The contribution of health behaviors to preventable morbidity and premature mortality in the U.S. is significant. Therefore, scaling effective behavioral counseling interventions (BCIs) to enhance healthy behaviors for the U.S. population is critical.

Recently, Curry and colleagues described challenges in applying the methodology of the U.S. Preventive Services Task Force (USPSTF) to BCIs with the goal of encouraging researchers, clinicians, and funders to support research that optimizes the ability to make evidence-based recommendations on BCIs for primary care, based on research that can usefully inform these decisions. They focused on challenges that had hindered previous research from being relevant, such as the choice of study populations, intervention protocols, and behavioral and health outcomes. Additional major research gaps in making evidence-based recommendations on BCIs were further defined during the USPSTF-sponsored Behavioral Counseling Forum (hereafter noted as the “Forum” and described in further detail by Curry and Whitlock in this supplement) held on November 6, 2013.

The USPSTF evidence review process provides insights to key research gaps, which are described both in the evidence reviews as well as in summary form in the USPSTF recommendation statements. Despite this, the field often does not fill these gaps or systematically compare gaps that have been identified across topics. As a result, the same unaddressed themes of missing or under-described data or design elements are repeated over time.

Therefore, the goal of this paper is to describe the types of gaps that the USPSTF encounters across its BCI topics and to provide suggestions for opportunities to fill them in order to facilitate research agendas that will enhance the evidence base for primary care–based behavioral counseling recommendations. To do this, we draw from both the USPSTF experience and the issues identified in the Forum.