Harlan W R
National Institutes of Health, Bethesda, Maryland 20892-0714, USA.
Am J Prev Med. 1998 May;14(4):302-7. doi: 10.1016/s0749-3797(98)00005-1.
Prevention of disease and disability and preservation of health are compelling strategies that are endorsed by the public, health care providers, and researchers. Despite this general acceptance of the concept, the "devil is in the details." What can and should be recommended with confidence to the public and health care providers regarding prevention and how can these recommendations be implemented? Prevention programs should be based on durable evidence of efficacy and should assure that the benefits of interventions and changes exceed the risks. The latter is particularly important for population-based primary prevention because many are influenced but fewer may benefit. Prevention research must provide the evidence of benefit and risk. The responsibility of the National Institutes of Health (NIH) is to develop the scientific basis for prevention and to train prevention scientists who are responsible for creating this science base. The interpretation and dissemination of information from research studies are important and necessary aspects to assure translation of the science into personal and public health practices. The components of prevention research are investigation of the factors that place individuals and groups at risk of disease and disability; trials of the interventions that can modify this risk; and testing the approaches that can effectively implement beneficial changes. NIH is committed to addressing these endeavors, and its individual Institutes and Centers support a broad portfolio of prevention research. This paper will provide an overview of NIH support, the functional relationships of prevention research within NIH, and background information that can be useful to those interested in research.
预防疾病和残疾以及维护健康是公众、医疗保健提供者和研究人员都认可的极具说服力的策略。尽管这一概念已被普遍接受，但“细节决定成败”。在预防方面，哪些建议可以且应该自信地向公众和医疗保健提供者推荐？这些建议又该如何实施？预防项目应以可靠的疗效证据为基础，并应确保干预措施和改变所带来的益处超过风险。对于基于人群的一级预防而言，后者尤为重要，因为许多人会受到影响，但受益的人可能较少。预防研究必须提供益处和风险的证据。美国国立卫生研究院（NIH）的职责是为预防建立科学基础，并培养负责创建这一科学基础的预防科学家。对研究结果的解读和传播是确保将科学转化为个人和公共卫生实践的重要且必要的方面。预防研究的组成部分包括调查使个人和群体面临疾病和残疾风险的因素；对可改变这种风险的干预措施进行试验；以及测试能够有效实施有益改变的方法。NIH致力于开展这些工作，其各个研究所和中心支持广泛的预防研究项目。本文将概述NIH的支持情况、NIH内部预防研究的功能关系，以及对那些对研究感兴趣的人可能有用的背景信息。
