In this episode of
Expert Insights for the Research Training Community, Dr. William
T. Riley, director of the NIH Office of Behavioral and Social Sciences
Research, shares the advantages and challenges of integrating the
social/behavioral sciences and biomedical sciences. He also provides
examples of this integration in recent trans-NIH initiatives.
The original recording of this episode took place as a webinar on May 19,
2020, with NIGMS host Dr. Judith Greenberg. A Q&A session with webinar
attendees followed Dr. Riley’s talk.
Recorded on May 19, 2020
Download Recording [MP3]
Welcome to Expert Insights for the Research Training Community—A podcast
from the National Institute of General Medical Sciences. Adapted from
our webinar series, this is where the biomedical research community can
connect with fellow scientists to gain valuable insights.
Dr. Judith Greenberg:
Good afternoon. I’m Judith Greenberg. I’m Deputy Director of NIGMS, and
I’m pleased to welcome all of you to another one of our NIGMS webinars
for trainees and for others.
We organized these webinars to give you some interesting perspectives on
a variety of science-related topics at a time when we know most of you
cannot be in your labs—even though that’s probably where you’d rather be
Before we begin, I want to thank a number of people who’ve made these
webinars possible. First of all, the communications team at NIGMS who
publicize these so well. To our IT people who’ve done a fabulous job in
all the technology and making them work so well. I also want to thank
all of you who are participating in this, and, of course, most of all
our speakers who’ve taken their time to put together interesting
Today’s webinar is entitled “Integration of Behavioral and Biomedical
Sciences at the NIH,” which we think is an important area and not always
OK, now to my introduction of Dr. Riley. I’m going to be brief because I
know he’s going to tell us something about his own career path that
brought him to his current position as Associate Director for Behavioral
and Social Sciences Research and the Director of the Office of
Behavioral and Social Sciences Research—OBSSR—at NIH, where he has been
in that position for the last five years.
He’s also been in other parts of NIH for a total of 15 years. During
that time, he was also at the National Institute of Mental Health, the
National Heart, Lung, and Blood Institute, and the National Cancer
Institute. He holds an appointment at George Washington University in
their School of Public Health, and his research interests include
behavioral assessment, technology-based interventions for health risk
factors, and the application of engineering and computer science
methodologies to the behavioral sciences. Dr. Riley holds a PhD in
And so now let me turn it over to him. Dr. Riley.
Dr. William Riley:
Judith, thank you so much and thank all of you for attending. It’s
wonderful to be here and actually quite an honor. It’s very nice for
both Jon and Judith to invite me to do this.
I’ve long admired the T32 program at NIGMS, and particularly the efforts
in integrating behavioral and biomedical sciences, so I’m looking
forward to doing this, and hopefully we can stimulate some discussion as
we move forward.
So let me begin with a brief history of both OBSSR and, as Judith said,
maybe a brief history of me and my career.
So OBSSR has been open since 1995. This is their 25th anniversary. We
coordinate behavioral and social science research across the NIH. Our
roles are many, but primarily leading trans-NIH behavioral and social
science research initiatives, conducting workshops in emerging areas,
supporting training, and, of course, co-funding institute and center
grants. OBSSR doesn’t fund grants directly, but we work with our IC
partners to do that work.
So a brief history of me. I was reflecting on this and I usually tell
people about the fact that I’ve moved from position to position mostly
out of opportunities that have arisen, but I have to start with a
limitation for how I became a psychologist.
When I went to college, I originally wanted to be an astronomer. I was
one of the few guys who took his date out into a field to look at the
stars and actually looked at the stars with them when we got out there.
I started as a math major, and unfortunately as the whiz kids were doing
differential calculus in minutes, it was taking me hours to do the same
problems, and I realized pretty quickly that my calling was probably not
in mathematics. So I still have quite an interest in that. I just sort
of do the work a little slower than others do.
I spent about 15 years in academic medical settings and sometime in the
research and development space, mostly in the computer science and
engineering area. This was back before the days of iPhones, and we were
doing portable handheld devices, mostly to do health behavior change and
behavioral assessment types of things in a more automated way.
As Judith said, I spent about 15 years at the NIH, lastly here at OBSSR,
and I’ve been here about five years now. So just a backdrop about
funding for behavioral and social science research at the NIH. We’ve
seen a growth in funding pretty much every year over the last five
years, both in basic research and then overall in behavioral and social
science research at the NIH. And that portfolio represents a little over
10 percent of the total NIH budget.
Now keep in mind when we’re counting this we’re counting anything that
has a behavioral and social science component to it, so it’s not that
these are all prototypical behavioral or social science studies and
projects. Most of them have some piece or component that’s behavioral in
nature, but that still represents a little over 10 percent of the
overall NIH budget.
