Behavioral and Social Sciences Research Branch

Dr. Melissa Riddle, Chief
riddleme@mail.nih.gov, 301-451-3888






Dr. David B. Clark
clarkd2@mail.nih.gov, 301-594-4814

Overview

The Behavioral and Social Sciences (BSS) Research Program supports basic and applied BSS research to promote oral health, to prevent oral diseases and related disabilities, and to improve management of craniofacial conditions, disorders and injury. The BSS research program views oral health as one component of a larger system of health and well-being, and encourages both basic and applied research that incorporates other aspects of health and well-being that contribute to oral health. This view of oral health as a component of general health builds on the Surgeon General’s report on oral health in America (2000), and on the 2007 report of the Office of Behavioral and Social Sciences Research (OBSSR), National Institutes of Health. Links to the full text of these reports are included at the bottom of this webpage.

Multidisciplinary and team science

The program aims to draw on the expertise of researchers from multiple fields of study, including those with a focus on basic and clinical oral health, and those from other fields whose research might be applicable to oral health. Depending on the research questions of interest, projects may draw from the theories, measures and methods of a single scientific discipline, or from those of multiple scientific disciplines. NIH now recognizes multiple principal investigators on research applications, so that investigators from different scientific disciplines, or within a single discipline, can collaborate and receive appropriate credit for significant contributions (http://grants.nih.gov/grants/multi_pi/).

Methodologies

The BSS research program encourages the use of a variety of methodologies, depending on the research questions of interest. For example, studies may utilize randomized clinical trials methodology, or may utilize other methods such as single-case, within-subjects, historical control, microanalytic change process, and other designs. Studies are strongly encouraged to utilize methods that allow for a test of mechanisms of action. Mechanisms of action are causal explanations for behavior. These are distinguished from correlates, predictors, mediators, moderators, risk and protective factors, etc., which may be candidate mechanisms, but have not been demonstrated as having a causal link with the outcome(s) of interest. For further guidance on addressing mechanisms of change in BSS research,  please see the materials and archived video presentation of an NIAAA-sponsored symposium entitled, “Spring 2008 Symposia Series on Mechanisms of Behavior Change: Why People Change,” 2/27/08.  Also, please see resources and funding opportunities developed by the NIH Common Fund related to the science of behavior change: http://commonfund.nih.gov/behaviorchange/.

Research Areas of Interest

Health Behaviors Research

Basic health behaviors research clarifies how health behaviors, including oral health behaviors, develop and are maintained across the lifespan. Examples include, but are not limited to:

• Studies that develop and test novel theories or novel applications of existing theories of initiation and maintenance of health behavior, and/or of health behavior change.
• Studies that identify the mechanisms by which children and/or adults learn and maintain oral health behaviors.
• Studies that compare psychosocial determinants of several health behaviors, e.g., nutrition choices, oral hygiene, exercise behavior, or other self-care behaviors.
• Studies that identify modifiable behavioral or social barriers to the initiation and maintenance of oral health.
• Studies that identify individual, family, and/or community resources or strengths upon which oral health prevention or treatment interventions could build.
• Research developing and validating psychosocial instruments or methods that measure under-studied mechanisms of health behaviors.

Applied health behaviors research develops and tests interventions that promote oral health. Interventions may target prevention of oral disease, or appropriate treatment for an existing oral or craniofacial condition, disease or injury. Interventions may target a general, specific or clinical population. Development and testing of community-wide or public health interventions to promote health and oral health are also encouraged. Examples include, but are not limited to:

• Studies that test interventions to improve oral health self care
• Studies that test interventions to increase appropriate engagement in professional preventive or restorative oral health care, or participation in recall or follow-up visits
• Studies that test interventions targeting health behaviors associated with oral health (e.g., tobacco or other drug use, nutrition, etc.)
• Studies testing interventions to address health conditions or behaviors that are associated with oral health (e.g., diabetes, eating disorders, drug abuse or dependence, etc.)
• Studies developing and testing community interventions to be delivered to broad (e.g., “universal”) populations, e.g., at schools, work places, social centers, places of worship, etc.
• Studies developing and testing oral health campaigns utilizing media, such as television, radio, internet, etc.
• Studies developing and testing strategies for removing barriers in accessing oral health care.
• Studies that develop and implement curricula to train oral health and other health professionals in the identification, prevention, and management of behavioral and social factors relevant to oral health (e.g., screening, brief intervention, and referral for smoking cessation, diabetes management, eating disorders, etc.)

