The U.S. Preventive Services Task Force (USPSTF) has released its “12th Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services.”
In 2022, the USPSTF continued to fulfill its mission of improving the health of people nationwide by making evidence-based recommendations about clinical preventive services such as screening tests, counseling about healthy behaviors, and preventive medications. These recommendations help healthcare professionals and their patients make informed healthcare decisions.
In this annual report, the USPSTF calls attention to high-priority research gaps related to promoting healthy behaviors throughout life. The report reinforces the Task Force’s commitment to improving health equity by highlighting research gaps specific to high-risk populations.
Read the executive summary below or access the full report here.
Executive Summary
The U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent, volunteer panel of national experts in prevention, primary care, and evidence-based medicine. The Task Force makes evidence-based recommendations about clinical preventive services that can be delivered or referred from primary care to improve the health of people nationwide. The Task Force assesses the strength of the evidence and the balance of benefits and harms of a preventive service in people without signs or symptoms, including screening tests, behavioral counseling, and preventive medications.
Each year, Congress charges the USPSTF to provide a report that identifies gaps in the scientific evidence base and recommends areas for future research. In some cases, clinical preventive services have been well studied, but there are important evidence gaps that prevent the USPSTF from making recommendations for specific populations. The Task Force recognizes that disparities persist in healthcare and health outcomes based on age, race and ethnicity, sexual orientation, gender identity, and social determinants of health, such as economic and social conditions. Greater inclusion of populations disproportionately affected by health conditions in research will help the USPSTF issue recommendations that improve the quality of preventive care. In turn, this will hopefully lead to improved access to and use of these preventive services, reduced disparities in healthcare, and increased health equity.
In this 12th Annual Report to Congress, the Task Force calls for more research in areas where evidence is lacking in order to improve the health of children, adolescents, adults, and pregnant people, particularly in Black, Hispanic/Latino, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander communities.
Where More Research Is Needed Related to Promoting Healthy Behaviors Across the Lifespan
In this report, the USPSTF calls attention to high-priority research gaps from its recent recommendations related to promoting healthy behaviors across the lifespan. The Task Force has a long-standing commitment to, and specific methods for, evaluating the evidence for clinical preventive services and making recommendations that promote health and prevent chronic conditions. Although chronic health conditions may affect anyone, some groups of people are at higher risk because of the sex they were assigned at birth, gender identity, race, ethnicity, income, geographic location, or other factors. The Task Force hopes to improve health equity by highlighting research gaps related to healthy behaviors, high-risk populations, and health outcomes. The Task Force recognizes that everyone can improve their health by participating in physical activity, eating a healthy diet, and eliminating unhealthy alcohol and tobacco use. Empowering people through behavioral counseling to adopt healthy lifestyle behaviors can be a way to increase the span of healthy living, reduce health disparities, and result in long-term health benefits.
Future research in the following areas may help fill gaps and may result in new recommendations that will help improve the health of people nationwide:
- Behavioral Counseling Interventions for Healthy Diet and Physical Activity for Cardiovascular Disease (CVD) Prevention in Adults Without Known Risk Factors
- Recruit sufficient numbers of participants from populations disproportionately affected by CVD to understand the benefit of physical activity and dietary behavioral counseling interventions in these populations.
- Evaluate best practices for clinicians and patients to navigate known environmental and structural barriers to healthy diet and physical activity.
- Design and test interventions to reduce sedentary behavior. The recent increase in working from home during the COVID-19 pandemic may present an opportunity to perform research on effective interventions that reduce sedentary time.
- Develop and evaluate culturally appropriate and tailored interventions that may reduce disparities related to cardiovascular health.
- Behavioral Counseling Interventions for Healthy Diet and Physical Activity for CVD Prevention in Adults With Cardiovascular Risk Factors
- Encourage greater consistency and standardization of outcome measures in studies, specifically those for physical activity and diet, to better understand the range of effects and interpret the pooled effects.
- Examine the effects of the use of newer technologies, such as wearable activity trackers. In addition, examine the effects of internet-based resources such as daily caloric intake applications or other low-intensity approaches that may be valuable in low-resource settings.
- Behavioral Counseling Interventions for Healthy Weight and Weight Gain in Pregnancy
- Assess the specific components of intensive behavioral interventions, including the specific content, optimal frequency, length of sessions, and number of sessions needed for an intervention to be effective.
- Assess whether interventions should be tailored to promote healthy weight gain in populations of pregnant people of advanced maternal age (i.e., older than age 34 years); adolescents; historically underserved populations such as Black, American Indian/Alaska Native, and Hispanic/Latino persons; and populations with increased rates of overweight and obesity.
- Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons
- Examine effective components of behavioral counseling, including understanding interventions that provide the greatest benefits to high-risk populations.
- Examine whether e-cigarettes increase adult tobacco smoking cessation and the potential harms of e-cigarette use.
- Examine newer modalities and remotely delivered interventions (mobile phone apps and internet-based interventions).
- Screening for Prediabetes and Type 2 Diabetes in Children and Adolescents
- Address the effects of lifestyle interventions, pharmacotherapy, or both for treatment of screen-detected prediabetes and diabetes on health outcomes in children and adolescents, particularly in racial and ethnic groups that have a higher prevalence of diabetes.
- Address the effects of screening on health outcomes in children and adolescent populations reflective of the prevalence of diabetes in the United States, particularly in racial and ethnic groups that have a higher prevalence of diabetes.
- Screening for Prediabetes and Type 2 Diabetes in Adults
- Evaluate data on the effects of lifestyle interventions and medical treatments for screen-detected prediabetes and diabetes on health outcomes over a longer followup period, particularly in populations that have a higher prevalence of diabetes.
- Examine how best to increase uptake of lifestyle interventions, especially among populations at highest risk for progression to diabetes and adverse health outcomes.
- Enroll racial and ethnic populations that experience a higher prevalence of prediabetes and diabetes to understand the effects of screening on health outcomes.
- Screening and Interventions for the Prevention of Dental Caries in Children Younger Than Age 5 Years
- Assess the effectiveness of oral health educational and counseling interventions for parents and caregivers/guardians of young children.
- Enroll children from racial and ethnic populations that have historically been underrepresented (Black and Hispanic/Mexican American children) to understand the benefits and harms of risk assessment tools and preventive interventions.
- Validate the accuracy and use of caries risk assessment tools for use in primary care settings and determine how referral to dental care by primary care clinicians affects caries outcomes.
Future research in these areas can help fill these gaps and may result in important new recommendations that will help to improve the health of children, adolescents, adults, and pregnant people, particularly in Black, Hispanic/Latino, and American Indian/Alaska Native communities. The USPSTF hopes that identifying evidence gaps and highlighting them as research priorities will inspire public and private researchers to collaborate and target their efforts to generate new knowledge, address important health issues, and reduce health inequities.