And of the players, the largest ones in terms of—this is from last
year—competitive behavioral and social science research funding by
institute: NIA and NIMH usually battle it out, but unfortunately this
one blocked out the others, so it kind of does every other. But some of
those institutes tend to do the larger amounts—NCI, NHLBI, NICHD. Some
of those other institutes also fund a fairly large amount. And I will
just sort of note that even the ones that are kind of at the bottom are
not at the bottom because they don’t care about behavioral and social
science research; it’s partly the size of their portfolio overall as
We began a couple of years ago looking at sub-categories of the
behavioral and social science research that we fund at the NIH, and as
you’ll see from this slide, we tend to do a fair amount of research and
some basic research in attention and learning and memory—that’s always
been a core basic research/foundational science at the NIH—as well as
social processes and determinants, healthcare and disease management,
and mental health. And then you can see some of the others as you go
down the list.
We’ve had a strategic plan for three or four years now, about three
years now. So three core strategic priorities for us are scientific
priorities for us. One has been that we felt like for many years that
the pipeline from basic to applied research in the behavioral and social
sciences isn’t as strong as it should be, so we’ve been working to
improve the translation of basic research into applied behavioral
intervention research over the last few years.
The other is in methods, measures, and data infrastructures, improving
the way we go about measuring these behavioral and social phenomena,
doing that more precisely and more accurately, as well as improved
methodologies for understanding these phenomena.
And then the other thing that’s been a consistent concern for us has
been the adoption of behavioral and social sciences research in the
community. I’m envious of the fact that the biomedical sciences have the
FDA and have the systems in place to be able to implement into hospital
systems. Part of the problem for the behavioral and social sciences is
that we not only implement in healthcare systems, we also implement in
communities and schools and policy makers and all kinds of other groups
as well. And the ability to be able to foster adoption of the science in
those areas is particularly important.
I’ll talk a bit in a little bit about some of the COVID-19-related
issues, but that’s a good example where there is some very clear
research in some areas having to do with how you manage pandemics, how
you deal with some of these things, how you communicate risk, and that
science gets applied somewhat spottily depending upon on who’s doing the
talking and how it’s being done.
So in the process of putting together our strategic plan, we identified
four transformative opportunities that Dr. Collins and I wrote about a
few years back in 2016, and these really do kind of begin to get you
thinking a bit about the integration of biomedical and behavioral
sciences and other sciences as well.
One of the areas was in integrating neuroscience into the behavioral and
social sciences. And that connection, whether it’s behavioral
neuroscience, cognitive neuroscience, social neuroscience, have all
been, I think, great opportunities to wed those things together more
than they previously had been. There have been a lot of transformative
advances in measurement science. This includes sensor technologies and
some of the things we’re doing now with phones and sensors and wearables
and home-based sensors—those types of things—as well as actually just
improvements in how we do patient-reported outcomes and self-report work
as well. There have been some really nice improvements in that area. The
digital intervention platforms, which I’ll talk about a little bit more
later, and our ability to be able to do our interventions with reach and
scalability that we previously weren’t able to do.
As many of you know, most behavioral interventions are very labor
intensive, resource intensive, mostly have been done in the past face to
face, in person. We thought we were doing reach and scalability when we
had group sessions instead of individual sessions, but now that work has
been ported to websites, mobile technologies, and a variety of other
ways for us to be able to extend the reach and scalability of our
And then we’ve had a lot of large-scale population cohorts and data
integration efforts across those cohorts that have allowed us to answer
questions we previously have not been able to answer. The integration of
biomedical and behavioral sciences has actually been a principle OBSSR
since its inception.
This is an initial article from Norm Anderson, who was the first OBSSR
director during its inception and the early days of OBSSR. And he talked
about the discoveries of behavioral and biomedical sciences being
equally critical for health, but that knowledge of both of those need to
be integrated for us to really advance. And that’s been a core theme of
our office since its inception, to move forward and integrate better the
biomedical and the behavioral sciences at the NIH.
But of course there are some challenges to integrating this work and
doing transdisciplinary work. For one, it’s an interpretation of
different languages. We don’t always use the same terminology, and
actually the worst is when we use the same terminology but mean
different things as we say those. Often when I say “mechanism” with my
biomedical colleagues they’re thinking about some process that occurs
under the skin, and many times the mechanisms I’m talking about are
mechanisms that actually reside in the environment, among social
interactions and those sorts of things as mechanisms.
We also have to check our scientific assumptions—we each have our own.
I’ve been fortunate in some ways that I have never worked in the
psychology department in my entire career. I’ve always worked in medical
centers or the NIH, which are predominantly more biomedical in nature
and the only time I didn’t work in those areas I worked in a private
firm that was primarily computer scientists and engineers. So I’ve never
really had the luxury that I think my psychology-department colleagues
sometimes have of being able to talk to one another and just know that
their scientific assumptions they all agree to already, you have to kind
of put those on the table and make sure we’re clear about what those
We also have to merge different research cultures. Research standards
and accepted approaches are different among these various disciplines.
Causal inference and what we mean by causal inference, and what is
considered adequate justification or evidence for causal inference
differs by these situations. It would, if it weren’t for the ethical
constraints, it would be very nice to do a study in which I randomly
assigned children at birth to adverse childhood events over the course
of their lifetime and see what the impact is on their health, but that’s
obviously not something we can do, even though that would give us much
better causal inference data on the impact of adverse negative events
and the mechanisms of that on health.
