swl 579a session 4 instructor: j. david hawkins university of washington 10/21/09
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SWL 579A Session 4SWL 579A Session 4
Instructor: J. David HawkinsUniversity of Washington
10/21/09
While you wait -While you wait -
What is the difference between sensitivity and specificity of a measure?
EPIDEMIOLOGY ETIOLOGY EFFICACY EFFECTIVENESS DISSEMINATION
1. Identify problem or disorder(s) and review information to determine its extent
2. With an emphasis on risk and protective factors, review relevant information-both from fields outside prevention and from existing preventive intervention research programs
3. Design, conduct, and analyze pilot studies and confirmatory and replication trials of the preventive intervention program
4. Design, conduct, and analyze large-scale field trials of the preventive intervention program
5. Facilitate large-scale implementation and ongoing evaluation of the preventive intervention program in the community.
The preventive intervention research cycle. Preventive intervention research is represented in boxes three and four. Note that although information from many different fields in health research, represented in the first and second boxes, is necessary to the cycle depicted here, it is the review of the information, rather than the original studies, that is considered to be part of the preventive intervention research cycle. Likewise, for the fifth box, it is the facilitation by the investigator of the shift from research project to community service program with ongoing evaluation, rather than the service program itself, that is part of the preventive intervention research cycle. Although only one feedback loop is represented here, the exchange of knowledge among researchers and between researchers and community practitioners occurs throughout the cycle.
Principles for Culturally Competent Prevention Science
• Include multiple groups in studies.• Compare prevalences and rates of
positive and problem behaviors and outcomes.
• Include measures of ethnic identify or acculturation to understand degree to which group differences reflect culture.
• Examine levels of risk and protection exposure in different groups.
Principles for Culturally Competent Prevention Science
• Examine the strength of association of risk and protective factors with outcomes in different groups after controlling for socioeconomic status.
• Use engagement approaches that effectively involve the focal audience.
• Use communication strategies that effectively communicate with the focal audience.
Perceived opportunities for prosocial
interaction/involvement with prosocial family,
classmates, teachers and classroom activities
Interaction/involvement with prosocial family, caregivers, teachers,
classmates, and classroom activities
Perceived rewards for interaction/involvement with prosocial family, caregivers, teachers,
classmates and classroom activities
Family management
Classroom management
School policies
Position in the social structure
Perceived opportunities for interaction with
antisocial family and caregivers, and/or
involvement in aggressive and other
problem behaviors
Interaction with antisocial family and caregivers, and/or
involvement in aggressive and other
problem behaviors
Perceived rewards for interaction with
antisocial family and caregivers, and/or
involvement in aggressive and other
problem behaviors
Skills for interaction/involvement
• Home-based services• Preparing for the Drug Free Years
• Respect & Responsibility• Proactive Family Management
• Newsletters
ANTISOCIAL PATH
PROSOCIAL PATH
(+) (-) (+,-)
Attachment and commitment to prosocial
family, caregivers, teachers, classmates
and classroom activities
Proactive ClassroomManagement
TeacherInstructional
Skills
Constitutional factorsInterpersonal and problem solving skills training and
summer camp
How to Help your Child Succeed in
SchoolAfter school study clubs
Belief in prosocial
family, caregivers, and school
values
Belief in antisocial family and caregivers’ values
Attachment and commitment to antisocial
family and caregivers
Drug and delinquency initiation
Note: Interaction or moderating effects are indicated by an arrowhead pointing to a structural path rather than a construct. Shaded circles indicate program interventions
The Social Development Model: Elementary School Period
Individual CharacteristicsBe Aware of…
The Social Development The Social Development StrategyStrategy
The Goal… Healthy Behaviors …for all children and youth
Healthy Beliefsand
Clear Standards
…in families, schools, and peer groups
Start with…
Build…Bonding
–Attachment–Commitment
…to families, schools, and peer groups
By providing… Opportunities Skills Recognition …in families, schools, and peer groups
Social development in a parent child interaction.
Parent-Child Interaction Coded for
OpportunitiesInvolvementRewardsBonding
etc.
