Modeling Interdisciplinary Research to Advance Behavioral Health Care Holly Hills, PhD Tara Richards, PhD Abstract Over the past 15 years, scientists have become increasingly interested in interdisciplinary research collaborations. The integration of multiple perspectives to provide input into the most complex issues in science is thought to offer the best opportunity to find real-world answers to difficult problems. In this review and introduction to the special section on interdisciplinary research in behavioral health care, the value of a collaborative strategy is explored. Examples from the research presented in the special section are described to identify how processes were modified and interpretations made richer by these collaborations. Also discussed are potential impediments to researchers choosing to work from an interdisciplinary perspective. Conditions that are thought to encourage collaborative, interdisciplinary perspectives are also described.

Introduction Across all scientific disciplines, increased attention has been paid to the concept of “interdisciplinary research” (IDR) and the value it could bring to providing insight into complex, multidetermined issues. Interdisciplinary research is defined by the collaboration of researchers, each bringing perspectives from their own disciplines, to work on a common research problem in an effort to produce an explanation that is more complex and sophisticated than could have been achieved in isolation.1,2 This approach combines data, tools, methods, concepts, and theories identified with distinct disciplines in an effort to create an understanding of an issue that is greater than the sum of its parts.3 Encouragement of interdisciplinary collaboration has come from the scientific community which attributes these efforts as contributing to important breakthroughs, creation of innovation, and the expansion of research into new and creative areas.4 The result of these collaborations can lead to profound changes in how individual researchers conceptualize the research questions and designs that have characterized their previous work. Adding a diversity of perspectives can result in “challenges to deeply held, sometimes unquestioned beliefs” (p. 575).5

Address correspondence to Holly Hills, PhD, Department of Mental Health Law and Policy, Louis de la Parte Florida Mental Health Institute, College of Behavioral and Community Sciences, University of South Florida 13301 Bruce B. Downs Blvd, Tampa, FL, 33612, USA. Email: [email protected]. Tara Richards, PhD, School of Criminal Justice, University of Baltimore, 1420 North Charles Street AC242B, Baltimore, MD 21201, USA.

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These collaborative efforts often bring together researchers and clinicians and are thought to produce more useful findings that can readily be applied to practice.6 Across the sciences, from agriculture to nursing, a consistent theme has emerged in research design discussions that solutions to complex problems are often beyond the scope of a single discipline.7–10 In recent years, support for interdisciplinary research has emerged from a variety of sources. In the USA, the National Institutes of Health (NIH) and the National Science Foundation (NSF) have encouraged IDR through funding initiatives. In Canada, the Canadian Institutes of Health Research (CIHR) and in Great Britain, the UK Research Councils have supported these efforts. Funding agencies are moving towards requiring applicants to build interdisciplinary research teams and demonstrate how interdisciplinary skillsets will be used in funded projects. In a recent Interdisciplinary Behavioral and Social Science (IBSS, NSF 12-614) announcement, special review criteria were identified that would evaluate the interdisciplinarity of the research team, the approaches to be used, and the “expected intellectual significance” of the findings. NSF required applicant teams to include at least three senior personnel from at least two different disciplinary fields and encouraged the development of a research design that “integrates scientific theoretical approaches and methodologies” from multiple disciplines. An NIH announcement, “Network and Infrastructure Support for Development of Interdisciplinary Aging Research” (PAR 13-287), supports the development of “novel interdisciplinary research approaches” that will advance cross-discipline collaboration. Still, despite increased interest in creating these collaborations, some critics contend that IDR diverts valuable resources from important discipline-based research.11,12 IDR teams can face challenges when melding their work as they may possess strong, and sometimes conflicting, beliefs about appropriate methodologies and theoretical models. Early career researchers may find that their tenure committees, which are often comprised of members from a singular discipline, may be unfamiliar with interdisciplinary journals.5 Journal reviewers, themselves, may be unfamiliar with theories and methods used by a scholar in a different discipline creating problems with manuscript reviews as well as suggestions for revisions.5 For this special section of JBHS&R, researchers engaged in interdisciplinary collaborations in the behavioral health care were solicited. As the content of published work often does not describe how the collaborative inputs informed decisions about research questions and methodologies, contributing authors were asked about elements of their work that were illustrative of the “interdisciplinary” nature of their efforts. Some examples of these collaborative efforts from the papers included in this issue are described below.

