To identify recent studies in the scientific literature that evaluated structured postgraduate public health and biomedical training programs and reported career outcomes among individual trainees, a comprehensive search of several databases was conducted to identify published studies in English between January 1995 and January 2012. Studies of interest included those that evaluated career outcomes for trainees completing full-time public health or biomedical training programs of at least 12 months duration, with structured training offered on-site. Of the over 600 articles identified, only 13 met the inclusion criteria. Six studies evaluated US federal agency programs and six were of university-based programs. Seven programs were solely or predominantly of physicians, with only one consisting mainly of PhDs. Most studies used a cohort or cross-sectional design. The studies were mainly descriptive, with only four containing statistical data. Type of employment was the most common outcome measure (n = 12) and number of scientific publications (n = 6) was second. The lack of outcomes evaluation data from postgraduate public health and biomedical training programs in the published literature is a lost opportunity for understanding the career paths of trainees and the potential impact of training programs. Suggestions for increasing interest in conducting and reporting evaluation studies of these structured postgraduate training programs are provided.

BackgroundLarge cross-disciplinary scientific teams are becoming increasingly prominent in the conduct of research.PurposeThis paper reports on a quasi-experimental longitudinal study conducted to compare bibliometric indicators of scientific collaboration, productivity, and impact of center-based transdisciplinary team science initiatives and traditional investigator-initiated grants in the same field.MethodsAll grants began between 1994 and 2004 and up to 10 years of publication data were collected for each grant. Publication information was compiled and analyzed during the spring and summer of 2010.ResultsFollowing an initial lag period, the transdisciplinary research center grants had higher overall publication rates than the investigator-initiated R01 (NIH Research Project Grant Program) grants. There were relatively uniform publication rates across the research center grants compared to dramatically dispersed publication rates among the R01 grants. On average, publications produced by the research center grants had greater numbers of coauthors but similar journal impact factors compared with publications produced by the R01 grants.ConclusionsThe lag in productivity among the transdisciplinary center grants was offset by their overall higher publication rates and average number of coauthors per publication, relative to investigator-initiated grants, over the 10-year comparison period. The findings suggest that transdisciplinary center grants create benefits for both scientific productivity and collaboration. Large cross-disciplinary scientific teams are becoming increasingly prominent in the conduct of research. This paper reports on a quasi-experimental longitudinal study conducted to compare bibliometric indicators of scientific collaboration, productivity, and impact of center-based transdisciplinary team science initiatives and traditional investigator-initiated grants in the same field. All grants began between 1994 and 2004 and up to 10 years of publication data were collected for each grant. Publication information was compiled and analyzed during the spring and summer of 2010. Following an initial lag period, the transdisciplinary research center grants had higher overall publication rates than the investigator-initiated R01 (NIH Research Project Grant Program) grants. There were relatively uniform publication rates across the research center grants compared to dramatically dispersed publication rates among the R01 grants. On average, publications produced by the research center grants had greater numbers of coauthors but similar journal impact factors compared with publications produced by the R01 grants. The lag in productivity among the transdisciplinary center grants was offset by their overall higher publication rates and average number of coauthors per publication, relative to investigator-initiated grants, over the 10-year comparison period. The findings suggest that transdisciplinary center grants create benefits for both scientific productivity and collaboration.

Background: Large cross-disciplinary scientific teams are becoming increasingly prominent in the conduct of research.Purpose: This paper reports on a quasi-experimental longitudinal study conducted to compare bibliometric indicators of scientific collaboration, productivity, and impact of center-based transdisciplinary team science initiatives and traditional investigator-initiated grants in the same field.Methods: All grants began between 1994 and 2004 and up to 10 years of publication data were collected for each grant. Publication information was compiled and analyzed during the spring and summer of 2010.Results: Following an initial lag period, the transdisciplinary research center grants had higher overall publication rates than the investigator-initiated R01 (NIH Research Project Grant Program) grants. There were relatively uniform publication rates across the research center grants compared to dramatically dispersed publication rates among the R01 grants. On average, publications produced by the research center grants had greater numbers of coauthors but similar journal impact factors compared with publications produced by the R01 grants.Conclusions: The lag in productivity among the transdisciplinary center grants was offset by their overall higher publication rates and average number of coauthors per publication, relative to investigator-initiated grants, over the 10-year comparison period. The findings suggest that transdisciplinary center grants create benefits for both scientific productivity and collaboration. (Am J Prev Med 2012; 42(2): 157-163) Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