So we have to come up with other ways of being able to do that to seek a
causal inference in that situation. Smoking cessation literature and
smoking literature is actually a pretty good example of that. Not doing
RCTs but coming to an accepted sort of standard for causal inference. As
best as I can remember over the course of 50 years of smoking research,
never really assigned people to smoke or not smoke, but we looked
through a lot of ways of being able to control for potential confounds
to be able to show a clear relationship between smoking and ultimate
disease. And their publication standards are also a little different.
There are Nobel laureates in economics that have maybe 50 publications.
Now those publications are quite large, quite voluminous, but 50
publications in a cell biologist’s lab would be the kind of thing you
would do in a couple of years. It just has to do with the difference in
the size of a research publication, and what it means, and how people
tend to think about publications in that work.
Computer science is another good example of that, because their
presentations in scientific society meetings actually in a lot of ways
carry as much weight if not more weight than it does for publications,
where that’s quite different in both the behavioral and biomedical
And then we, obviously, have to know how to play well with others. Be
able to listen to each other, be able to try to understand each other’s
perspectives and work well together as we do that. There’s one other
piece of this, though, that I want to make sure we cover, and that’s
this concept that psychology and behavioral science is common sense. And
this is one of the things that I think we often struggle with as we
start integrating behavioral and biomedical sciences.
So let me just step back from this and give you a sense of what I’m
talking about. Everybody, by evolution and all other factors, are
amateur behavioral theorists. You have to be. It’s how you come up with
deciding how you’re going to predict the behavior of other human beings,
what they’re going to do, how to react to environments and those sorts
And so we build our own theories in our mind and our head about how we
function and how other people function. But those experiences are
obviously idiosyncratic, only to us, and also cognitively biased in a
variety of ways. But everybody has those.
Now what some people, I think, believe is that behavioral scientists, as
a result of our career study, we may have a slightly better “common
sense” regarding human behavior than some other people do. I tend to
reject that concept with possible, maybe, but I think what really sets
us apart as behavioral scientists is that we embrace the counterfactual
of that commonsense solution. Whatever it is that we think might be
right, our first thought is, “Maybe that’s not right. Maybe there’s an
alternative hypothesis for why this person has engaged in that
behavior.” And then we subject those hypotheses to rigorous scientific
So we tend to be, I think, as I talk to people that I consider to be
really good at this field, they’re the people who question everything
that they think and every experience that they have to ensure that it’s
not an idiosyncratic or biased perspective that they have about human
I want to give a few examples of some of the transdisciplinary research
that’s going on at the NIH, and I’ll spend a little time on COVID-19
since it’s so pressing right now. But first I wanted to mention the
BRAIN Initiative, which has been in Phase I of the BRAIN Initiative,
focused very much on neurocircuitry and tools and instruments and
capabilities to be able to assess that neurocircuitry in ways we’ve
previously been unable to. And the BRAIN Initiative has been extremely
successful at that work.
As they shift to Phase II, they shift to actually applying that work to
combining those approaches into understanding cells and circuits and
brain and behavior at the end of all of that. So one of the things I’m
really looking forward to in Phase II of the BRAIN Initiative is the
ability to be able to use those tools now to be able to understand from
very elementary behaviors up to more complex behaviors and be able to
Now, to be able to do that, we’ve, over the course of the last decade or
so, have gotten extremely good at precise and accurate and temporally
dense neuroscience analysis and neuroscience measurement. We need to be
able to step up to the plate on the behavioral side and provide an equal
level of temporal density, precision, and accuracy on the behavioral end
of that spectrum so that we can map these things together more carefully
than we currently are able to do.
The HEAL Initiative is another example of a transdisciplinary research
program. This is the NIH HEAL Initiative that last year awarded nearly a
billion dollars in funding in a multi-pronged approach that includes
behavioral sciences and important research questions in that area. And I
listed here some of the recently funded projects. One of the things that
we did in the early days of the HEAL Initiative as people were talking
about could we develop better analgesics for pain control and could we
develop better ways to treat people with opioid dependence, one of the
things we wanted to make sure was clear is that there are significant
social and behavioral factors associated both with chronic pain and with
opioids, and some of the research that needs to move in that area in
order to improve our ability to treat opioid dependence and chronic pain
So the recently funded projects of the HEAL Initiative, I think you see
a really nice integration of biomedical and behavioral research, looking
at things like acute to chronic pain signatures. Discovery and
validation of biomarkers and end points. A really nice study looking at
the healing communities and looking at opioid dependence more from a
community-based sociological perspective and how to address that. Work
within the justice community on opioid research and treatment.
Behavioral research to improve our medication-assisted treatments for
opioid dependence, and a number of other things like that. So I think
this has been a really nice example of integrating behavioral and
biomedical research in a transdisciplinary way.
But let me finish by saying a little bit about COVID-19 and some of the
things that I think are important here as well in terms of that same
integration of biomedical and behavioral research. I said this in a blog
recently, and I said it in the perspective of this is a really simple
way to think about it.