Application of Interdisciplinary Collaborations Okamoto and colleagues’ work on promoting social competence and resilience (PSCR) in native Hawaiian youth was informed through the collaborative efforts of representatives from social work, psychology, sociology, and computer science, as well as community level stakeholders interested in investigating the social and cultural contexts of substance use among those living in rural communities. Their research focused on building a new drug prevention program from the “bottom up” by targeting the values, beliefs, and attitudes of the program’s targeted consumers. The research was informed by an ecological/systems perspective central to the field of social work while, at the same time, was driven by contextual and ecological orientations emphasized primarily by research in social work and sociology. The team collaborated to develop a mixed-methods multiphasic study, using both focus group and survey research questions. For the qualitative phases of the research study, aspects of community psychology informed the methodology and analysis (e.g., CBPR, placebased research), while in the quantitative phases, survey design and analysis were informed by methodological principles characteristic of sociology (e.g., multivariate modeling). Interpretations of the data focused on the social, cultural, and relational aspects related to drug offers. The funded

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project’s interdisciplinary research design was also driven by the National Institute on Drug Abuse’s (NIDA’s) prioritization of multidisciplinary teams in their requests for proposals. To address the issue of the association of engagement in treatment for substance use disorders and employment, Dunigan and coauthors’ team from Brandeis University’s Heller School turned to data that was collected and linked across multiple agencies by collaborators in Washington State. Researchers at Brandeis and researchers and policy makers in Washington State collaborated on the development of the research questions and proposal, and both groups were involved in the development and examination of substance abuse treatment performance measures. Together, the Brandeis and Washington State investigators represent a broad range of expertise in the delivery of clinical care, economics, statistics, health policy, and research design. The team combined Washington State staff’s understanding of employment trends and measures pertinent to the State and Brandeis researchers’ statistical and methodological skills for analysis of the data and performance measures. Specifically, the team members in Washington provided “real world” insight into the seasonality of employment in the State that contributed to the idea of conducting analyses using three measures of employment; team members from Brandeis provided expertise regarding the most appropriate analytical approach (e.g., Heckman models). Their interdisciplinary design was informed, in part, by The Heller School’s commitment to using multidisciplinary approaches that generally consist of researchers and policy analysts with varied backgrounds who utilize an applied interdisciplinary research approach to examine policies and programs that respond to the changing needs of vulnerable populations. The funder for this effort National Institute on Alcohol Abuse and Alcoholism (NIAAA) encouraged applicants to develop research questions and methods that were multidisciplinary in nature. Eby and colleagues investigated the impact of New York State’s requirement for substance use disorder (SUD) treatment organizations to become 100% tobacco-free. This multidisciplinary effort engaged collaborators representing interests in I/O psychology, health-care delivery, and SUD treatment. Interdisciplinary collaboration was explicitly encouraged in the announcement that funded this effort (NIDA). The diversity of the research team made it possible to contextualize the aims of the research to the unique context of SUD treatment (e.g., to longitudinally examine SUD clinicians’ commitment to the required changes, use of provided resources to aid the implementation of the changes, and their perceptions of the implementation process) and collaborated in choosing appropriate methodologies (e.g., mixed models for nested data with repeated measures). In the interpretive phase of the work, the breadth of the collaboration allowed for the articulation of salient and relevant policy recommendations (e.g., importance of staff buy-in when implementing tobacco-free policies). Croff et al. describe the findings from their qualitative investigation of culturally based models of care for substance abuse treatment for American Indians/Alaska Natives (AI/AN). The interdisciplinary collaboration included representatives from anthropology, public health, social work, and psychology. The diversity of backgrounds was deemed necessary given the cultural components of the research (traditional healing/culturally relevant care among American Indians combined with evidence-based practices for substance abuse treatment). An anthropologist, the lead author, contributed strength in the area of cultural interpretation and inquiry and qualitative approaches; a behavioral scientist contributed expertise regarding the cycle of addiction and the mental health issues that accompany it. Additional members provided expertise in the complexities of tribal–state relationships. Their combined experience and perspectives allowed for a more meaningful understanding of their findings related to the points of frustration and disconnect between the state authorities and state and tribal providers. Henwood, Padgett, and Tiderington’s work involved engaging research collaborators who had strong theoretical backgrounds, were close to frontline practice, and had the system-level knowledge necessary to meet the research objectives. Henwood’s perspective from conducting practice-based research during his tenure as an administrator and clinical director of a behavioral health agency, as well as Tiderington’s experience as a frontline provider whose research interests have focused on the therapeutic alliance, provided an important contextual backdrop to this study. Padgett’s background as a trained anthropologist with expertise in qualitative methods allowed the

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team to investigate the complex environment of behavioral health services. The encouragement of funders (NIH) was judged by the authors as instrumental in allowing for this team science effort.

