Confessions of a team science funder.

When I arrived at the National Cancer Institute in July of 1998, my colleagues and I were afforded a remarkable opportunity: create and build a new division of the National Institutes of Health (NIH)’s largest institute. Visionary leadership, a rapidly growing budget, a wealth of new positions to fill, and an intriguing array of scientific opportunities presented a unique context within which to revisit the most recalcitrant and complex challenges in cancer control. There was only one (of many, as we were later to learn) problem. Many of the career staff who had been reassigned into our newly formed Behavioral Research Program shared neither our excitement nor our enthusiasm. As a newly arrived team leader, I was soon awash in a tidal wave of skepticism. With no government experience, I was viewed as naive and unrealistic. Many of the most experienced staff were also the most cynical and pessimistic. Having felt unsupported and disconnected from their previous leadership, they were dispirited, demoralized, and reluctant to commit to ambitious new objectives. Collaboration within and between agencies was minimal; trust was extinct. Furthermore, there were substantive disagreements about mission and priorities. To a large degree, these reflected the training and disciplines of the staff. Advocates of public health programs, trained primarily in public health or preventive medicine, argued that funds should primarily support contracts to state health departments to implement what was already known. Skeptical about the population-level impact of behavior change interventions, this group supported close coordination with advocates and community leaders to effect policy change. In contrast, members of the academic research community, including a few social and behavioral scientists who had recently moved into government, felt that new and better evidence was critically needed to understand the mechanisms underlying health behavior and improve the efficacy of clinical interventions. I soon learned that the National Institutes of Health was emerging from its own internal battles concerning the relative importance of traditional clinical research versus basic biomedical science. The Genome Project and its related spin-offs were generating a contagious confidence among basic scientists in their ability to reinvent and revitalize what they viewed to be a moribund clinical enterprise. Clinical programs within the agency were shuttered, a new generation of basic scientists were promoted or recruited, and physiology gave way to molecular biology. The expanding budget of the NIH enabled new investments in technology, the development of model systems, the expansion of university facilities, and an increasingly reductionist model of medicine and public health. Gene discovery ruled the day, catalyzed by competition both within and between the public and private sectors. Research on health care, policy, economics, and interpersonal processes were viewed as beyond the appropriate domain of the NIH. Many behavioral scientists at NIH shared the sense of isolation and lack of support reported by many of my National Cancer Institute (NCI) colleagues. But within NCI, change was underway. President Clinton appointed Barbara Rimer as Chair of the National Cancer Advisory Board, the first woman and first behavioral scientist to serve in this role. The NCI Director, Richard Klausner, initiated a major reorganization of the institute, creating the Division of Cancer Control and Population Sciences in late 1997 and appointing Rimer as its first director Robert Hiatt, a physician and epidemiologist, joined shortly thereafter as Deputy Division Director. Together, the three of us, with input from many re-energized colleagues, immediately set out to formulate strategic scientific goals that focused on expanding support for interdisciplinary research. Within the domain of behavioral research, our primary strategy was both explicit and expensive: to support and advance transdisciplinary team science, implemented though centers of excellence with stringent requirements for conceptual and methodological integration in the complex problem domains that we believed were critical to address in order to accelerate progress in cancer control research and practice: tobacco use, communication, population health disparities, and obesity. These signature initiatives (totaling nearly $285 million in funding from the National Cancer Institute over the last decade) were carefully designed to bring together diverse disciplines with limited histories of prior collaboration to support novel collaborative science. We made a special effort to entice and support investigators in disciplines that had not been central to the NCI constituency: geographers, sociologists, anthropologists, social workers, economists, psychometricians, statistical modelers, kinesiologists, urban designers, journalists, cognitive scientists, and environmental health experts, just to name a few. But we also conceived the transdisciplinary centers as a grand experiment in team science, incorporating evaluation efforts designed not only to assess the impact of the work, but also to advance the science of team science itself through the development and application of new methods. What follows are some personal reflections on the lessons learned from the 13 years since the first of these initiatives, the Transdisciplinary Tobacco Use Research Centers (TTURC), was launched (in collaboration with the National Institute on Drug Abuse, the Robert Wood Johnson Foundation, and the National Institute on Alcohol Abuse and Alcoholism). Because most of the articles in this issue discuss team science issues from the perspective of investigators as members or leaders of project teams, my focus will be a more distant and global one, spanning across many years, many initiatives, and the team-related issues that arise among federal and non-federal funders as well as investigators.