But with my infections disease colleagues I often say, “You tell me what
you need people to do, and I’ll tell you how to help them do it.” What
sort of things will get them to do the things that we’d like for them to
do? Keep in mind that most of the current mitigation efforts we have
right now are social/behavioral interventions, risk communication, hand
washing, social distancing.
We need to be able to optimize adherence to those. And every day on the
TV we see people who are not adhering to that, and how might we go about
improving that adherence to social distancing? Balancing the cost and
benefit with economic and social impacts.
And then there’s obviously some significant downstream health impacts
from those economic and social impacts, especially in mental health and
substance abuse, but also in physical conditions that have a significant
psychosocial stress aspect to them as well. And then optimizing testing
uptake, and then thinking down the road, optimizing vaccine uptake.
So I won’t go into detail on this slide because I’ve said most of this
already. Some of the mitigation efforts that are important and why they
are important. Our ability to actually do better modeling with better
data, especially around some of the social and behavioral
characteristics, economic impacts, and social impacts, that we need to
be able to better measure and have better data.
Right now what we’re doing is mostly using data from prior flu epidemics
as the base by which we begin to do that. But as we move forward, we are
beginning to pick up more data that improves our precision with these
models. Let me move on here.
The other that’s been a real, I think, important component of this work
that if you think back to if this had happened 15 or 20 years ago, what
would be our ability to deliver health care in a remote way, it would be
abysmal. But because of the work that’s been done in telehealth and
digital health, mobile health, we have abilities to be able to automate
a lot of what we do, to offload and remotely provide access to
healthcare in ways we’ve previously been unable to do, and to be able to
reduce the healthcare disparities as a result of that.
Now, one of the things we have to be careful about is that the same
people who are most affected and most disparate in terms of health
outcomes right now are also the people with less access to broadband and
computer systems and mobile technologies to be able to access these
things remotely, so we need to be able to address those as well.
Obviously, in the concept of doing testing, there’s an important
component here to think about that has again to do with social and
I’m very grateful that my biomedical colleagues are working steadily and
hard and fast on improving the speed and the platforms by which we do
testing for SARS-CoV-2, but the other part of that is to recognize that
testing uptake is important. The assumption that once we have adequate
testing that people will, of course, want them is actually a poor
Back in the 1950s, we had tuberculosis screening buses. They drove from
community to community and did X-ray screenings for tuberculosis to do
screenings. And people realized after a while of doing that, that people
weren’t coming. They weren’t being screened; they weren’t using the
facilities. The convenience alone was not sufficient to get people to
uptake the screening behavior. And that was the birth of the health
belief model and things like perceived susceptibility and severity of
illness and perceived benefits and barriers to testing that were
important considerations as you try to improve the ability of people to
uptake the testing that was going to be provided.
And then once the testing’s occurred, you’ve got health literacy issues
you need to deal with with interpretation, the effects of that on
mitigation behavior—so for instance if I test negative, does that now
mean I feel comfortable breaking all the rules about hand washing and
social distancing and other things in order to be able to do that? And
then services and hand-off and referral. And again, particularly in
health-disparate populations in which those referrals and resources are
So if they end up in a situation in which they test positive, will they
have those resources available to them? And if they don’t, why would
they then subsequently go through getting tested if it doesn’t matter
from their perspective? And then, obviously, like I said, complicated in
rural and underserved communities where that’s even more of an issue to
I want to touch just briefly on psychosocial recovery from COVID-19.
There’s a lot of research, obviously, now on the treatment and
therapeutics and getting people through to recovery, but there’s also a
lot of work that we need to do on what happens to them post recovery and
during the recovery process. Not only physical recovery, but also
So we have some literature about post-intensive care syndrome, in which
people have difficulty with stress and depression and other sort of
mental health factors as a result of coming out of intensive care, and a
fairly significant intensive care experience, but that’s obviously
exacerbated in the current situation by social isolation and the lack of
family contact during those intensive care efforts under COVID-19.
And then, of course, as people recover, issues of stigma and also
survivor’s guilt of those who made it versus those who didn’t. So
there’s a lot of factors there that we need to be able to consider and
be able to address as we integrate the biomedical and behavioral work
So just to briefly, just so people are aware of some of the things that
are already out there. There’s a number of urgent competitive and
administrative supplements in COVID-19 going on right now addressing a
lot of the things that I just sort of walked you through. OBSSR leads
one of those, but a lot of the specific institutes and centers have
their own as well, and so there’s a lot of ways in which people who are
existing grantees of the NIH can subsequently do more work in that area.
The other thing I wanted to mention briefly to all of you is that as
this pandemic was coming along, we had people beginning to do surveys
out in the field, and I was concerned we would have nothing but one-off
surveys of everybody asking a slightly different question about social
distancing, or handwashing, or any of those other factors, and as a
result of that, we would not be able to do any data integration or
comparison between survey samples.
