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The HBB designs and conducts behavioral and observational research to identify determinants of health behavior and to test the efficacy and effectiveness of educational, behavioral, and environmental strategies for improving or protecting maternal, child, and adolescent health. The research is conducted within an adolescent development framework and focuses on the influences of individual characteristics, parents, and peers on adolescent health behavior.
The HBB also provides service to the Division, Institute, NIH, DHHS, and the profession via consultation, collaboration, and assistance to advance the goals of the Institute; and recruits, trains, and mentors highly qualified students and trainees at various stages of their careers to position them for professional careers in health behavioral research.
There are three main areas of ongoing research: young novice drivers, family management of diabetes, and adolescent problem behavior.
To explore DIPHR's data sharing opportunities, please visit our
Biospecimen Repository and Data Sharing (BRADS) site.
- Adolescent Health Behaviors: NEXT Longitudinal Study: The NEXT Generation Health Study is a 7-year study of a nationally representative sample of 10th graders that started in 2009. It aims to improve our understanding of factors leading to the development of healthy and unhealthy behaviors during adolescence and young adulthood, including the effects of peer activity on adolescent health behaviors. Recent findings include:
- Using data from the NEXT Generation Health Study, HBB researchers investigated the consequences of peers’ escalating use of alcohol during 10th and 11th grades. Drinking with peers was related to an increase in alcohol use over time; this increase in use could be attributed to an increase in the perceptions of peer alcohol use, also known as “descriptive norms.” These findings provide further support for incorporating social norms into prevention strategies to reduce the harmful effects of adolescent alcohol use. (Brooks-Russell et al., Prevention Science 2014) PMID:23564529
- HBB researchers also conducted a series of studies on driving while impaired (DWI) and riding with an impaired driver (RWI) in the NEXT Generation Health Study. In the first study, they reported a high prevalence of DWI (13%) and RWI (24%) among 11th grade students (Li et al., American Journal of Public Health 2013, PMID:24028236). When they subsequently investigated risk factors for DWI and RWI, they found that risky driving behaviors predicted later DWI and RWI, and that younger age at licensure and exposure to RWI were associated with higher risk of later DWI (Li et al., Pediatrics 2014, PMID:24639277). Finally, they sought to determine the extent to which parents knew about their children’s DWI, and found that parents’ monitoring knowledge did not increase after their children reported in DWI (Li et al., Traffic Injury Prevention 2015, PMID:25941751). The findings suggest that comprehensive approaches to the prevention of DWI, RWI, and other risky driving behavior are needed; RWI and early licensure could be important prevention targets in reducing DWI; and further research is needed on intervention targets to enhance parental awareness of their adolescents’ impaired driving.
- Health Behavior Change in Medical Settings: Dietary Management of Type 1 Diabetes
- Among persons with type 1 diabetes, healthful eating is critical for long-term health, but is difficult to achieve. Diets of children with type 1 diabetes are often low in fruits, vegetables, and whole grains and high in foods of minimal nutritional value, both factors that increase risk for future adverse health outcomes. HBB investigators conducted the CHEF family-based behavioral nutrition intervention, which integrated motivational interviewing, active learning, and applied problem-solving to increase intake of whole plant foods among youth with type 1 diabetes. The intervention significantly improved overall adherence to dietary guidelines and increased intake of whole plant foods across the 18-month study period. These findings indicate the potential utility of incorporating such strategies into clinical care, and suggest that improvement in diet quality can be achieved in families living with this burdensome disease. (Nansel et al., International Journal of Behavioral Nutrition and Physical Activity 2015, PMID:25952160)
- Hypoglycemia is a common, acute complication of diabetes that typically increases in response to efforts to achieve optimal glycemic control. During adolescence, glycemic control typically worsens due to both hormonal and psychosocial factors. HBB investigators designed and conducted the WE-CAN Manage Diabetes trial to determine if a family-based, clinic-integrated behavioral intervention can prevent this decline in glycemic control without increasing the risk of hypoglycemia. The intervention used an applied problem-solving approach to help families more effectively identify and respond to difficulties implementing the diabetes management regimen. In the second year of the 2-year trial, concurrent with improvement in glycemic control, the intervention cut the risk of a hypoglycemic event in half (hazard ratio=0.49, p=0.02). Findings support the utility of this approach for improving health outcomes for youth with type 1 diabetes. (Gee et al., Diabetic Medicine 2015, PMID:25763988)
- HBB researchers led the development of a special issue of the Journal of Adolescent Health devoted to teenage driving. With initial funding from the NIH Office of Disease Prevention and further funding from NICHD, authors were commissioned to write review papers for the special issue. Bruce Simons-Morton guided the development of the reviews and served as the Editor for the special issue.
- One of the review papers focused on the effectiveness of parent-focused interventions, with considerable attention to the HBB Checkpoints Program (Curry et al., Journal of Adolescent Health 2015, PMID:25941751). It concluded that these programs can improve teenage driving safety when they are comprehensive and include multiple components.
- The second paper, by Kate McDonald and colleagues, including former HBB postdoctoral fellow Anuj Pradhan, reviewed the literature on hazard anticipation training programs for young drivers. The author concluded that the method has potential for improving teenage driving safety, but that research on long-term follow-up is lacking (McDonald et al., Journal of Adolescent Health 2015, PMID:26112734).
- Marie Claude Ouimet, another former HBB postdoctoral fellow, was the lead author on a paper about teenage passengers. The review concluded that peer passengers increased risk for fatal crashes, but that the literature was less clear about whether peer passengers increased risk in studies of non-fatal or fatal and non-fatal crashes combined (Ouimet et al., Journal of Adolescent Health 2015, PMID:26112735).
- Finally, long-time HBB collaborator Sheila Klauer and a team that included HBB’s own Johnathon Ehsani, described the state of the evidence on the association of secondary task engagement with driving performance and outcomes (Klauer et al., Journal of Adolescent Health 2015, PMID:26112736). The authors noted strong evidence that secondary tasks—those that take the driver’s eyes off the forward roadway (e.g., texting, dialing, answering calls)—were strongly associated with dangerous outcomes, particularly among teenager drivers.