A New Era for Basic Behavioral Research at NIH

A sustained effort launched by the Association for Psychological Science (APS) has resulted in an unprecedented boost for basic behavioral science at the U.S. National Institutes of Health (NIH) in the form of a cross-cutting structure — the NIH Basic Behavioral and Social Science Opportunity Network, or OppNet — that will fund $120 million of research through 2014.

OppNet didn’t happen overnight. It is the culmination of a process that began in the mid-1990s, when the U.S. National Academy of Sciences (NAS) called on NIH to support more behavioral science training, given the central role of behavior in health. NIH leadership rejected the NAS recommendation, reflecting an institutional lack of recognition of the importance of behavior in health and the research that looks at this area. Based on this and NIH’s history of resistance to making health and behavior a priority, APS concluded that the only remedy was a structural change at NIH and further determined that any meaningful structural change had to include a stable and visible program of support for basic behavioral research.

We made the case for change to NIH but, finding deep-seated opposition there, worked to bring pressure to bear on NIH from Congress, NAS, and other influential science policy organizations, all of which agreed that increased support for behavioral science, including basic behavioral research, was in the best interest of the nation’s public health and well-being. Eleven years, hundreds of communications ranging from testimony to informal conversations, dozens of Congressional directives, and numerous blue ribbon reports later, we have the OppNet program, a stable commitment to basic behavioral research that signals a new era for health and behavior at NIH.

That’s the condensed version of the OppNet odyssey. But take a few minutes to read the unabridged history and timeline. It is not only an APS success story; it’s also a classic example of the complex dance of science policy. (And of course, an alphabet soup of acronyms.)

A Disconnect Between Health Needs and NIH Policies

The new basic behavioral science initiative at NIH is rooted in an event that took place in 1994, when NAS issued its Congressionally-mandated quadrennial report on biomedical and behavioral science research training. Traditionally, that report was the vehicle through which NAS made recommendations to NIH about the number and size of National Research Service Award (NRSA) training grants in various disciplines, and NIH would generally adopt the recommendations in setting its training budget. But, in a departure from past reports, which looked at training in terms of the scientific job market, the ’94 report tied its recommendations for NIH training directly to health needs. Citing the central importance of behavior in many of the nation’s leading health problems, NAS said NIH should hold steady the number of biomedical NRSAs and increase the number of behavioral science NRSAs. NAS also said the dollar amount of NRSA stipends should be increased. That report included APS Past President Richard Thompson and then-APS Board member Nancy Cantor among its authors, with APS Executive Director Alan Kraut providing testimony about behavior and health.

In the intervening four years, NIH increased the amount of the stipends, but otherwise ignored NAS’s recommendations regarding behavioral science training. In 1998, as NAS was gearing up for its next training report, Kraut asked NAS to renew its previous recommendations for behavioral science training grants, suggesting that NAS could make it easier for NIH to implement the report by specifying institutes where behavioral science should be stimulated. As part of this, he asked NAS to “insist that the National Institute of General Medical Sciences (NIGMS) support behavioral research training.”  NIGMS’s mission is to support basic research in all disciplines; it is known as “the basic research institute” at NIH.

After his formal statement to the NAS training committee, Kraut talked informally with senior NIH officials also in attendance at the NAS meeting. It was clear from their comments, he recalls, that “there was a huge disconnect between health and behavior on one hand and NIH’s view of basic behavioral science on the other.”

“I remember walking back to the office, thinking that this was not going to happen from within at NIH,” said Kraut. “And that’s really when we launched our initiative to change the way behavioral science research and training, particularly basic behavioral science, were viewed and supported there.”

Congress Joins the Fray

That was in early 1998. A few months later, Kraut testified in the U.S. House of Representatives on NIH’s annual appropriations and explicitly asked Congress to strengthen basic behavioral science at NIH by creating a research and training program at NIGMS.That recommendation sparked a conversation between House Appropriations Committee Member Patrick Kennedy (D-RI) and Kraut that turned into a long-term collaboration between APS and Rep. Kennedy in support of research in health and behavior.

Along the way, several other key members of Congress joined the effort to strengthen basic behavioral research at NIH and establish a program at NIGMS, including Reps. Brian Baird (a clinical psychologist, D-WA), Tim Ryan (D-OH), James Walsh (R-NY), and Jim Leach (R-IA), and on the Senate side, Daniel Inouye (D-HI), Tom Harkin (D-IA), and Arlen Specter (then R, now D-PA). Their interest took the form of multiple letters to NIGMS and the NIH Director, a colloquy (a planned discussion) on the Senate floor, statements in the Congressional Record, meetings with NIH leadership and with psychological scientists, and a lot of discussion in the reports that Congress sends to NIH to explain the intent behind the annual budget numbers.