So we quickly set up a survey item repository in which people could send
in the surveys that they’re fielding for COVID-19-related variables, and
then we would post them and make them available so that others could
borrow from that and use what’s already out there and what’s already
being fielded. And we had those in two places—in the Disaster Research
Response (DR2), which is at NIEHS, and with the National Library of
Medicine, and then in the Phoenix Tool Kit as well there are COVID-19
protocols. So those are all posted for people to be able to use what’s
already out there and available, as opposed to creating their own yet
And let me just finish up by saying that I’ve been feeling like I’ve
been skating where the puck was, not where the puck is going, and so I
think we need to begin to think more forwardly about how we integrate
behavioral sciences and the biomedical sciences related to COVID-19,
whether it’s the unwinding of the mitigation efforts that are currently
going on, or dealing with the backlog of elective care, or helping
families manage complicated bereavement in situations in which people
have died, whether from COVID-19 or just from other causes and have not
been able to go through the natural sociological bereavement process
that we typically have. Recovery complications that we talked about.
And then down the road, we’re going to also have to begin to address,
once we have a vaccine, vaccine hesitancy and concerns about the vaccine
and people who spread misinformation about vaccinations and that sort of
thing and being able to address that as well.
So let me stop there. You can find me easily. This is my contact
information and information about our office. Happy to respond to people
if you have questions or concerns or anything, but I’ll open it now
back, Judith, to you for questions.
Thank you, Bill, that was terrific. To start off, Bill, two closely
You talked a little about the challenge of merging the cultures, the
biomedical and the behavioral. The first part of the question is, at
NIH, for example, what do we do or what does your office do, to bring
together those two sides of research to integrate them?
And let me ask the second part, because it’s probably all together, and
that is, for trainees who are trained in the behavioral research area,
how do they gain enough expertise in biomedical research to be
successful in biobehavioral research?
So maybe you can address it both from the researcher’s point of view but
also trainees as they’re
thinking of their futures.
Great questions, Judith. Thank you.
As far as the research efforts and how the NIH does this, I think we’ve
been very fortunate at the NIH that at the early stages of OBSSR we had
to make the case that behavioral and social science was important at the
I don’t think we have to make that case now, so I’ve felt very fortunate
that Institute directors, NIH leadership, rank and file project officers
across the span of the research that the NIH funds, whether they
understand behavioral and social science specifically, they certainly
understand its importance, they understand its value, they understand
the potential for it to be integrated. And that’s been a very useful
thing, at least in terms of receptivity to it, that I think has been
And the other thing that I think, and this has been a problem for the
behavioral and social sciences for some time, is we don’t act
defensively. As an office, we go in and offer the things that we believe
are useful to offer, try to be humble about it, not oversell what we
think the behavioral sciences can do or can’t do, and try to be very
clear about that. And in situations where I don’t think we have much to
offer, we say, “We don’t have much to offer.” Places where we think we
do, we sort of offer that up, but try to think of it more in a service
And I think that’s been really helpful for the office as we try to
integrate some of this work. So I think that’s at least how we’ve been
doing it at the NIH in terms of doing that work. For trainees, I think
it’s really interesting.
I think it’s important—I mean, this is almost like learning a language.
Yes, you can study it in books all you want, but ultimately you’ve got
to get in the trenches and you’ve got to work with biomedical colleagues
and ask lots of questions to try to understand what they’re doing and
why they’re doing it, what’s going on, and I think that’s an important
component of what we have to do.
Being siloed in disciplines, I think, is increasingly less likely to
happen in most academic settings. But even if you feel a little siloed,
it’s important to get out and take classes in other disciplines, learn
from other areas, do that kind of work. That said, I still think you
have to get up to speed quickly in certain situations.
I remember I felt pretty comfortable when I went to NIMH because I had
been doing work for some time in the mental health area and in the
health risk behavior area, and I felt pretty comfortable. I’d worked
mostly in psychiatry departments. I felt pretty comfortable when I got
to the NIMH.
My next move to NHLBI I knew some of the same health risk behaviors were
still important, but my understanding of cardiovascular science was next
to nothing, and so this will sound like I’m really a geek, but on the
vacation I had between NIMH and NHLBI, I took the textbook of
cardiovascular science with me to the beach and I spent my week reading
about cardiovascular function and cardiovascular diseases and all those
sorts of things—not necessarily because I wanted to understand it at the
level that my cardiovascular research colleagues did, but at least
understand the language and understand the type of things they think
about and the things that they worry about.
And I think that’s also important, that you quickly immerse yourself in
the work that you have to do with your biomedical colleagues and try to
get up to speed. Read their literature, look at research that they would
typically look at and read periodically, and I think all of these things
Sticking with training for a minute, what are, or are there, other
careers for PhD students who are trained in the behavioral and social
sciences, other than research?
Yeah, there’s a lot of areas. And I think we actually helped sponsor,
along with NSF, a few years back a National Academies report on graduate
training in the behavioral and social sciences that’s worth people
taking a look at. It’s an easy workshop report to find on the National
And our concern there was exactly what you’re asking about, Judith,
which is we continue to train as if we believe we’re cloning more
behavioral researchers; they’re just going to go into academia and do
exactly what everybody else has done all this time.