Stress and Health Research

Basic research clarifies how behavioral and social factors influence inflammation, wound healing, immunity to infection, and other health and oral health outcomes. Examples include, but are not limited to:

• Laboratory-based studies testing the effects of experimentally-manipulated stressors on immunity.
• Real-time assessment of naturally-occurring stressors and immunity outside the laboratory.
• Testing the use of salivary-based diagnostics of stress and immunity (e.g., patient acceptance, feasibility, compliance, etc.).
• Research developing and validating psychosocial instruments or methods to measure stress or stressors related to oral health.

Applied research develops and tests interventions to improve wound healing, immunity to infection, and other health outcomes relevant to oral health. Examples include, but are not limited to:

• Research testing the effects of a stress-reduction behavioral intervention on wound healing after invasive dental procedures.
• Research testing the effects of a behavioral intervention on immune function and oral complications among immune-compromised patients.
• Research developing or adapting an existing stress-reduction intervention for use in oral health care settings, e.g., to improve engagement and retention in treatment.

Pain Research

Basic pain research clarifies the mechanisms linking psychosocial processes (e.g., cognitive, emotional, behavioral, and social processes) and the experience of acute and/or chronic pain. Examples include, but are not limited to:

• Research testing the psychosocial determinants of acute pain perceived during dental procedures.
• Research testing the contribution of psychosocial processes to the onset, exacerbation, or resolution of persistent or chronic craniofacial pain conditions (e.g., temporomandibular joint disorders, headache and migraine conditions, burning mouth syndrome, Sjogren’s Syndrome, etc.).
• Research identifying modifiable behavioral or social barriers to effective management of acute or chronic pain.
• Research identifying individual, family and/or community resources or strengths upon which effective pain management interventions could build.
• Research developing and validating psychosocial instruments or methods to measure pain.

Applied pain research develops and tests interventions to prevent or manage acute and/or chronic pain conditions. Examples include, but are not limited to:

• Studies developing and testing novel behavioral or social interventions to improve management of chronic craniofacial pain conditions.
• Studies adapting and testing interventions used in other areas of pain management for craniofacial pain management.
• Studies of complementary or alternative techniques for pain management (e.g., acupuncture, meditation, exercise, etc.).
• Research developing and testing behavioral interventions for health care providers to improve delivery of care for individuals with chronic craniofacial pain conditions.
• Research developing and testing structural or organizational interventions to improve delivery of care for individuals with chronic craniofacial pain conditions.

Health Communication Research

Basic health communication research clarifies the role of health communication in oral health, including communication between patients and oral health care professionals, communication between oral health and other health care professionals, oral health literacy (i.e., an individual’s ability to utilize oral health care), diffusion and dissemination of health information, etc. Examples include, but are not limited to:

• Research identifying the mechanisms by which communication between patients and health professionals promotes effective oral health care.
• Research identifying health communication content, delivery media, source, frequency, etc. that successfully leads to oral self care and/or engages patients into professional preventive care or treatment.
• Studies identifying successful systems of multidisciplinary referral, communication and/or collaboration between oral health professionals and other health professionals who treat complex patients.
• Studies developing and validating psychosocial instruments that measure under-studied aspects of health communication.

Applied health communication research develops and tests interventions to improve oral health by improving oral health communication among patients, communities and oral health care professionals. Examples include, but are not limited to:

• Studies that develop and test interventions to train oral health professionals in the most effective communication methods.
• Studies that develop and test interventions that improve oral health care in general populations or in specific populations.
• Studies that develop and test systems of multidisciplinary referral, communication and/or collaboration between oral health professionals and other health professionals who treat complex patients.
• Studies that test models for integrating relevant BSS concepts and interventions into existing oral health curricula and educational systems.

Research on Managing Serious and/or Chronic Illness

Basic research clarifies the mechanisms by which serious and/or chronic craniofacial illnesses (e.g., temporomandibular joint disorders, craniofacial anomalies and injuries, oral, head or neck cancers, oral complications of HIV infection, etc.) are related to patient, family and social functioning. Basic research also clarifies the barriers to better oral health for individuals with serious and/or chronic illnesses (e.g., those with congenital or acquired cognitive, neurological, or psychiatric conditions; those with cancers, HIV or AIDS, diabetes, etc.). Examples include, but are not limited to:

• Studies clarifying the mechanisms by which serious and/or chronic illness impact patient, family and social functioning.
• Studies clarifying the mechanisms by which patient, family and social functioning contribute to successful management of serious and/or chronic illness.
• Studies adapting models of chronic disease management to serious and/or chronic craniofacial diseases.

