID-19, millions of Americans lacked access to mental health resources, and now in the midst of a global pandemic, resources are more limited in times of greater need. In March 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided funding for mental health reforms; yet many barriers remained to receiving sufficient care. In February 2021, the Society of Behavioral Medicine recommended federal legislators expand Community Behavioral Healthcare Centers, increase funding for Federally Qualified Healthcare Centers and School Based Health Centers, incentivize providers to accept Medicaid, and institute more statewide licensing flexibilities to expand the reach of mental health care. In March 2021, the American Rescue Plan was signed into law and provided an additional ~$4 billion in funding for community mental health services, implementing substance abuse prevention and treatment programs, increasing the behavioral health workforce, promoting behavioral telehealth within primary care, increasing school-based mental health services, implementing suicide prevention programs, and improving services for traumatized families. This significant investment in parents and children’s mental health is a tremendous step in the right direction and provides reassurance that relief is underway. Ongoing surveillance of the programmatic and clinical outcomes that result from these new policy reforms will be important for identifying areas that may need continual support as our nation recovers from COVID-19.

Society of Behavioral Medicine (SBM) does not support "Public Charge Rule" changes affecting immigrants' food security.

Federal nutrition assistance programs, especially the Supplemental Nutrition Assistance Program (SNAP), are an important safety net for households in the USA. Although few immigrant households are eligible for SNAP, those who need the program are less likely to participate than nonimmigrant households. Documented barriers to participation include language challenges and anti-immigrant rhetoric. However, previous research indicates that when immigrant households do participate in SNAP, their young children experience less food insecurity and the household as a whole makes fewer tradeoffs between food and other necessities. The Public Charge Rule limits ability to obtain a green card based on participation in public assistance programs. A recent change to this rule added programs to include some noncash programs, including SNAP. Although the vast majority of immigrants who are subject to the Public Charge Rule are not eligible for SNAP, misunderstanding of the rule and fear threaten to reduce SNAP enrollment and consequently increase food insecurity in immigrant families. Spillover effects may occur for families not targeted by changes in the Public Charge Rule as well as decreasing access to other safety net programs that are not impacted by the proposed changes, such as The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and school meals programs. In order to support the food security of immigrant families in the USA, we recommend that the Department of Homeland Security and the Department of State remove all non-cash safety net programs from the Public Charge Rule.

The International Society for Behavioral Medicine (ISBM) and the Society of Behavioral Medicine (SBM) advocate for the inclusion of behavioral scientists in the implementation of the Global Action Plan for the prevention of non-communicable diseases (NCDs) in low- and middle-income countries

Non-communicable diseases (NCDs) are the leading cause of death and disability in the world with the majority of deaths occurring in low- and middle-income countries (LMICs). The financial implications of disease and disability due to NCDs, combined with the costs of long-term management, are major causes of impoverishment and serve as barriers to socio-economic development. The transition from infectious diseases to NCDs as leading causes of mortality in LMICs is driven by several factors, primarily increasing globalization, urbanization, ageing of populations and economic development. Responding to these challenges will require local and comprehensive primary and secondary prevention efforts. The World Health Organization's Global Action Plan provides a road map and an array of policy options to achieve nine voluntary global targets by 2025. The primary responsibility of governments in responding to the challenge of NCDs includes international scientific cooperation to support national and local efforts. The implementation of such efforts to prioritize the prevention of NCDs will create an environment in which the rising trend of the NCD burden could be potentially halted and reversed. When developing NCD policies, stakeholders should consider evidence-based strategies which can be implemented by multidisciplinary teams that are led or have the participation of behavioral medicine scientists. Behavioral medicine strategies should be incorporated into the policy and intervention framework developed to target NCDs in LMICs.

Riding the Wave of Digital Transformation in Behavioral Medicine.

Digital technologies provide a platform for accelerating science and broadening impact in behavioral medicine. The objective of this invited keynote presentation or paper is to offer a blueprint for navigating the rapidly changing waters of digital health. A strategic literature review on digital health technologies in behavioral medicine was combined with a review of relevant policy initiatives to yield insights on: (a) knowledge building, (b) collaboration, and (c) public health stewardship. Digital platforms offer unprecedented leverage for accelerating science, facilitating collaboration, and advancing public health. Early successes in behavioral medicine demonstrated how digital platforms could extend the reach of theory-based behavioral therapeutics through increases in efficiency and scale. As medical investments in health information technology increased, the field of behavioral informatics emerged as the collaborative glue binding behavioral theory into a new generation of patient-facing applications, clinical decision support tools, evidence-based communication programs, and population health management strategies. As a leader within the interstitial space between medicine, psychology, and engineering, the Society of Behavioral Medicine is in a distinct position to exert influence on the ways in which our science is utilized to eliminate health disparities; improve support for patients, caregivers, and communities; to promote general health and well-being; and to offer relief when confronted with psychological pain or addiction. Riding the wave of digital transformation has less to do with mastering the complexities of the latest technologies and more to do with adhering closely to established principles for navigating a rapidly changing information environment.

Society of Behavioral Medicine (SBM) position statement: provide funding for incentive programs to expand healthy food offerings in SNAP-authorized small food stores.

Individuals and families with limited access to healthy foods often experience increased risk for poor diet and chronic disease. Low-income communities are more likely to have a large number of small food stores (e.g., corner stores and dollar stores) compared to higher-income communities. Since many of these small food stores participate in the Supplemental Nutrition Assistance Program (SNAP), increasing healthy food offerings in these stores may expand healthy food retail in low-income communities. We recommend the provision of funding for incentive programs that encourage SNAP-authorized small food stores in low-income communities to expand their healthy food offerings. This programming should (a) provide seed grants to store owners to develop or reconfigure store infrastructure, (b) offer store owners technical assistance and educational materials on marketing strategies for promoting healthy food items to customers, and (c) give a tax break to SNAP-authorized small food stores in low-income communities that maintain a predetermined minimum stock of U.S. Department of Agriculture-recognized staple foods.

Lessons learned from the initial 4 years of the SBM Mid-Career Leadership Institute.

In 2015, the Society of Behavioral Medicine (SBM) created the Mid-Career Leadership Institute. The initial model that motivated the creation of the institute came from my participation in the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) program, specifically designed to enhance the leadership skills of senior female faculty in the health sciences. My participation in ELAM was transformative. It led me to run for president of SBM in 2014, to consider how behavioral scientists could similarly benefit from mid-career leadership training, and ultimately to work with the SBM Executive Director, the SBM Leadership Institute Steering Committee, and leadership training professionals to launch the Leadership Institute in 2016. The overarching goal of the SBM Leadership Institute is to train mid-career behavioral scientists engaged in academic and health care settings to develop essential skills needed to navigate the unique challenges of mid-career. Central to this goal is a focus on integrating diversity, equity, and inclusion into their emerging leadership roles through participation in training exercises, lectures, and dynamic group discussions. To optimize the Leadership Institute experience, opportunities were developed, including mentoring from SBM seasoned members, peer mentoring through the creation of "learning communities," career coaching, and additional networking opportunities. The purpose of this brief commentary is to summarize lessons learned by highlighting program evaluation, describing key changes over the initial 4 years, and sharing future plans for leadership training.

Experiences of social scientists in health research settings: SBM Leadership Institute.

The Society of Behavioral Medicine (SBM) Leadership Institute provides leadership training for mid-career behavioral medicine scientists. As an institute fellow, I explored the experiences of social scientists working in healthcare settings. Exploratory research to describe the experiences, barriers, and facilitators social scientists face working in a healthcare delivery and research system. Our research questions were exploratory, focused on understanding (a) the experiences of social scientists working in a healthcare delivery and research system, (b) barriers that social scientists face working in a healthcare delivery and research system, (c) perceived value of sociological and anthropologic methods to clinicians and other health researchers, and (4) to understand the landscape of organizational models that feature social scientists as part of a larger scientific enterprise. We developed a plan for needs assessment activities. We conducted a design workshop of social scientists (n = 11). Using human-centered design methods, we elicited experiences and asked participants to develop a prototype model where social scientists could find career fulfillment with minimal structural barriers. We found that social scientists feel a strong sense of pride in their social science training and passion for the work they do. They reported occupying multiple disciplines at once, including multiple promotion and reputational expectations. Participants commonly reported that they themselves, as well as collaborators, viewed social science work, particularly qualitative research, as supplemental to quantitative work. Participants described perceptions that social science research is less rigorous or requires less training compared with other disciplines. Participants identified several contextual factors that influenced the perceived value of social science research in healthcare, including the focus of external funding priorities on larger clinical questions, organizational structure, and tangible leadership support of social science. The SBM Leadership Institute created a space for preliminary research into an area that could improve the experiences and research impact of social and behavioral scientists.

SBM Mid-Career Leadership Institute: replacing "fake it till you make it" with authentic leadership.

Increasingly the organizational environments in which we work can be characterized as Volatile, Uncertain, Complex, and Ambiguous (VUCA). Equipping leaders to thrive in VUCA environments requires more than merely imparting a list of competencies that can be observed, described, and measured. Indeed, competency-based leadership training runs the risk of being insufficient, incongruous, idealized, fragmented, and unconsciously coercive. Rather than helping leaders develop the more elusive and subtle leadership qualities and attributes necessary to thrive in VUCA environments, competency-based training can leave them feeling inadequate, as if they do not ever quite measure up, and can fuel "imposter syndrome". The Society of Behavioral Medicine (SBM) Mid-Career Leadership Institute provided training that was far more than competency based. It was broad enough to be relevant to fellows working in a variety of contexts and provided a framework directly applicable across settings. The training was multipronged and included: a 2 day in-person workshop designed to maximize active participation; intensive mentoring by both peers and senior members of SBM; three individual one-on-one executive coaching sessions with a professional career coach; and a leadership project in which we applied the knowledge gained during our training in our diverse organizational settings. The SBM Mid-Career Leadership Institute training increased my self-awareness about important leadership concepts, the executive coaching sessions helped me become more productive, and the relationships I built have helped me develop my professional network and deepen my connection with fellow scientists and practitioners. "Fake it till you make it" and feelings of insecurity and self-doubt have been replaced by authentic leadership.

Introduction to the Special Issue of the SBM Mid-Career Leadership Institute: leadership and behavioral medicine in context.

In 2016, we established the year-long Society of Behavioral Medicine (SBM) Mid-Career Leadership Institute. Individuals are often selected for leadership positions without intentional training in needed leadership skills, including strategic planning, building collaborative teams, goal setting, negotiation, and communication. The purpose of the Leadership Institute is to: (a) provide opportunities for mid-career professionals to build and sustain their leadership capacity; (b) create cohorts of connected fellows in behavioral medicine fields, disciplines, and institutions, who can support one another throughout their professional careers; and (c) enhance specific skills needed to navigate the challenges of mid-career. Over the first 4 years of the Institute, 139 fellows have participated, representing 35 states. Most of the fellows hold PhDs (93%) as a terminal degree. This special issue is dedicated to the leadership experiences of fellows, faculty, senior SBM mentors, peer mentors, and executive coaches.

Perspectives on the benefits of leadership training for career growth among three mid-career behavioral scientists.

Participation in the Society of Behavioral Medicine (SBM) Mid-Career Leadership Institute was invaluable in navigating challenges and opportunities experienced by behavioral scientists at key mid-career transitions. Professionals are expected to take on more responsibilities at mid-career, often with minimal guidance and/or relevant training in the requisite leadership skills. The SBM Leadership Institute provided concrete practical strategies for managing time, work email, planning/goal setting, and conflict resolution. The purpose of this commentary is to review the impact of the SBM Leadership Institute on new leadership roles obtained by three SBM Leadership Fellows. Practices adopted as a result of the Leadership Institute will be discussed (e.g., right sizing the workload, "inbox zero," starting with priority work, and single tasking). The use of these strategies resulted in increased productivity and reduced work stress. Furthermore, one-on-one executive career coaching and participation in our learning community cultivated the direct, effective communication skills needed to take on new leadership roles/projects (e.g., transitioning to department chair, running for SBM board, launching ACSM Exercise is Medicine On Campus program). The leadership projects helped to push Fellows out of their comfort zones and provided excellent opportunities for networking and increased involvement in organizations and professional societies. In sum, the SBM Leadership Institute helped instill the confidence and focus needed to surmount midcareer obstacles and accelerate into the next career phase.

