New theory and further development of theoretical notions on health behavioral change is very much needed. There is a major disconnect that exist between what people know and understand that will do them harm and resulting destructive behaviors in light of that knowledge. We witness the phenomenon of sexual and drug related behaviors with full knowledge that such behavior(s) will have a high probability of HIV infection. Similar disconnect(s) exist with smoking and tobacco related behaviors even with the Surgeon Generals' warning printed clearly- hazardous for your health and may cause lung cancer and related diseases. People continue to light-up even with this knowledge and there is increasing evidence of an increase in smoking rates of teens and young adults.

We feel that a major breakthrough has occurred with the acceptance for publication of the book edited and co-authored, The Health Behavioral Change Imperative: Theoretical, Educational and Practice With Diverse Populations (2002- Lippicott, Williams and Wilkens-Kluwer Academic Press). The book content deals with the disconnect, focused on cultural, social, ethnic, faith and other critical behavioral variables that contribute heavily to health outcomes. The further development of health behavioral change theory and related public health prevention practice is critical. This need is recognized given the prevalence of HIV/AIDS, sexually transmitted diseases, cardiovascular disease, cancer, diabetes, violence and other preventable diseases. The up to ninety-eight per cent (98%) preventable disease rate among African Americans means that if the methodology was available regarding health behavioral change - prevention theory and related knowledge, morbidity and mortality rates could be significantly and effectively reduced.

[top]

GOALS OF NATIONAL CENTER

The health behavioral change theory and related public health practice development is dependent on utilizing the best minds in social and behavioral science medicine-psychiatry, psychology, counseling and sociology of health within a "think tank" - brain-trust format. The colleagues that co-authored the book, The Health Behavioral Change Imperative, is the core group of theoreticians and practitioners best qualified to engage in the theory building, practice development and research needed to educate the current and next generation of public health and community health professionals. Further, the group will be augmented with a psycho-behavioral pharmacist, a sociology of health scientist, a cultural and health anthropologist and other cutting edge social-behavioral scientists both as members of the core group and as Associate Fellows on research and specific theory building and practice developmental projects.

The socio-behavioral scientists and health scientists discussed above are designated as Senior Fellows in the Center for Health Behavioral Change. Projects may include Senior Fellows and Associate Fellows in various combinations given the nature of theory development and/or research being undertaken. Hence the goals are as follows:

1. To develop health behavioral change curricula materials including advanced learning modules, monographs, and occasional papers series for use by schools of public health, psychiatry, psychology departments and related disciplines.
2. To identify the most pressing research needs regarding health behavioral change and commission research and also submit proposals to agencies (i.e., NIH, NIMH, HUS) and foundations (Kellogg, Robert Wood Johnson, Pew, i.e.) to conduct research in behavioral change areas. The research will be conducted under the leadership of the National Center for Health Behavioral Change.
3. To develop training materials for practitioners of public health and related disciplines on cultural competence as practiced in cross-cultural behavioral change interventions in partnership with the Multicultural Task Force of the American Counseling Association and in partnership with NIH (presently under negotiation).
4. To provide technical assistance to Schools of public health and related disciplines in developing Health Behavioral Change Curriculum and to integrate cultural competence content into their course work including epidemiology, bio-statistics, health policy, health education and other areas of the curriculum.
5. To convene the best minds nationally in the health behavioral change field including psychiatry, psychology, social work, nursing, counseling, medical sociology, cultural and medical anthropology to further identify and advance theoretical notions and to develop health behavioral change theory. We will also validate theory through practice and basic research.
6. To identify and further develop scholarship of application to foster community based public health practice within new practice constructs and to conduct practice focused research with the objective of validating community based public health practice. Emphases will be placed on disseminating findings through consultations, curriculum materials, monographs and through multimedia methodology including distance learning - web based programs, CD ROM's, video tapes and other readily accessible means.

[top]

Senior Fellows: National Center for Health Behavioral Change

[top]

MAJOR PROGRAM FEATURES

The director/principal investigator has convened the best minds nationally in health behavioral change theory building, practice and research/ publication and appoints them as Senior Fellows in the National Center for Health Behavioral Change. It is the responsibility of the Senior Fellows to carry out the work of implementing the six (6) goals identified above. The Senior Fellows were selected specifically with competence in the areas that goal attainment will demand. Hence, they have demonstrated their ability in practice, consultation, professional development, research and publication. The ability to deliver the goals in which they hold relevant experience, academic preparation and competence will be determined and their contract with the Nation Center for Health Behavioral Change will be based on the above.

The Senior Fellows are convened as a group a minimum of four (4) times a year to further the objectives of this national center. We will communicate by videoconferences, chat-room meetings, computer-generated video communication and by other means. The senior fellow group will be divided as to their specialties in relation to goals, one (1) through six (6) above. A goal-objective chairperson will be designated in each goal area to provide additional innovative leadership to insure collective goal obtainment. These six (6) chairpersons and the director/principal investigator will make up an executive group to oversee the overall work and goal attainment being accomplished within the specified time frames.

We are identifying Associate Fellows that will assist in goal obtainment who will bring specific expertise. They will function as project directors and leaders of specific goal obtainments. The Senior and Associate Fellows will be from multiple disciplines in health and behavioral sciences and emphasis will be placed on team work and interdisciplinary collaboration. This author brings extensive experience in producing excellent products and outcomes working with professionals representing disciplines in medicine, psychiatry, psychology, social work, counseling, public health, pharmacy, sociology and other behavioral science disciplines.

[top]

Demand for Deliverables Identified in Goals

The pandemic we face in HIV/AIDS and STD's as well as the critically high prevalence rates that exist in cardiovascular disease, cancer, strokes, violence (school and youth violence) and other critical areas demand solutions. As stated previously my survey research with highly trained and community based practitioners revealed that from ninety (90) to ninety-eight per cent (98%) of the morbidity and mortality from the above disease entities is preventable! This reality therefore sends a strong and fervent plea for primary prevention curriculum, training of public health personnel. Some public health programs have observed and contacted me regarding community-based curriculum suitable to prepare practitioners for practice in the inner cities of America. Drew University in Los Angeles, for example; we are currently assisting in starting their community based MPH and potentially a Dr.PH program.

The twenty-seven (27) accredited schools of public health in our survey in 1996 stated that they did not teach community based practice at the doctorate level. Agencies and institutions that serve low-income minority - people of color and low-income persons of all races are seeking help due to the high patient loads and caseloads they carry. Without prevention practitioners that can emphasize and educate communities on wellness and prevention programs the heavy patient loads will eventually bankrupt the managed care system. Additionally, the sicker patients will not be accepted (preexisting conditions) and will add to the tax burden with uncompensated care at urban hospital centers. Hence, the morbidity and mortality rates that grow out of this reality become even more unacceptable because the vast majority of the diseases are preventable.

Cultural competence is a critical need for public health practitioners. How can anyone plan prevention programs, social marketing and/or awareness campaigns without full knowledge of the culture, values, health attitudes, health behaviors and related variables? It simply cannot be effectively done without cultural competence. Therefore, to lower the extremely high prevalence rates of preventable disease, we must move quickly to prepare cross-cultural competence in public health which lags behind all behavioral sciences and human service disciplines in this area such as psychiatry, psychology, social work and nursing.

The training materials, monographs and all other materials are in demand. These materials are not available or made accessible for schools and programs in public health. The related research will further develop the science needed to energize more health behavioral change theory building. We also, with more research, will be able to design and test for efficacy practice sets and modalities that will be most productive as we further redefine public health practice.

[top]