Background: No high-quality study to date has shown that screening reduces lung cancer mortality, and expert groups do not recommend screening for asymptomatic individuals. Nevertheless, lung cancer screening tests are available in the U.S., and primary care physicians (PCPs) may have a role in recommending them to patients.Purpose: This study describes U.S. PCPs' beliefs about and recommendations for lung cancer screening and examines characteristics of PCPs who recommend screening.Methods: A nationally representative survey of practicing PCPs was conducted in 2006-2007. Mailed questionnaires were used to assess PCPs' beliefs about lung cancer screening guidelines and the effectiveness of screening tests and to determine whether PCPs would recommend screening for asymptomatic patients. Data were analyzed in 2009.Results: Nine hundred sixty-two PCPs completed the survey (absolute response rate = 70.6%; cooperation rate = 76.8%). One quarter said that major guidelines support lung cancer screening. Two thirds said that low-radiation dose spiral computed tomography (LDCT) screening is very or somewhat effective in reducing lung cancer mortality in current smokers; LDCT was perceived as more effective than chest x-ray or sputum cytology. Responding to vignettes describing asymptomatic patients of varying smoking exposure, 67% of PCPs recommended lung cancer screening for at least one of the vignettes. Most PCPs recommending screening said they would use chest x-ray; up to 26% would use LDCT. In adjusted analyses, PCPs' beliefs and practice style were strongly associated with their lung cancer screening recommendations.Conclusions: Many PCPs' lung cancer screening beliefs and recommendations are inconsistent with current evidence and guidelines. Provider education regarding the evidence base and guideline content of lung cancer screening is indicated. (Am J Prev Med 2010;39(5):411-420) Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine

This study collected data five times between 1983 and 2002 from 400 participants who originally came from upstate New York. These participants completed structured interviews as did their mothers three times. LISREL analysis generally supported the hypothesized model. The results indicated that having parents who smoked and having low educational aspirations and expectations were associated with being unconventional, which, in turn, was related to having low emotional control and reporting more internalizing behaviors. Internalizing behaviors were directly associated with a lower likelihood of smoking cessation, as was parental smoking. Research and clinical implications are discussed and the limitations noted.

INTRODUCTION:In order to better understand how tobacco control efforts are coordinated across agencies of the Department of Health and Human Services (DHHS), we assessed tobacco control-related communication between tobacco control leaders across DHHS.METHODS:Cross-sectional surveys were collected from individuals representing 11 DHHS agencies, and social network analyses were used to assess linkages and map agencies' tobacco control communication.RESULTS:Individuals within the Office of the Secretary and Centers for Disease Control and Prevention (CDC) were most central to the network, and those of highest rank were most likely to be central to the network (F = 4.03, p = .024). The Centers for Medicare and Medicaid Services, Food and Drug Administration, Health Resources and Services Administration, and Substance Abuse and Mental Health Services Administration had no or almost no contact with other agencies. There was considerable between-agency contact variability, and the CDC was the most central agency.DISCUSSION:Tobacco control communication across DHHS agencies was present but extremely variable. This inconsistency may compromise the ability of the DHHS to address tobacco use, a critical public health problem, in a coordinated and efficient fashion. In light of the new leadership at DHHS, this analysis describes a systems approach that can be reimplemented as a means of understanding and improving communication and collaboration to improve public health.