Applied research develops and tests interventions to support patients, families and others in the social environment in managing serious and/or chronic craniofacial conditions or illness, including temporomandibular joint disorders, craniofacial anomalies and injuries, oral, head or neck cancers, oral complications of HIV infection, and others. Applied research also develops and tests interventions to eliminate barriers to better oral health for individuals with serious and/or chronic illnesses (e.g., those with congenital or acquired cognitive, neurological, or psychiatric conditions; those with cancers, HIV or AIDS, diabetes, etc.). Examples include, but are not limited to:

• Research developing and testing interventions to support parents in caring for children with craniofacial disorders or injuries.
• Research adapting and testing interventions used with other serious or chronic illnesses for use in improving management of craniofacial disorders or injuries.
• Research developing and testing methods of clinical training for health care professionals in effective management of craniofacial disorders or injuries (e.g., screening patients on psychosocial functioning, brief advice to prevent risky situations related to craniofacial injuries, referral to specialty care if needed, etc.).
• Research developing and testing interventions to improve oral health care for patients with chronic and/or serious illness.

Cross-Cutting Research Areas

Health Disparities

Across all areas of NIDCR’s BSS research program, and both in basic and applied research, investigators are encouraged to address the needs of special populations where disparities in health have been identified. Regarding oral health, these special populations include racial and ethnic minorities, those with limited income and other resources, those who are geographically isolated, those with compromised immunity, those who are institutionalized, and elderly populations. The disparities of particular interest include the burden of oral diseases experienced; access to, and utilization of, preventive care and treatment; and outcomes of care.

For further information about NIDCR’s Health Disparities Research Program, please contact:

Dr. Ruth Nowjack-Raymer
Email: Ruth.Nowjack-Raymer@nih.gov
Telephone: 301-594-5394
http://www.nidcr.nih.gov/Research/DER/ClinicalResearch/HealthDispar.htm

Models, Methods and Measures Development

Across all areas of NIDCR’s BSS research program, and both in basic and applied research, development of models, methods or measures may be necessary in order to test the research questions of interest. Studies that develop and test models of oral health behavior, or adapt and test models of oral health behavior that have had utility in other areas, are encouraged. Studies that develop and test new methods, or new applications of methods, for BSS research in oral health also are encouraged. Studies that develop and test new measures, or adapt existing measures, to test mechanisms of interventions related to oral health are of high priority. Measurement approaches that are innovative, convenient, and cost-effective are especially encouraged because of their applicability within community and health care settings, although method and measure quality is of highest priority.

For further information about NIDCR opportunities related to models, methods and measures research, please contact:

Dr. Melissa W. Riddle
Email: riddleme@mail.nih.gov
Telephone: 301-451-3888

Research Training and Career Development

Across all areas of NIDCR’s BSS research program, and both in basic and applied research, the development and training of investigators who are equipped to conduct BSS research related to health and oral health is an essential component of the field’s success. Research training is supported for investigators at all career stages: undergraduate, predoctoral, post-doctoral, early independent career, mid-career, and senior scientist. BSS research related to oral health may benefit from a multidisciplinary or interdisciplinary perspective, and so training experiences that provide participants with exposure to multiple fields are encouraged.

For further information about research training and career development at NIDCR, please contact:

Dr. Lynn Mertens King
Email: Lynn.King@nih.gov 
Telephone: 301-594-5006
http://www.nidcr.nih.gov/CareersAndTraining/

Additional Resources

• For the full text of the Surgeon General’s report, please see the following website:http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/ 
  
  The suggested citation is:
  U.S. Department of Health and Human Services. Oral Health in America : A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.
  
  
• For information on the Nation’s overall goals related to oral health in America, please see the Healthy People 2020 oral health objectives: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=32 
  

Contact Information

The BSSRB programs are managed using a team approach. For more information about any of the programs supported by BSSRB, please feel free to contact either Dr. Riddle or Dr. Clark. Because of our training and experience, there is a designated lead program officer for the following areas, whom you are welcome to contact directly: