IBTN 2020 Session 3A: Behavioural Treatment Development: A Framework for Progression

Duration: 23 minutes

Presented by Lynda Powell, PhD

View the Q&A session

Speakers have kindly provided responses to questions submitted by conference participants during the Discussion session that did not get an opportunity to be discussed.

  1. Question from Simon Bacon – It is clear that there is an importance to do more development work for interventions, but how do we balance this with getting funding and publishing? This is especially true for junior faculty.

Some funders do support development work including feasibility studies and qualitative work. But we may need to do more lobbying of funders and publishers – and this response is relevant to some other questions below.

Marie Johnston – moderator
  1. Question from Jovana Stojanovic – In terms of prevention, and ever limited health care resources, how do you think behavioral trials can be optimized to influence policy-level changes and increase their implementation in health care systems?

Policy-level changes are most likely to be influenced by large trials or systematic reviews. And this is exactly what the BMRC is promoting [Freedland, K. E. (2019). The Behavioral Medicine Research Council: Its origins, mission, and methods. Health Psychology, 38(4), 277–289. https://doi.org/10.1037/hea0000731]. In the UK it is more difficult to get support for prevention than for healthcare – is this true everywhere?

Marie Johnston – moderator
  1. Question from Eric Hekler – As you mentioned, most early trials fail and that’s a good thing. Based on this, what do you think the right proportion of funding to enable proof of concept work? What also, about how there is an implied linear pathway to getting the “big” grants that translate into “academic success?” Our Tenure and promotion imply that we can’t fail. How do we shift financial and cultural norms to enable us to do the more Small N work we need to reduce waste of funds and resources?

When a trial fails, it only fails as an application, it should not fail as science – we should be able to learn something from it. Regarding work with small numbers, the key thing is the quality of these small studies – can they answer a question? We have had success in publishing small N studies that investigate whether theoretical predictions supported in large between person studies are also supported within persons. I have no specific suggestions for funding.

Marie Johnston – moderator
  1. Question from Leonardo Reynoso – In my country, we cannot randomize people for different conditions (treatment/control) in hospitals, so we need to work n=1 designs. Any recommendation about this?

These two papers may be helpful: McDonald, S., Quinn, F., Vieira, R., O’Brien, N., White, M., Johnston, D. W., & Sniehotta, F. F. (2017). The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: a systematic literature overview. Health Psychology Review, 11(4), 307-323. and Shaffer, J. A., Falzon, L., Cheung, K., & Davidson, K. W. (2015). N-of-1 randomized trials for psychological and health behavior outcomes: a systematic review protocol. Systematic reviews, 4(1), 87.

Marie Johnston – moderator

There is a growing literature about N-of-1 designs, which can be very useful. But I’m surprised to learn that RCTs are not possible in your country and would like to learn more about that.

Evan Mayo-Wilson – presenter

PLEASE NOTE: Though numerous questions were submitted by conference participants, only the questions for which we obtained responses are shared here.