Nearly 10 years ago, the Tobacco Control Research Branch of the National Cancer Institute (NCI) at the National Institutes of Health (NIH) developed a transdisciplinary initiative to explore the application of systems thinking approaches and methods to research, practice, and policy in tobacco prevention and control. The Initiative on the Study and Implementation of Systems (ISIS)1,2 was relatively new for NIH and resulted in much discourse among some scientists because of its sheer breadth and the scope of what it hoped to achieve: answers to the questions “Is it possible to understand the interplay of factors that both sustain and potentially disrupt tobacco use?” and “What structures and functions are essential for both understanding that complexity and improving our efforts in tobacco control?” We chose tobacco as an exemplar proof of concept for applying complexity theory and systems science to a wide range of behavioral and public health challenges.

The new systems science approaches emerging in public health research are not new at all; they have a track record earned over several decades in other disciplines, such as physics, operations research, economics, engineering, and, more recently, systems biology. At their core, systems science methodologies are designed to generate models, or simplified versions, of reality. By replicating the real world in important ways—simplifying where possible while retaining the critical aspects relevant to the problem under study—we can better understand the structural complexity of real-world problems that results from the interaction of specific phenomena and their environments. Systems science approaches have been used to address wide-ranging topics such as wildfire control, overfishing, decline of ancient civilizations, climate change, and terrorism networks. A major reason for their recent adoption in the public health arena is a growing recognition of their utility for addressing the complex problems rampant in public health generally1 and in specific domains (e.g., neighborhood effects on health and obesity).2,3 A small but growing number of studies have employed systems science methodologies to understand and address public health problems such as pandemic flu,4 HIV/AIDS,5 diabetes prevalence,6 and heroin markets.7 A few researchers have been using systems science to further tobacco control for nearly a decade.8,9

INTRODUCTION In recent years, there has been a proliferation of potential reduced-exposure tobacco products (PREPs) marketed that claim to be less harmful or less addictive, compared with conventional cigarettes. Tobacco control scientists have raised concerns about the potential adverse impact of marketing of these products for smoking prevention and cessation efforts. Although these products have not been widely used among smokers, there are few data available on consumers' awareness and attitudes toward these products. METHODS Data were obtained from the 2003 and 2005 Health Information National Trends Survey, a nationally representative telephone survey of adults 18 years and older regarding health communication and associated beliefs and behaviors. Our study population consisted of 6,369 respondents in 2003 and 5,586 respondents in 2005, of whom 19% were current smokers and 28% were former smokers. RESULTS In 2005, 45% of respondents had heard of at least one PREP product, while only 4.8% had actually tried one. Awareness and use were substantially higher among current smokers (55.6% and 12.7%). Awareness was highest for Marlboro Ultra Smooth (MUS) (30.2%), Eclipse (18.2%), Quest (7.8%), and Ariva (5.4%), while less than 2% for any other product. Of respondents who had tried a PREP, 50% cited harm reduction or assistance in quitting as a reason for trying the product and 30% believed that the product was less harmful than their usual brand. In the combined 2003 and 2005 dataset, 54.4% of current smokers stated that they would be "very" or "somewhat" interested in trying a cigarette advertised as less harmful, while only 3.2% of former smokers and 1.1% of never-smokers were interested. Among current smokers, interest was higher in females and non-Hispanic Whites, and among daily smokers, those who smoked 20 or more cigarettes per day and those who were not considering quitting. Smokers interested in PREPs were substantially more likely to rate their perceived lung cancer risk as high (40.3% vs. 8.3%) and to worry frequently about developing lung cancer (19.7% vs. 4%). DISCUSSION These results suggest that there is a substantial level of interest among current smokers in cigarettes marketed with claims of reduced exposure or harm. Of particular concern is that "health conscious" smokers and heavy smokers not planning to quit may be especially vulnerable to PREP marketing messages and view such products as an alternative to smoking cessation.