Discussion The contributors for this special section appear to have realized the goals of interdisciplinary research collaborations. Their work focused on complex behavioral health issues which were informed by a diversity of perspectives. The choice of research questions, the decisions regarding methodologies and instrumentation, and the sophistication in their interpretations were made possible by their broad and cross-disciplinary team membership. Working in isolation, less comprehensive studies would have been achieved. Multiple factors encouraged their joint effort, including the awareness that implementation of their research, in many cases, would not have been successful, nor as valuable, had they approached the work from a mono-discipline perspective. Significantly, many authors acknowledge that they were encouraged by explicit direction from funders that this orientation to problem solving would put them at an advantage when their proposals were evaluated. As has been noted by those writing on the science of team science, interdisciplinarity is a difficult concept to measure as it encompasses both process and outputs. The process of integration—how knowledge came to be integrated as the research was conceptualized and conducted—is harder to measure than the outputs of research, which can be observed and evaluated once the work has been published.3

Implications for Behavioral Health The field of behavioral health care is complex and requires a diversity of perspectives that can provide a strong theoretical foundation, methodological rigor, appropriate measurement and real-world interpretation of findings so that policy and practice decisions can be made to improve service delivery. Interdisciplinary research offers the opportunity to answer increasingly complex questions impacting large segments of society. If IDR is discouraged, the process of “intellectual inbreeding” could harm the quality of the research being produced and lead to a shift away from complex questions.4 van Rijnsoever and Hessels13 articulate three directives to encourage IDR activity that are worth repeating. In order to elevate the value of interdisciplinary research, it must be rewarded in performance evaluations and promotions. They also conclude that women are more likely to collaborate in interdisciplinary activity, so the recruitment and retention of them is essential to a diverse research portfolio. Finally, engaging research partners from outside academia may encourage interdisciplinary model development. Additionally, funders appear to have had a significant role in encouraging the collaborative efforts described; the requirement and funding of these collaborations should continue as it has had the effect of broadening and validating interdisciplinary efforts.

Acknowledgments The authors would like to acknowledge the support of Junius Gonzales, MD, UTEP and NIDA in supporting related work (R13 DA022908) that made this special issue possible. Conflict of Interest The authors of this paper have none to declare.

References 1. Rosenfield PL. The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. Social Science Medicine. 1992; 35:1343–1357. 2. Rhoten D, Pfirman, S. Women in interdisciplinary science: Exploring preferences and consequences. Research Policy. 2007; 36:56–75.

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3. Wagner CS, Roessner JD, Bobb K et al. Approaches to understanding and measuring interdisciplinary scientific research (IDR): a review of the literature. Journal of Informatics. 2011; 165:14–26. 4. Rafols I, Leydesdorff L, O’Hare A et al. How journal rankings can suppress interdisciplinary research: a comparison between innovations studies and business & management. Research Policy. 2012; 41:1262–1282. 5. Campbell, LM. Diversity: overcoming obstacles to interdisciplinary research. Conservation Biology. 2005; 19(2):574–577. 6. Schlesinger LB. Relevant, practical, interdisciplinary research: a challenge for us all. Journal of Offender Therapy and Comparative Criminology. 2008; 52(4):375–377. 7. Abrams DB. Applying transdisciplinary research strategies to understanding and eliminating health disparities. Health Education and Behavior. 2006; 33:515–531. 8. Bindler RC, Richardson B, Daratha K et al. Interdisciplinary health science research collaboration: strengths, challenges, and case example. Applied Nursing Research. 2010; 25:95–100. 9. Lowe P, Phillipson J. Reflexive interdisciplinary research, Journal of Agricultural Economics. 2006; 57(2):165–184. 10. Younglove-Webb J, Gray B, Abdalla CW et al. The dynamics of multidisciplinary research teams in academia. Review of Higher Education. 1999; 22:425–440. 11. Marks AR. Rescuing the NIH before it is too late. Journal of Clinical Investigation. 2006; 116:844. 12. Weissmann G. Roadmaps, translational research, and childish curiosity. The Journal of the Federation of American Societies for Experimental Biology. 2005; 19:1761–1762. 13. van Rijnsoever FJ, Hessels LK. Factors associated with disciplinary and interdisciplinary research collaboration. Research Policy. 2011; 40(3):463–472.

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Modeling interdisciplinary research to advance behavioral health care.

Over the past 15 years, scientists have become increasingly interested in interdisciplinary research collaborations. The integration of multiple persp...
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