Focuses on behavioral or environmental (social, economic, cultural, physical) factors associated with primary and secondary prevention of disease in populations; the behavioral, biological, or clinical variations among populations; or the integration of behavioral, biological, and environmental factors.
As discussed previously, prevention research (including clinical preventive services research) has been underfunded and undervalued, yet it is crucial to understanding how to improve health. The following section of this chapter discusses the specific research approaches that the committee believes will, if properly funded, contribute greatly to the understanding of the determinants of health and to evaluation of the effectiveness of public health interventions.
The term population-based research means that the research focuses on groups or populations rather than individuals (Scrimshaw et al., 2001). Population-based research draws on populations or random samples of populations at a national, state, or local level. In general, it builds on an understanding of the determinants of health that includes multiple levels of influence, from environmental (both social and physical) to behavioral to individual (biological, genetic). Although all research does not incorporate all potential levels, increased understanding of etiology and prevention will come about by working at multiple levels. Examples of well-known population-based research include the Framingham Heart Study, which continues to yield new insights, and the Woman’s Health Initiative (see Box 8–1).
Although population-based studies are often used to generate hypotheses about the potential risk factors for disease, population studies can also test hypotheses developed in earlier studies. Most of the earlier population-based data collection focused on the biological and environmental risk factors for disease. There is, however, an increasingly rich amount of data about the social determinants of health (see Chapter 2), and investigators are poised on the brink of being able to link these social risk factors with biomedical factors, thereby developing a more complex model of disease and health through population-based studies.
Community-based research is an overarching concept of collaborative research that encompasses many different types of studies (e.g., applied, descriptive, and evaluative). Community-based participatory research is defined as research that involves all stakeholders in each aspect of a study