BACKGROUND:Over the past decade, tobacco companies have introduced cigarettes and smokeless tobacco products (known as Potential Reduced Exposure Products, PREPs) with purportedly lower levels of some toxins than conventional cigarettes and smokeless products. It is essential that public health agencies monitor awareness, interest, use, and perceptions of these products so that their impact on population health can be detected at the earliest stages.METHODS:This paper reviews and critiques existing strategies for measuring awareness of PREPs from 16 published and unpublished studies. From these measures, we developed new surveillance items and subjected them to two rounds of cognitive testing, a common and accepted method for evaluating questionnaire wording.RESULTS:Our review suggests that high levels of awareness of PREPs reported in some studies are likely to be inaccurate. Two likely sources of inaccuracy in awareness measures were identified: 1) the tendency of respondents to misclassify "no additive" and "natural" cigarettes as PREPs and 2) the tendency of respondents to mistakenly report awareness as a result of confusion between PREPs brands and similarly named familiar products, for example, Eclipse chewing gum and Accord automobiles.CONCLUSION:After evaluating new measures with cognitive interviews, we conclude that as of winter 2006, awareness of reduced exposure products among U.S. smokers was likely to be between 1% and 8%, with the higher estimates for some products occurring in test markets. Recommended measurement strategies for future surveys are presented.

Background: Despite significant declines in smoking rates in the United States, a substantial percentage of adults continue to smoke. Improved understanding of current smokers and their contact with sources of cessation support future tobacco control efforts. Recent evidence suggests that hardcore smokers, established smokers without a history of quit attempts, have less contact with cessation support. Although gender is among the major factors that influence smoking cessation, no research is available on gender differences among hardcore smokers. Methods: Demographic, environmental, and smoking-related characteristics of female hardcore smokers and male hardcore smokers and other female smokers were examined. Data from 17,777smokers from the 2003 Current Population Survey Tobacco Use Supplement were analyzed. Results: Compared with female hardcore smokers, male hardcore smokers were more likely to have contact with smoking restrictions at work (OR = 1.69) and at home (OR = 1.45). Compared with female hardcore smokers, female other smokers were more likely to have seen a healthcare provider during the past year who advised them to quit smoking (OR = 1.39) and more likely to have smoking restrictions at work (OR = 1.25) and at home (OR = 2.32)). Measures of nicotine dependence suggested that female hardcore smokers were less dependent than male hardcore smokers but more dependent than other female smokers. Conclusions: The sociodemographic and healthcare access variations in tobacco use identified in our analyses have significant public health implications and underscore the vital need for clinical and scientific advances in tobacco use prevention and control efforts.

This study examined associations between cigarette smoking, cancer, and self-reported physical (SF-36 Physical Component Summary Score, [PCS]) and mental health (SF-36 Mental Component Summary Score, [MCS]) among 123,567 Medicare beneficiaries enrolled in managed care plans. As expected for a sample of older individuals, the SF-36 PCS mean (42.6) was lower than the U.S. general population mean of 50. The SF-36 MCS mean (51.7) for the sample was higher than the general population mean. In addition, least squares means revealed significantly poorer health for current smokers and those who recently quit, regardless of their cancer status. Although statistically significant, the differences between current smokers and never smokers were small among those with or without cancer. Encouraging smokers to quit and providing abstinence support to persons who have recently quit may help reduce health-related impacts of cigarette use.

OBJECTIVE:This Overview paper (I of V) summarizes research work to date on monitoring the tobacco use epidemic, discusses the recommendations made at the November, 2002 National Tobacco Monitoring, Research and Evaluation Workshop sponsored by the U.S. National Cancer Institute (NCI), Centers for Disease Control and Prevention (CDC), the American Legacy Foundation, and the Robert Wood Johnson Foundation on the topic of tobacco surveillance and evaluation, and discusses the current state of affairs. METHODS:A conceptual model based on the classical infectious diseases framework/paradigm focusing on the Agent, Host, Vector and Environment is used to integrate the work presented in the four other papers that appear in this supplemental issue of Preventive Medicine. RESULTS:The Agent paper (II) describes surveillance on tobacco products and biomarkers; the Host paper (III) describes surveillance on the smoker/user, or potential smoker/user; the Vector paper (IV) describes monitoring of industry activity; and the Environment paper (V) describes several key strategies for monitoring influential environmental factors. Overall, some improvements to the nation's surveillance system have been made in recent years. However, additional steps are needed to optimize measurement of tobacco use and factors influencing use in the United States. CONCLUSIONS:Tobacco monitoring efforts play a vital role in combating the epidemic of addiction and disease produced by various tobacco products. The knowledge and experience gained by the tobacco use prevention and control community through this commitment to linkages of data collected in the domains of Vector and Environment, in addition to Agent and Host, could inform monitoring of a wide range of other public health issues as well, including diet and nutrition, physical activity, overweight and obesity, and substance abuse.