APS was central to these activities, all the while educating legislators and other science policy leaders about the nature of basic behavioral research and its potential to identify and understand the physiological, genetic, psychological, and social factors involved in health and behavior. As Kraut noted, “those outside of NIH often had a much more realistic picture of health problems” and recognized the central role of behavior in many, if not most, of the nation’s health problems. “There was greater recognition [by members and staff in Congress] of the importance of studying the fundamental behavioral processes that cause or manifest in health conditions — heart disease, high blood pressure, cancer, lung disease, obesity, suicide, teen pregnancy, drug and alcohol abuse, and addiction — all of these and many others are largely behavioral,” said Kraut.

The issue gained momentum over the ensuing years as the pile of Congressional directives to support basic behavioral research grew higher and higher against NIH’s stonewalling; it became an annual rite in which Congress would ask NIH to structure support for basic behavioral science and NIH would nimbly sidestep the topic, by delaying or deferring or simply not responding. In the next budget cycle, Congress would again ask and NIH would again demur.

But the pattern was disrupted in 2003 when, concluding as APS had done years earlier that this change was not going to come from within at NIH, Reps. Kennedy and Baird developed legislation to mandate the establishment of a program for basic behavioral science at NIH. News of the bill prompted NIH Deputy Director Raynard Kington to ask the legislators in a face-to-face meeting to hold off and to instead allow NIH to conduct a blue-ribbon study on the matter. Reps. Kennedy and Baird agreed, but warned that they were prepared to move ahead with their legislative solution if meaningful results weren’t achieved.

“You should know that we will need convincing if the task force concludes that, contrary to Congress’s stated opinion and current statutory authority, NIGMS has no significant role to play in basic behavioral research and training,” said Kennedy and Baird in a letter to Kington. “The fact that NIGMS has not funded much basic behavioral research in the past, or that it generally does not work with human beings is not a persuasive argument that NIGMS has no proper role to play in basic behavioral science.”

NIH Ignores Its Own Advisors

The pattern was disrupted in 2003 when, concluding as APS had done years earlier that this change was not going to come from within at NIH, Reps. Kennedy and Baird developed legislation to mandate the establishment of a program for basic behavioral science at NIH. News of the bill prompted NIH Deputy Director Raynard Kington to ask the legislators in a face-to-face meeting to hold off and to instead allow NIH to conduct a blue-ribbon study on the matter. Reps. Kennedy and Baird agreed, but warned that they were prepared to move ahead with their legislative solution if meaningful results weren’t achieved.

“You should know that we will need convincing if the task force concludes that, contrary to Congress’s stated opinion and current statutory authority, NIGMS has no significant role to play in basic behavioral research and training,” said Kennedy and Baird in a letter to Kington. “The fact that NIGMS has not funded much basic behavioral research in the past, or that it generally does not work with human beings, is not a persuasive argument that NIGMS has no proper role to play in basic behavioral science.”

“We know that much exciting behavioral research is being funded at institutes across NIH, but one of the central missions of NIGMS is to fund the basic science that can be translated across multiple institutes,” said the legislators. “This function is just as logical with respect to basic behavioral science as other basic research.”

NIH Director Elias Zerhouni formed the cumbersomely-titled Working Group of the NIH Advisory Committee to the Director on Research Opportunities in the Basic Behavioral and Social Sciences to assess the current status of those sciences at NIH and provide recommendations. The Working Group included Robert Levenson and Susan Fiske, both Past Presidents of APS, as well as APS Fellows Laura Carstensen, William Greenough, James Jackson, Richard Davidson, Bruce McEwen, and seven others.

During this same general time period, the National Institute of Mental Health (NIMH), which for years had been the traditional home for behavioral science research and training at NIH, began jettisoning its support for basic behavioral science in favor of more translational and mission-specific research. This development gave even greater urgency to the Working Group’s task because important areas of basic research that were being dropped by NIMH needed to find a home elsewhere in NIH.

After an in-depth review of NIH’s basic behavioral science activities, the group called for a stable infrastructure for the field much along the lines of what APS and Congress had been asking for. Specifically, the group noted that there was some support for basic behavioral science at a number of institutes — including the National Cancer Institute and the institutes on drug abuse and alcoholism, child development, heart, and infectious diseases — and that such programs should be encouraged to flourish at the individual institutes.

But, the group said, “there is a clear need for a home for basic behavioral and social science research that is critical for the NIH mission but does not fit into the framework of a particular developmental period or disease.” They cited the precipitous changes in priorities at NIMH as evidence of the vulnerability of this research.

At last! An NIH-convened panel of distinguished scientists all chosen by the NIH Director had taken a systematic look into basic behavioral science across all of the institutes and determined that there was a crucial gap in support. NIH couldn’t ignore the advice of its own committee, right?

If only.

In a characteristic display of institutional defiance, NIH’s leadership rejected the Working Group’s findings, and, in a 2006 report to Congress, said essentially, “Thanks, but no change is needed; everything’s fine with basic behavioral science here.”

Chaos ensued.

Ok, not exactly chaos, but at least what passes for chaos in science policy. NIH’s response was challenged by members of the Working Group, who, in a joint letter to Congress, said that NIH has grossly exaggerated the amount of support for basic behavioral science being supported by the institutes and that “the NIH response underestimates the impact of recent changes at NIH that makes the funding situation for basic BSSR even more dire.” The Working Group’s letter re-ignited Congress’ desire to see the stonewalling end, and the regular players once again stepped in to keep the pressure on NIH. Letters and meetings ensued, yada yada yada…by now it’s a familiar drill.

