Jeremy Steglitz

The seventh column on Evidence-Based Behavioral Medicine synopsizes a systematic review by Chewning and colleagues (Pat Educ Couns 86:9–18, 2012) on patient preferences for shared decision-making regarding treatment and screening. A total of 115 studies were included in the final analyses. In 63 % of studies, a majority of patients preferred sharing decisions with their primary care physician, as opposed to delegating health decisions to their provider. A time trend appeared such that in studies published more recently, a greater percentage of patients, particularly cancer patients, preferred sharing decisions. Further research should seek to better understand how the decision making of specific patient populations is influenced by life course changes and secular trends. Longitudinal studies can help to elucidate how patient decision-making preferences evolve over the course of illness and health status changes in different medical conditions.

Obesity is a public health crisis that has reached epidemic proportions. Although intensive behavioral interventions can produce clinically significant weight loss, their cost to implement, coupled with resource limitations, pose significant barriers to scalability. To overcome these challenges, researchers have made attempts to shift intervention content to the Internet and other mobile devices. This article systematically reviews the recent literature examining technology-supported interventions for weight loss and maintenance among overweight and obese adults. Thirteen studies were identified that satisfied our inclusion criteria (12 weight loss trials, 1 weight maintenance trial). Our findings suggest that technology interventions may be efficacious at producing weight loss. However, several studies are limited by methodologic shortcomings. There are insufficient data to evaluate their efficacy for weight maintenance. Further research is needed that employs state-of-the-art methodology, with careful attention being paid to adherence and fidelity to intervention protocols.

The fifth column on Evidence-Based Behavioral Medicine is focused on the Institute of Medicine’s (IOM) report entitled “Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research.” The IOM has reported that chronic pain affects 116 million American adults, which is greater than the total of heart disease, cancer, and diabetes combined. It is recommended that data collection takes place at regular intervals using standardized questions, survey protocols, and electronic medical records with the aim of the identifying the following: subpopulations at risk; characteristics of acute and chronic pain; health consequences of pain, including death, disease, and disability; and longitudinal trends of pain. In addition, health education programs should be redesigned to include information about self-management, actions to prevent injuries at the individual and community level, advocacy for pain treatment, and support for improved prevention and control policies. Through teamwork between various professions, from physicians, nurses, and psychologists to physical therapists, pharmacists, and policy makers, advancements in pain awareness, education, research, and treatment should begin to materialize.