Leadership, behavioral science, and interprofessional teamwork.

The greatest challenge I face as a pediatric oncologist is breaking life-threatening news to patients and their parents. I frequently felt the need to improve my ability to deliver such information in a professional, yet compassionate way. I was fortunate to participate in the Leadership Institute, which provided me with the skills and perspectives that inspired me to seek out team-centered methodologies and medical decision-making theories. After learning techniques for priority setting, situational leadership, expressing empathy, and conveying bad news, guidance from the Leadership Institute prompted me to collaborate with nursing, social work, and chaplaincy colleagues to develop a team-based approach for helping families facing end-of-life decisions. Our success in the clinical arena led to my leadership project, which focused on academic collaborations to develop an educational exercise for pediatric residents, and students in nursing, social work, and chaplaincy, designed to introduce learners to these techniques and the experience of conducting end-of-life discussions as part of an interprofessional team. We published an initial description of this 4-hour simulation-based training session and now plan to submit our cumulative 3-year quantitative and qualitative results. This commentary describes my growing appreciation of the power of behavioral medicine, and how the lessons learned through the Society of Behavioral Medicine and the Leadership Institute have not only facilitated the success of my project but also enriched multiple aspects of my professional life.

Definition and Characteristics of Behavioral Medicine, and Main Tasks and Goals of the International Society of Behavioral Medicine\u2014an International Delphi Study

BackgroundIn the past decades, behavioral medicine has attained global recognition. Due to its global reach, a critical need has emerged to consider whether the original definition of behavioral medicine is still valid, comprehensive, and inclusive, and to reconsider the main tasks and goals of the International Society of Behavioral Medicine (ISBM), as the umbrella organization in the field. The purpose of the present study was to (i) update the definition and scope of behavioral medicine and its defining characteristics; and (ii) develop a proposal on ISBM’s main tasks and goals.MethodOur study used the Delphi method. A core group prepared a discussion paper. An international Delphi panel rated questions and provided comments. The panel intended to reach an a priori defined level of consensus (i.e., 70%).ResultsThe international panel reached consensus on an updated definition and scope of behavioral medicine as a field of research and practice that builds on collaboration among multiple disciplines. These disciplines are concerned with development and application of behavioral and biomedical evidence across the disease continuum in clinical and public health domains. Consensus was reached on a proposal for ISBM’s main tasks and goals focused on supporting communication and collaboration across disciplines and participating organizations; stimulating research, education, and practice; and supporting individuals and organizations in the field.ConclusionThe consensus on definition and scope of behavioral medicine and ISBM’s tasks and goals provides a foundational step toward achieving these goals.

Society of Behavioral Medicine (SBM) position statement: support increased knowledge and efforts to address the financial burden associated with cancer treatment.

Millions of individuals and their families struggle with both treatment-related and out-of-pocket (OOP) economic repercussions of a cancer diagnosis, an effect increasingly referred to as "financial toxicity." In 2014, the Agency for Healthcare Research and Quality (AHRQ) estimated the total U.S. expenditures for cancer at $87.8 billion dollars with patient OOP costs accounting for $3.9 billion dollars (2014). These figures do not take into account indirect costs, such as those from lost earnings. As a result, financial toxicity can extend well beyond the active treatment phase and have a substantial impact on a household's economic reserve and financial resilience well into the future. Of the 9.5 million U.S. adults aged 50 years and older diagnosed with cancer (2000-2012), 42.2% have depleted their assets at 2 years and 38.2% were financially insolvent in 4 years. Bankruptcy rates are 2.65 times higher among cancer survivors than matched controls. A full 70% of Americans want to have conversations about the costs of care with their health care providers, but only 28% report doing so. Delaying or deferring these conversations can have major financial consequences for patients. According to a polling conducted for the Robert Wood Johnson Foundation (RWJF) by Avalere Health, almost 20% of patients report forgoing care when they have questions about costs. A critical element to achieve this is to have accurate cost information, including health care insurance coverage policies. Specifically, while patients and their families look to their health care providers to help them better navigate the cost implication of their treatment choices, most who are willing to undertake this challenging task need to have accessible and comprehensive (including direct and indirect) cost information to facilitate the discussion.