‘Stay Tuned, You’ll See Major Changes’

As Kennedy and Baird were gearing up to introduce their bill, Zerhouni stepped down as NIH Director in October 2008, and Kington was named Acting Director. In early 2009, Kraut met with Kington, who was a former Director of the NIH Office of Behavioral and Social Sciences Research, to see if they could finally come to a resolution on basic behavioral science at NIH. Although there were some philosophical differences on how to create the needed infrastructure, all agreed that the issue needed to move forward. Kington indicated that his office was developing a cross-NIH initiative toward this end, modeled on the existing NIH Neuroscience Blueprint, and that NIGMS Director Jeremy Berg and National Institute on Aging Director Richard Hodes were slated as its co-chairs. This was the early concept that would evolve into OppNet.

It also helped that during an NIH appropriations hearing, Rep. Tim Ryan (D-OH), one of the more recent Congressional members to join the fight, asked Kington for an update, and Kington essentially unveiled the initiative. “This is just getting started now and will be playing out over the next year,” he told Ryan. “I think this is the right approach. Dr. Berg and Dr. Hodes are committed to making this work. We’ve seen it work before and stay tuned, you’ll see major changes.”

Over the ensuing months details leaked out, and there were rumors of $20 or $30 million in the pot. Not so bad to start, we thought, but maybe this could be increased a bit? Then in early September 2009, the announcement was made: OppNet will fund $120 million in basic behavioral and social science research beginning in 2010 and continuing at least through 2014. The years of working with our Congressional allies and refusing to accept NIH’s “no” have produced a critical step forward for psychological science, one that will yield new insights into behavior and ultimately improve health and save lives.

APS is looking forward to working with NIH to shape OppNet and to make sure that Congress is aware of the progress in our fundamental understanding of the connections between health and behavior. But we’re also taking a moment to savor the success.

“I am so proud of the lead APS took on this,” said Kraut. “I can’t tell you how many times over the years our efforts here were met with teenage-like eye rolls (sorry, teenagers) by groups whose members will no doubt benefit from this initiative along with ours. ‘Pie in the sky’ they called it. ‘Too grandiose.’ They were right in one sense. It is likely the biggest infusion of behavioral and social science funding in history.”

What It Means for the Field

Others who worked hard on this issue are also savoring the outcome. “As a member of the Working Group, and as a research scientist, I came to realize how vital it is for us to argue explicitly for the importance of behavioral and social sciences to the nation’s health,” said Fiske. “The establishment of this new NIH initiative reflects that value.”

Her Working Group colleague Levenson agreed. “This is wonderful news for psychological science and for public health. Increasing NIH’s investment in basic behavioral and social science research will hasten the pace of discoveries in critically underfunded areas of basic science.”

“Moreover,” said Levenson, “these discoveries will have enormous implications for our understanding of the etiology, course, and amelioration of a broad spectrum of physical and psychological disorders. This recommitment to basic behavioral and social science research, overcoming what at times seemed like immovable opposition, is a tribute to over a decade of work by a highly dedicated group of visionary legislators, scientists, scientific organizations, and NIH leaders and staff. Bravo to all who fought such a good and important fight!”

The Office of Behavioral and Social Sciences Research is charged with coordinating OppNet throughout NIH. “OppNet is a great opportunity that will provide new funding for basic behavioral and social sciences research and will strengthen the NIH focus on these sciences,” said OBSSR Acting Director Chris Bachrach. “Almost all the NIH institutes and centers already fund basic research in these sciences; now we will be actively collaborating to promote new advances. Nothing could be more important: The NIH has a vital stake in drawing on these sciences to fulfill its mission.”

Individual institute programs are the framework of the NIH behavioral research enterprise, but the principle of the whole being larger than the sum of its parts is beautifully illustrated here. One of the many benefits of a cross-institute structure is the profound effect of having all of the NIH institute directors sit at one table on a regular basis to discuss the issues concerning basic behavioral science. Not only will institutes hear what each is doing in the field, but they will hopefully come to broad consensus about what is needed, which will benefit research progress and citizens as a whole. Another anticipated benefit will be a focus on training — a priority for APS and also the subject of many years of testimony and report language in Congress.

The genesis and development of OppNet had many supporters across NIH, including Robert Croyle, a social psychologist who heads the National Cancer Institute’s Cancer Control and Population Sciences Division. “OppNet will serve as a catalyst for a new set of collaborative initiatives that fully engages the leadership of the Institute and Center directors across the NIH,” said Croyle. “This engagement is essential to the long-term health of the psychological sciences at NIH.” One key aspect of OppNet will be its explicit emphasis on interdisciplinary collaboration, he noted. “It is essential that psychological scientists utilize this opportunity to expand interdisciplinary collaborations, rather than retreat into comfortable silos.”