Nonetheless, the committee suggested that it was not surprised that the prevention area is relatively small. The committee endorsed the notion that rushing ahead with preventive interventions without fully understanding the biological effects of these interventions is not good. Prevention research should focus on individual behavioral change, an emphasis on regulation, and widespread dissemination of protective measures that people themselves can employ to limit exposure.
The committee noted that much of the ongoing preventive activities are not gender-specific; opportunities for examining gender-specific factors would be useful and would improve the potential for prevention. Such opportunities should include different gender-specific learning practices or behaviors. The committee also suggested taking advantage of the behavioral science literature that deals with preventive strategies.
In conclusion, the committee suggested that the overall research portfolio is not balanced between exposures and the presumed mechanisms that affect our health. This is particularly true for exposures relevant to women who work. As for epidemiology, some mainstream research issues are being addressed, but some critical issues are missing from the portfolio.
Discussions with the agency representatives revealed three factors that should also modify the interpretation of these analyses:
Definitions of terms are not necessarily consistent across the agencies. Prevention and preventive strategies for prevention, for example, may be categorized by one agency as prevention and by another as intervention. Intervention may occur with a specific drug, but it may also be preventive strategy.
Other research, not particularly focused on women's health, may nevertheless be relevant. This may be the cause of an underestimate of the complete portfolio that is directly applicable to the task.
Research from other components of the agencies may not be represented in the project listings. Because a limited number of NIH components are participating in this study, other relevant work in other components may also be relevant to the task.
These caveats, taken together, suggest that this analysis is, at best, an underestimate of the work that is being done and is a subset of research activities in the agencies. Nonetheless, a review of the projects identified thematic areas in which substantial research is being conducted, as well as areas in which there are gaps in research and opportunity. The committee suggested that the agencies review their research portfolios using identical definitions, expanded to include all possible adverse influences on women's health. Following this suggested expansion, an assessment of the relevant research portfolios should be carried out again.