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Environmental Factor

Environmental Factor

Your Online Source for NIEHS News

August 2018

Beyond the clinic — describing success in environmental health

A new paper from NIEHS offers a tool to help scientists describe how environmental health research translates into public health improvements.

When it comes to telling stories of success, scientists in the field of environmental health face a challenge distinct from other biomedical researchers — there is no pill or clinical intervention at the end. A paper published July 16 in the journal Environmental Health Perspectives offers a new way for environmental health scientists to describe what is known as translational research.

Kristi Pettibone Pettibone said one goal of the framework is to provide a map for researchers, to remind them of the paths available to move basic research into benefits for human health. (Photo courtesy of Steve McCaw)

“Typically, our grantees aren't coming up with clinical treatments or pharmaceuticals,” said lead author Kristi Pettibone, Ph.D., from the NIEHS Policy Analysis Branch. “They are, however, asking and answering scientific questions that affect public health in a positive manner.”

“Establishing a shared understanding and common vocabulary for discussing translational research … supports our strategic plan and provides a structure for researchers to clearly articulate the complex, multiyear process of scientific discovery and impacts,” said Linda Birnbaum, Ph.D., director of NIEHS and the National Toxicology Program (NTP).

The right tool for the job

Assessing how research improves public health calls for the right yardstick, or framework, to measure it. The plot points used to tell the story of other biomedical research translation, such as the spectrum described by the National Center for Advancing Translational Science (NCATS), may miss the story when it comes to environmental health.

As a result, an advisory board charged NIEHS in 2015 to draw up a framework that scientists and those who oversee their grants can use to tell — and evaluate — their translational research stories.

Prevention is key

“In the labs and seminar rooms of biomedical research institutions, the phrase ‘translational science’ is synonymous with bench-to-bedside,” said Pettibone. “That is, from the laboratory [lab bench] to a drug, therapy, or health guideline that can treat or reduce disease and other health conditions.”

In contrast, environmental health research may lead to removal of inorganic arsenic from infant rice cereal or development of a better analyzer of mercury contamination, she explained. The new framework has its origins in this distinction between treatment and prevention.

Where science meets policy

Pettibone, the framework’s chief architect, was drawn to the challenge by her background and interest in public policy. “I’m always looking to see how research influences policy,” she said. “Policies have the potential to improve the health of such large numbers of people.”

“For example, guidance calling for pediatricians who treat kids with asthma to make recommendations about how families clean their homes might help just as many people as drugs designed to treat asthma,” Pettibone suggested.

Christie Drew Drew said that one benefit of the framework is to help researchers use consistent terminology when communicating outcomes of their work. (Photo courtesy of Steve McCaw)

“We wanted to provide grantees with a map of potential paths their research might take through the translational research cycle,” said Christie Drew, Ph.D., head of the NIEHS Policy Analysis Branch. “Our mission is to impact human health. This is a way to help our grantees show how they are doing that.”

NIEHS-wide effort

Although the framework project started in an NIEHS grant program, it drew upon staff from throughout the institute. “Over the course of two years, we worked with leadership from NTP, the Office of the Director, the Clinical Research Unit, and staff throughout the Division of Extramural Research and Training,” Drew said. “This framework would not exist without the contributions from the whole team.”

The team also received input from grantees, researchers from the U.S. Environmental Protection Agency, NCATS, and the U.S. Centers for Disease Control and Prevention (CDC).

Mapping potential paths, telling stories

Pettibone and her co-authors developed a system of concentric rings that represent different types of scientific studies (see text box below for details).

TRF Overview The general framework of five rings is applicable to fields beyond environmental health science. (Photo courtesy of NIEHS)

As a storytelling tool, the overall framework is adaptable to fields beyond environmental health, such as criminal justice or education. The rings provide a way to track evolution from concept to broader impact.

“My mother is an educator. This framework can be used to describe how an idea that started in a classroom, say, moved to pilot testing, was communicated more broadly, and ultimately led to a change in curriculum.”

Check out the NIEHS web pages, Translational Research at NIEHS, to learn more about the framework, read case studies, download templates, and discover other resources.

Citation: Pettibone KG, Balshaw DM, Dilworth C, Drew CH, Hall JE, Heacock M, Latoni AR, McAllister KA, O'Fallon LR, Thompson C, Walker NJ, Wolfe MS, Wright DS, Collman GW. 2018. Expanding the concept of translational research: making a place for environmental health sciences. Environ Health Perspect 126(7):074501.

The Full Translational Research Framework represents five categories of translational research in concentric rings: fundamental questions (rectangles), application and synthesis (oval), implementation and adjustment (hexagons), practice (circle) and public health impacts (triangles). Within each ring, nodes describe the types of activities that might occur. In this diagram we combine all five rings and their respective nodes or activities, as described above, into one model of the full framework. The model is shown as a series of concentric rings. The inner ring is Fundamental Questions, the next ring is Application and Synthesis, followed by Implementation and Adjustment. The fourth ring represents the Practice category of translational research. The outside ring represents the Impacts category. Translational research in environmental health science can be visualized as movement from one node to another, regardless of which ring it is on. (Photo courtesy of NIEHS)

The framework in action

Drew and Pettibone are sharing case studies with grantees to help them tell their stories. Visit the NIEHS website for examples on using the framework, including citations to publications of the research discussed below.

This case study, from the University of Cincinnati (UC) and Michigan State University (MSU), involves a Breast Cancer and the Environment Research Program (BCERP) project. BCERP is jointly funded by NIEHS and the National Cancer Institute.

  • Translational milestones 1 After findings from the CDC’s National Health and Nutrition Examination Survey showed elevated levels of polyfluoroalkyl chemicals (PFCs) in some populations, the UC BCERP project added PFCs to the list of chemicals screened in their study of young girls.
  • Translational milestone 2Among the girls screened in the next year, about half had PFC serum concentrations above the 95th percentile. Both of these milestones are represented on the Group and Population node of the inner, or fundamental research, ring.
  • Translational milestone 3 UC researchers presented these findings at a BCERP grantee meeting, where BCERP scientists from MSU offered to further study PFCs. Their research, represented by the inner ring’s In Vitro Organism node, found stunted mammary development and delayed onset of puberty in female mice exposed to PFCs.
  • Translational milestone 4 — Researchers working with breast cancer prevention advocates and other community partners shared the biomarker results with the families, which is one type of Public Health Practice, located on the Practice ring.
  • Translational milestone 5 The team expanded the PFC analysis to all girls aged 6-8 years in their study, which is represented by moving to the Group or Population Node on the fundamental research ring.
  • Translational milestone 6 With help from families involved in the studies, the exposure source was confirmed to be a pollutant in the public water supply, coming from an upstream discharge. This work is considered In Situ research, also found on the inner ring.
  • Translational milestone 7 — Moving out to the Policy node of the Practice ring, UC researchers partnered with Cincinnati and Northern Kentucky water treatment departments between 2007 and 2012 to reduce PFC levels through water filtering.
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