Over the past few decades there has been a rise in the number of federally funded large scientific research initiatives, with increased calls to evaluate their processes and outcomes. This article describes efforts to evaluate such initiatives in one agency within the U.S. federal government. The authors introduce the Evaluation of Large Initiatives (ELI) project, a preliminary effort to explore how to accomplish such evaluation. They describe a pilot effort of this project to evaluate the Transdisciplinary Tobacco Use Research Center (TTURC) initiative of the National Cancer Institute. They present a summary of this pilot evaluation including the methods used (concept mapping, logic modeling, a detailed researcher survey, content. analysis and systematic peer-evaluation of progress reports, bibliometric analysis and peer evaluation of publications and citations, and financial expenditures analysis) and a brief overview of results. Finally, they discuss several important lessons and recommendations that emerged from this work.

PURPOSE:As the science of team science evolves, the development of measures that assess important processes related to working in transdisciplinary teams is critical. Therefore, the purpose of this paper is to present the psychometric properties of scales measuring collaborative processes and transdisciplinary integration.METHODS:Two hundred-sixteen researchers and research staff participating in the Transdisciplinary Tobacco Use Research Centers (TTURC) Initiative completed the TTURC researcher survey. Confirmatory-factor analyses were used to verify the hypothesized factor structures. Descriptive data pertinent to these scales and their associations with other constructs were included to further examine the properties of the scales.RESULTS:Overall, the hypothesized-factor structures, with some minor modifications, were validated. A total of four scales were developed, three to assess collaborative processes (satisfaction with the collaboration, impact of collaboration, trust and respect) and one to assess transdisciplinary integration. All scales were found to have adequate internal consistency (i.e., Cronbach alpha's were all >0.70); were correlated with intermediate markers of collaborations (e.g., the collaboration and transdisciplinary-integration scales were positively associated with the perception of a center's making good progress in creating new methods, new science and models, and new interventions); and showed some ability to detect group differences.CONCLUSIONS:This paper provides valid tools that can be utilized to examine the underlying processes of team science--an important step toward advancing the science of team science.

Improving population health requires understanding and changing societal structures and functions, but countervailing forces sometimes undermine those changes, thus reflecting the adaptive complexity inherent in public health systems. The purpose of this paper is to propose systems thinking as a conceptual rubric for the practice of team science in public health, and transdisciplinary, translational research as a catalyst for promoting the functional efficiency of science. The paper lays a foundation for the conceptual understanding of systems thinking and transdisciplinary research, and will provide illustrative examples within and beyond public health. A set of recommendations for a systems-centric approach to translational science will be presented.

This study examined the associations of susceptibility, conceptualized as both a cognition (risk) and as affect (worry) and their possible interaction, with cancer screening behaviors. Data for this study were obtained from the 2003 Health Information National Trends Survey (HINTS). Hierarchical regression models assessed the ability of risk, worry and their interaction (after controlling for other important variables) to predict cancer-screening behaviors. Results found that risk and worry (but not their interaction) were associated with regular mammography screening and having had a sigmoidoscopy or colonoscopy but with neither FOBT nor PSA screening. The findings suggest that risk and worry are both important in predicting some types of screening behavior and that these variables operate independently.