odologies. Each committee member brought to the table their own perspective about what would be most effective, but the data were inadequate to convince any of the experts of a best approach to shaping and maintaining behavior change. While conventional wisdom tells us that we need to do more exercise, eat less, avoid tobacco, wear seatbelts, and be careful with firearms, deciding what specific interventions to produce and sustain these changes presents a dilemma.

A critical obstacle to answering definitively the question of what works best is the difficulty of generalizing the findings of current studies. Many factors contribute to the problem: outcome measures among the studies differ, populations studied differ, and methodologies differ. For example, an intervention may be exceptionally effective on a highly motivated population but fail for the general public. Measurement of a behavioral outcome such as self-reported tobacco use is difficult to compare with an outcome measure such as change in sales of tobacco. Another obstacle is that there are no rigorous evaluations of interventions. Evaluations may assess short-term changes, but long-term effectiveness should also be assessed because maintaining behavior change has been shown to be difficult. Only with additional research and evaluation of interventions will the best approaches be found. This report presents the current level of understanding and demonstrates the limits of the currently available research.

In preparing this report, the Committee on Health and Behavior: Research, Practice and Policy examined recent scientific advances about the biological, psychological, and social determinants of health and about the nature of the interactions between health and behavior. It also looked at research addressing interventions intended to change health-related behavior, cognition, and emotions, or interactions with the social environment (i.e., psychosocial factors) with the aim of improving health. Finally, it considered how to translate this knowledge from research to application.

The committee approached its charge with a broad vision of a variety of basic and applied sciences. This broad approach facilitated the recognition of relationships among different determinants of health and from various scientific disciplines. The tradeoff is that some subjects were not treated in depth or at all in the report, although wherever possible references are provided for readers who would like more information. The overall findings and recommendations appear at the end of this summary.



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