In reality, that’s not what happens. We have more and more social and
behavioral scientists that go into the private sector now than ever did
before, particularly in some of the technology and computer science
areas and that sort of thing. So that’s certainly one area where people
had been doing this work and actually doing research; it’s just not
research that gets published, but research in human factor analysis and
lots of other things like that.
There’s obviously people who still do practice in the field—still also
very important. I was trained in the Boulder Model, in which research
influenced practice and practice influenced research. I don’t know that
that model has held up as well as it probably could, but I really do
appreciate my colleagues who do both. And there was a time when I
actually did both, but it’s a hard thing to do.
It’s hard to be in practice and get the research done that you need to
get done as well. But I think that’s a helpful way for people to think
about that integration from research and practice also.
And then there’s obviously government work, which I think most people
don’t think about, and policy work and those types of things. There’s a
lot of people that I know who are behavioral and social scientists by
training who are in more sort of government administrative positions,
and you would say, “Well, what’s the rationale there?”
But it’s still mostly, policy is really primarily changing human
behavior, just at a higher level than at an individual level. And
understanding how people function, how they behave, how policies will
influence or impact them, what the consequences are, including the
unintended consequences, are all things that I think behavioral
scientists have the ability to be able to do in that space as well.
We have some COVID-19 questions. One of the questions has to do with
what areas in research on COVID-19—and I assume this is behavioral
research on COVID-19—do you think have been ignored or under-discussed?
And how can people begin to improve data collection from minority
communities such as incarcerated people or undocumented immigrants?
Gosh, there’s so many. I don’t know that they’ve been ignored. I think
there’s different levels of prioritization as people think about this.
I think for me, one of the things that struck me as this epidemic has
moved along and as people have done what, from my perspective, are
essentially social and behavioral interventions at the public health
level, one of the things that has struck me is that they eventually come
to figure out what it is that the research would have told them has been
in the research literature for 20-plus years.
So one of the things that I think gets ignored is that we’re slower to
make some of the implementations that we probably should make because
people really aren’t looking at the literature. They’re still thinking
of this as a commonsense solution as opposed to what does the research
tell us about how people adhere to hand washing? And what does it tell
us about paid sick leave and its impact on transmission rates and
reducing transmission rates from the flu epidemic and those sorts of
I will tell you one of the things that struck me in the early days of
this epidemic, Vice President Pence was saying at one point that he had
talked to some governors, and they were talking about the importance of
paid sick leave, and I had to keep my head from exploding because
there’s truly 20 years of literature on the impact of paid sick leave on
reducing transmission rates in the workplace. It’s there.
We have some pretty decent data on how well it’s quantified, those types
of things. So when you ask about what’s being ignored, a lot of times I
think it’s what’s being ignored is research that’s already out there
that’s not being adequately translated into policy and translated into
the things that we need to be able to do.
On the other question about the particular populations, it’s an area
that the NIH has been really interested in, trying to see how do we do
outreach in some of these areas where there have been particularly
significant impacts, incarcerated individuals is certainly one. The
issues having to do with the increases in rates among minorities,
increasing rates of death from COVID-19 and those sorts of things, and
trying to better understand…our assumption right now is that’s mostly
because of the comorbidities that they carry with them into being
infected, but it might also have to do with access to care and how
quickly they get in and all of those various things as well.
So understanding that a little bit better, I think, would be important
also. But I do think the question about incarcerated groups, if I step
back from that a little bit, the thing that I think is important for all
of us to think about is the community/sociological perspective about how
it is that people get infected, and what goes on, and the networking
phenomena that are a part of that. How people interconnect or don’t
interconnect. How they live together or don’t live together. All of
those factors are important in this transmission rate.
And if you look at most of our models, we use, appropriately because
that’s what models do, they simplify all of that into some basic
transmission rates, and that’s an area where I think, especially among
the places where we’ve had the biggest problem, which is groups that are
housed together—nursing homes, prisons and jails, those sorts of
things—those are places where, in retrospect, we could have moved a
little quicker to stop that infection rate at an earlier time.
Turning to another direction. You mentioned that one of the issues in
your strategic plan was improving the pipeline from basic to
translational research. So this is a two-part question again. Can you
tell us what you mean by basic behavioral research, and how do you
propose to improve the pipeline?
In two words or less. Basic behavioral research, all the work that we’ve
done in attention and learning and memory is one example. Most
behavioral interventions are learning interventions, right?
Understanding better how people learn, how they respond, the type of
things…the incentive structures that work or don’t work for them. Recent
research in self-regulation and attentional bias. There’s lots of
research areas in the basic behavioral sciences that have to do with
understanding why behavior occurs and in what context, and what are the
factors that lead to people behaving or not behaving in certain ways?
So there’s a large basic behavioral and social science research
portfolio at the NIH, even a larger one at the National Science
Foundation. So that’s the kind of research we’re talking about.
