In 2015, the National Academies of Sciences, Engineering, and Medicine convened two workshops with oversight from the Committee on the Science of Changing Behavioral Health Social Norms. The workshops provided input to the committee's deliberations and contributed to the development of the report Ending Discrimination against People with Mental and Substance Use Disorders. That report was issued to help the Substance Abuse and Mental Health Services Administration and the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, utilize the scientific evidence base in improving public attitudes toward and understanding of behavioral health, specifically in the areas of mental health and substance use disorders. This publication summarizes the presentations and discussions at the two workshops. Table of Contents Front Matter 1 Overview and Goals of Workshops PART I: WORKSHOP ON LESSONS LEARNED FROM DIVERSE EFFORTS TO CHANGE SOCIAL NORMS 2 Messaging to Change Social Norms 3 Methods 4 Big Picture Look at Social Change 5 Case Studies in Changing Social Norms PART II: WORKSHOP ON OPPORTUNITIES AND STRATEGIES TO PROMOTE BEHAVIOR CHANGE IN BEHAVIORAL HEALTH 6 Setting the Stage 7 Domestic Perspectives 8 Implementing Change in the U.S. Context: Critical Evaluations 9 A Cultural Cognitive Approach to Communicating About Child Mental Health 10 Implementing Change in the U.S. Context: Strategies for Reaching Audiences 11 Perspectives from Outside the United States References Appendix A: Workshop Agendas Appendix B: Biographical Sketches of Speakers

Nurses make up the largest segment of the health care profession, with 3 million registered nurses in the United States. Nurses work in a wide variety of settings, including hospitals, public health centers, schools, and homes, and provide a continuum of services, including direct patient care, health promotion, patient education, and coordination of care. They serve in leadership roles, are researchers, and work to improve health care policy. As the health care system undergoes transformation due in part to the Affordable Care Act (ACA), the nursing profession is making a wide-reaching impact by providing and affecting quality, patient-centered, accessible, and affordable care. In 2010, the Institute of Medicine (IOM) released the report The Future of Nursing: Leading Change, Advancing Health, which made a series of recommendations pertaining to roles for nurses in the new health care landscape. This current report assesses progress made by the Robert Wood Johnson Foundation/AARP Future of Nursing: Campaign for Action and others in implementing the recommendations from the 2010 report and identifies areas that should be emphasized over the next 5 years to make further progress toward these goals. Table of Contents Front Matter Summary 1 Introduction 2 Removing Barriers to Practice and Care 3 Achieving Higher Levels of Education 4 Promoting Diversity 5 Collaborating and Leading in Care Delivery and Redesign 6 Improving Workforce Data Infrastructure Appendix A: Data Sources and Methods Appendix B: The Future of Nursing: Leading Change, Advancing Health: Key Messages and Report Recommendations Appendix C: Committee Biographies

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers. Table of Contents Front Matter Summary 1 Introduction SECTION I Measurement : 2 Measurement of Fetal and Infant Maturity Section I Recommendations SECTION II Causes of Preterm Birth: 3 Behavioral and Psychosocial Contributors to Preterm Birth 4 Sociodemographic and Community Factors Contributing to Preterm Birth 5 Medical and Pregnancy Conditions Associated with Preterm Birth 6 Biological Pathways Leading to Preterm Birth 7 Role of Gene-Environment Interactions in Preterm Birth 8 Role of Environmental Toxicants in Preterm Birth Section II Recommendations SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth Section III Recommendations SECTION IV Consequences of Preterm Birth: 10 Mortality and Acute Complications in Preterm Infants 11 Neurodevelopmental, Health, and Family Outcomes for Infants Born Preterm 12 Societal Costs of Preterm Birth Section IV Recommendations SECTION V Research and Policy: 13 Barriers to Clinical Research on Preterm Birth and Outcomes of Preterm Infants 14 Public Policies Affected by Preterm Birth Section V Recommendations 15 A Research Agenda to Investigate Preterm Birth References Appendix A Data Sources and Methods Appendix B Prematurity at Birth: Determinents, Consequences, and Geographic Variation Appendix C A Review of Ethical Issues involved in Premature Birth Appendix D A Systematic Review of Costs Associated with Preterm Birth Appendix E Selected Programs Funding Preterm Birth Research Appendix F Committee and Staff Biographies Index

Recent concerns about the unexpected adverse effects of marketed drugs, such as COX-2 (cyclooxygenase-2) inhibitors or specific statins, raise concerns not only about reporting these events during premarket studies, but also about the responsibility for ongoing surveillance of drugs once they are on the market. Sometimes serious adverse drug reactions are fully appreciated only after a drug has been on the market for years. Therefore, when a drug is approved and released to the market, large numbers of patients will be exposed before all the potential adverse effects have been identified and thoroughly studied. Currently, there is no clearly defined process for addressing safety questions about drugs after premarketing research has occurred. In November 2005, the Institute of Medicine's Forum on Drug Discovery, Development, and Translation convened a workshop to explore issues associated with the reporting of ADEs. The workshop addressed the following questions: How can ADEs be effectively identified, particularly when the adverse effects are rare? How can the direct, causal effects of drugs be distinguished from simple associations? How can health-care professionals and their patients' aid in the identification of drug-related adverse events? How can knowledge of ADEs be more effectively used in clinical practice? Adverse Drug Event Reporting reviews current sources of information on adverse drug events, including the FDA's MedWatch program and the AERS, institutional review boards, and the CMS. This report considers the ways that consumers and advocacy groups can be involved in reporting adverse events, and discusses drug interactions, problems with current databases for capturing and evaluating interactions, and difficulties in communicating information about adverse drug interactions. This report also describes new requirements for information contained on drug labels and how labels can be used to communicate information about risks and drug interactions to consumers and practitioners. Table of Contents Front Matter Summary 1 Introduction 2 Current Adverse Event Reporting Systems 3 Active Surveillance Systems 4 Consumer Involvement in Reporting Adverse Events 5 Drug-Drug Interactions 6 Drug Labels References A Workshop Agenda B Speaker Biographies

Decades of research have demonstrated that children do not respond to medications in the same way as adults. Differences between children and adults in the overall response to medications are due to profound anatomical, physiological, and developmental differences. Although few would argue that children should receive medications that have not been adequately tested for safety and efficacy, the majority of drugs prescribed for children--50 to 75 percent--have not been tested in pediatric populations. Without adequate data from such testing, prescribing drugs appropriately becomes challenging for clinicians treating children, from infancy through adolescence. Addressing the Barriers to Pediatric Drug Development is the summary of a workshop, held in Washington, D.C. on June 13, 2006, that was organized to identify barriers to the development and testing of drugs for pediatric populations, as well as ways in which the system can be improved to facilitate better treatments for children.

The Oklahoma City bombing, intentional crashing of airliners on September 11, 2001, and anthrax attacks in the fall of 2001 have made Americans acutely aware of the impacts of terrorism. These events and continued threats of terrorism have raised questions about the impact on the psychological health of the nation and how well the public health infrastructure is able to meet the psychological needs that will likely result. Preparing for the Psychological Consequences of Terrorism highlights some of the critical issues in responding to the psychological needs that result from terrorism and provides possible options for intervention. The committee offers an example for a public health strategy that may serve as a base from which plans to prevent and respond to the psychological consequences of a variety of terrorism events can be formulated. The report includes recommendations for the training and education of service providers, ensuring appropriate guidelines for the protection of service providers, and developing public health surveillance for preevent, event, and postevent factors related to psychological consequences. Table of Contents Front Matter Executive Summary 1. Introduction: Rationale for a Public Health Response to the Psychological Consequences of Terrorism 2. Understanding the Psychological Consequences of Traumatic Events, Disasters, and Terrorism 3. Current Infrastructure in the United States for Responding to the Psychological Consequences of Terrorism 4. Developing Strategies for Minimizing the Psychological Consequences of Terrorism Through Prevention, Intervention, and Health Promotion 5. Conclusions and Recommendations for Effective Prevention and Response References Appendix A: Data Sources and Methods Appendix B: Committee and Staff Biographies

A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program's core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program's structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection. A Review of the HHS Family Planning Program recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations. Table of Contents Front Matter Summary 1 Introduction 2 Overview of Family Planning in the United States 3 Title X Goals, Priorities, and Accomplishments 4 Program Management and Administration 5 Collection of Data to Measure Program Outcomes References Appendixes Appendix A: Data Sources and Methods Appendix B: Population Research and Voluntary Family Planning Programs Appendix C: Title X Family Planning Program Regulations Appendix D: Program Guidelines for Project Grants for Family Planning Services Appendix E: Family Planning Program Assessment Rating Tool Appendix F: Committee Site Visits Appendix G: *Family Planning Annual Report* Data Elements Appendix H Summary of Previous Title X Evaluations and Reviews Appendix I: Title X and OPA-Funded Research Appendix J: Organization, Funding, and Management of the Title X Program Appendix K: Measurement of Quality in the Title X Family Planning Program Appendix L: Committee and Staff Biographies