And in the early days of behavioral interventions, we drew from basic
research to generate the behavioral interventions that we now currently
do. So when I was coming up in graduate school, I was learning about how
to treat phobias and panic and obsessive-compulsive disorder based on
basic operant and social-learning factors and basic research in that
area that led us to the interventions that we developed as a result of
We still do some of that, but my sense is that that translation is not
as strong as it could be. So one of the things that we’re trying to do
with our applied researchers, you have to kind of do this on both sides,
one is to make sure that basic research is thinking about what’s the
plausible pathway to health, the health outcome that needs to be
addressed, so that we’re targeting our basic research that we fund more
clearly toward that pathway.
And that doesn’t mean people always have to do translational research,
but they have to, in the back of their minds as basic scientists, at
least think about a plausible pathway that will get us to some applied
outcome, I think.
And then on the applied side, one of the things that I think we need to
do is incentivize researchers more to be able to pull from that basic
research that’s going on right now and develop novel and new strategies.
Right now I feel like we do too much applied research that’s basically
adaptations of existing interventions. We tweak them, we modify them a
little, we add this piece, or we subtract that piece, but in terms of a
new, novel component that hasn’t been done before, we don’t have as much
of that happening.
So we’ve been beginning to work on how do we incentivize that a little
bit more, and I think there’ll be more that we’ll be doing coming out in
the next year or two that will have to do with that as well.
You mentioned just now NSF, so this is a good time to ask. Does OBSSR
work with other government agencies? And if so, how?
We work with pretty much all the agencies that have a behavioral and
social science component to them, which is quite a few. We do have a
close relationship with the National Science Foundation. I serve as an
ex officio member of their advisory council for their social,
behavioral, and economic directorate. So we have that connection there,
and we work with them on a couple of cross-cutting projects as well,
including the graduate training effort with National Academy that I
mentioned a while back.
We also have pretty considerable interagency work with the CDC, with
HRSA, with AHRQ, with a lot of the more applied and public health end of
the spectrum in terms of adoption and improving adoption of some of the
research that the NIH funds to try to improve that effort. So we’ve done
some of that as well.
And then there’s actually an interagency group of social and behavioral
scientists that began under the Office of Science and Technology Policy,
but things have changed recently but we’ve kept the group going, which
is just representatives from all the various agencies—education,
justice, Department of Defense, etc. And in all of those areas there are
people doing really interesting social and behavioral research and also
applying that research to practice.
In the risk area, for instance, the people at NOAA and the people in the
weather service and that sort of thing think about this pretty often.
The people in environmental safety think about this pretty often. So
those are all areas where I think there’s a lot of interagency
interaction in this research space.
Thank you. Question about intramural research in behavioral and social
science. Which institutes and what kinds of things are they doing?
There’s a few. I would tell you I wish there were more in the intramural
space in social and behavioral
science than we currently have. But I think there’s a good basic group
of researchers in the intramural space doing this work. NHGRI has an
entire branch looking at social and behavioral aspects of genetic
testing and various aspects having to do with gene-environment
interactions, epigenetic research, and that sort of thing, so there’s a
fairly strong group there.
There’s a strong group at NIDA and NIAAA having to do with addiction and
substance abuse and behavioral interventions for that, as well as
behavioral assessment of those phenomena. So there’s a good group of
people working in that area.
There are some people more in the epi-survey- modeling area, the
population health research area, and they’re across the board. NIMHD has
a strong group there. Fogarty has some people really doing some
interesting modeling work in the behavioral sciences as well.
So there’s a spattering, I guess, across the various intramural groups
doing this research. One of the things that our office has been working
on is trying to get them connected and integrated with one another a
little bit better. I think they all feel a little siloed in their own
little institutes or the intramural space that they work in. So trying
to connect them better. And then once we have that, again, trying to
integrate better with some of the biomedical research that’s going on.
You mentioned a couple of times, the word “modeling” came up. We know
that requires strong computational and statistical skills. Can you talk
about whether and how behavioral training includes quantitative
training? How much of this do students learn in their graduate studies?
They learn a lot, but I wish they would learn more. I will say in a
graduate studies meeting we had, one of the people was talking about
their quantitative social science program, and nobody remembered from A
Few Good Men when it was asked whether it’s grave danger and he said,
“Is there another kind?” For me, is there another kind of social science
other than quantitative social science?
At the basic level, I think we get left behind if we don’t keep up with
some of the more cutting-edge advances in computational, statistical,
modeling, AI research that’s going on and using those for social science
and behavioral science research. So one of the things I’m always telling
trainees is whatever amount of quantitative research background you
think you have is probably not enough and learn more.
I feel very rusty because it’s been a long time, but we’ve moved from
statistical research, which is still a key base of the statistical
analyses that we do, and those, of course, have improved and advanced
over time. The computational modeling approaches, I think we’re seeing
behavioral and social scientists using that more and more, and that’s
great to see, and that also connects us to our computational
neuroscience colleagues a little better as well.
So it’s nice to see that work, and that gets us more into the modeling
space, and then the machine learning and AI approaches that have been
going on have also been sort of a nice space where I’ve seen,
particularly in the social sciences, some interesting work doing machine
So in all of that, it’s not that you have to know all of that, it sort
of feels like to me the same as when I read a cardiovascular textbook
just to make sure I got up to speed. You don’t have to be an AI
specialist, but you’ve got to know the language, you’ve got to know what
it’s able to do, you’ve got to know what things are its weaknesses and
strengths and be able to work with people who have those AI skills to be
able to analyze the data.
You mentioned the use of mobile devices in various behavioral
applications. Can you tell us a little more about that, especially in
the current environment with COVID-19, how the use of mobile devices
might expand for behavioral health?
Yeah, an area near and dear to my heart. This is one of the areas I feel
like I still have a little expertise in.
After a while you become sort of a generalist and can’t remember what
you had your expertise in. But the mobile health space, I think, again
broadly defined—so it’s not just smartphones but it’s smartphones and
sensor technologies and wearables and that sort of thing as well—has
really exploded and really, I think, created almost a paradigmatic
change in how we assess behavior so that what we typically did was ask
people primarily, or we had to do direct observation of what they did in
We now have this remote, unobtrusive, fairly temporally dense way of
observing people, but observing them via the sensor technologies and the
other things we have available to us through smartphones and that sort
of thing. So the ability to be able to sense behavior, sense the context
of that behavior, has really, I think, been a major change for the
One of the projects that we lead right now is called the Intensive
Longitudinal Health Behavior Network, and that network specifically
looks at using all the cutting-edge technologies we currently have
available to us to monitor behavior and to monitor context in real time
as closely as possible and temporally densely as possible to better
understand the factors that lead to change within people over time.
Most of our data in the behavioral and social sciences is really
individual differences between people and not differences within people
over time. And so it allows us to do a much more fine-grained analysis
of behavior and its contexts and its mechanisms and the things that
change as we move forward. So I think that’s been a really great boon in
And then, of course, the other thing that people mostly think about is
mobile health as a remote, scalable intervention, and being able to use
it for intervention purposes without having to have someone sitting
right in front of you to be able to do that. That has, in some cases, in
some situations, had good outcomes, in other situations more mixed and
more modest outcomes.
So I think there’s a lot of work yet to do on how we improve the
intervention that goes on remotely via mobile devices. But I think
there’s a lot of promise that is still there. And the other thing I
would just mention about that, marrying those two together does what we
call just-in-time adaptive interventions in which we often talk about
precision medicine, which is essentially a tailoring at baseline. We
determine based on baseline data how we’re going to treat this person.
Adaptive interventions in the mobile space really is we’re collecting in
real time data about the person and their behavior and the context that
they’re in and adapting our intervention over the course of the
intervention based upon the data that we’re collecting. And actually
there’s some AI applications of that that have been really interesting
to see as well. So it’s the marrying of the intense behavioral
assessment we can now do with those devices and then delivering
interventions that adapt to that data as well.
I’m going to put you on the spot with this question. In the last several
years, what would you consider to be some of the great triumphs of
I think there have been quite a few, if you think through some of the
things that have happened. We’ve had sort of the old list. Let me start
with a couple of the key ones there. I truly think that what we’ve done
in terms of changing smoking behavior over the course of our lifetime
has been a critical triumph and continues to be so. The one that’s now
coming is can we do a similar thing with e-cigarettes?
In the diabetes prevention space, that’s been around for some time as
well, but now out in the field and implemented in some regular basis to
do diabetes prevention using some of these behavioral techniques. I
think some of the work having to do with interventions in mental health
conditions, especially—I mean, we started with anxiety and depression,
but some of the research now, even in more severe
conditions—schizophrenia and bipolar disorder—some of that research has
been really nice work.
And again, I think one of the things that we’ve struggled with when you
look at accomplishments is how much better those would be if they were
fully implemented, if people actually did what the research suggested
you ought to do in those situations. Our work in adherence has been,
particularly in HIV, and of course the implementation effort right now
in HIV is particularly around implementation of what we already know is
So implementation science would be another area where I think there have
been some triumphs both for biomedical interventions and behavioral
interventions—how we go about making it more likely that people will
implement them moving forward.
I think we have time for one last question, and this one goes back also
to a career-related thing having to do with a career at NIH in the
behavioral sciences. And by this I’m guessing that the person is talking
about extramural kinds of positions rather than intramural research. Can
you say something about that?
There’s a really nice cadre and network of social and behavioral
scientists that work at the NIH in the extramural setting. They work
across almost all the institutes and centers. One of the nice things
that you can see from my career path has been that you can bounce from
institute to institute because social and behavioral sciences are
applicable across a lot of those, so you don’t have to be
institute-specific or disease-specific in where you think about
potentially landing at the NIH.
And the only thing I’ll mention as well, Judith, is when I left the
private sector to come to the NIH, I thought, “This will be a nice
sabbatical. I’ll do it for a few years, and I don’t know that it will be
that interesting, but I’ll at least learn how they work on the other
side and I’ll go back out.”
And here I am 15 years later. I found it particularly challenging and
important, and the ability to shape the field and work with the
community more broadly has just been a wonderful aspect of what I do on
a daily basis.
We’re glad that you’re here and that you stayed. And with that, I want
to thank you very much. This was incredibly interesting. I hope everyone
enjoyed it. Thank you all very much.
Thank you, Judith.
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