Seattle Social Development Seattle Social Development ProjectProject
Targeted Risk FactorsTargeted Risk Factors School Domain
Low commitment to schoolAcademic failure
Family DomainPoor family managementFamily conflict
Individual DomainEarly antisocial behaviorFavorable attitudesFriends who engage in problem behaviorEarly initiation
Study CharacteristicsStudy Characteristics All 5th grade students from 18 Seattle
elementary schools were eligible. Active consent required – 77% (n=808) of
eligible population consented. Comparison Group Design
Full treatment (grades 1-6) = 149 Late treatment (grades 5-6) = 243 Control = 206 Parent training only = 208 (not included in these
analyses) Demographics
51% Male 46% Caucasian, 26% African American, 21% Asian-
American 56% free-lunch eligible 40% from single-parent families
Seattle Social Development Project: Hypothesized Seattle Social Development Project: Hypothesized Effects of Teaching on Students’ Social DevelopmentEffects of Teaching on Students’ Social Development
Student Opportunities For Classroom Involvement
Student Classroom Involvement
Reinforcement for Classroom Involvement
~ From Peers
~ Perceived Reinforcement for School Involvement
Bonding
~ To Prosocial Peers
~ To SchoolStudent Skills for Classroom Involvement
Teaching Interventions
Proactive Classroom Management
Interactive Teaching
Cooperative Learning
SSDP/SOAR Teaching SSDP/SOAR Teaching PracticesPracticesProactive classroom management
Establish consistent classroom expectations and routines at the beginning of
the yearGive clear, explicit instructions for behaviorRecognize and reward desirable student behavior and efforts to complyUse methods that keep minor classroom disruptions from interrupting
instructionInteractive teaching
Assess and activate foundation knowledge before teachingTeach to explicit learning objectivesModel skills to be learnedFrequently monitor student comprehension as material is presentedRe-teach material when necessary
Cooperative learningInvolve small teams of students of different ability levels and backgrounds as learning partnersProvide recognition to teams for academic improvement of individual
members over past performance
Proactive Classroom Proactive Classroom Management- Law of Least Management- Law of Least InterventionIntervention– Least amount of Least amount of
time time – Least amount of Least amount of
teacher effortteacher effort– Least amount of Least amount of
negative negative attention on attention on studentstudent
– Least Least unpleasant unpleasant feelingfeeling
– Least disruption Least disruption to the learning to the learning environmentenvironment
Eye contactEye contact ProximityProximity PausePause First/ThenFirst/Then Encouraging Encouraging
desirable desirable behaviorbehavior
Cueing Cueing HumorHumor EmpathyEmpathy Modify Modify
instructioninstruction
Comparison in Use of Project Comparison in Use of Project Teaching Practice Between Teaching Practice Between Intervention and Control Teachers Intervention and Control Teachers at Grade Sixat Grade Six
Low Implementers of Project Practices
High Implementers of Project Practices
Row Totals
Control Control TeachersTeachers
1365.0%
735.0%
2046.5%
Intervention Teachers
834.8%
1565.2%
2353.5%
Column Total
2148.8%
2221.2%
43100%
X2 = 3.9 p ≤ .05
Results of the Hierarchical Linear Modeling of Results of the Hierarchical Linear Modeling of Children’s Measures Nested within Teachers’Children’s Measures Nested within Teachers’
Hierarchical Linear Modeling
STUDENTCAT aggregate score
Classroom involvement opps.Skills School grades Social & academicClassroom involvementReinforcement From peers From schoolBonding To school To prosocial peers
X2 df p63.31 36 0.004
220.90 36 0.001
71.49 36 0.001148.51 36 0.001106.05 41 0.001
147.84 41 0.001244.12 41 0.001
222.65 41 0.00185.97 41 0.001
ONE-WAY ANOVAt p2.69 0.001
1.03 0.311
1.26 0.2151.24 0.205
-0.25 0.800
0.47 0.6420.47 0.638
0.27 0.786-0.29 0.774
INTERV. VS.CONTROL
t p1.53 0.134
3.14 0.004
1.11 0.275-0.86 0.3832.49 0.009
-0.11 0.9142.36 0.023
2.23 0.0320.70 0.478
IMPLEMENT.SCORE
Total Aggregated Risk Factors Total Aggregated Risk Factors PerspectivePerspective
J ohn A. Pollard , P h.D. Developmental Research and Programs
No studentsin this area.
Insuffic ient number ofstudents in this area.
Neighborhood #2
Neighborhood #1 Neighborhood #3
Madison Middle School Barriers to Learning Profi le 8th Grade
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pe
rce
nt
At
Ris
k
School 2002 District 2002
Community Family School
Estimated National Value
Survey Participation Rate 2002: 87.4%
2002
Peer-Individual
Addressing Barriers with Effective Addressing Barriers with Effective ActionAction
3-5Early Childhood Education
prenatal-2Prenatal/Infancy Programs
6-14Family Therapy
prenatal-14Parent Training
Family Management Problems
Developmental PeriodProgram Strategy Factor Addressed
Effective Training for Middle School Effective Training for Middle School ParentsParents
Guiding Good Choices® (Spoth et al., 1998)Adolescent Transitions Program (Dishion and
Andrews, 1995)Parenting Adolescents Wisely (Gordon et al., 1998)Creating Lasting Connections (Johnson et al., 1996)The Iowa Strengthening Families Program (Spoth,
1998)Focus on Families (Catalano et al., 1999; 1997)
Nova High School Strengths Profi le 10th Grade
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Communityopportunities for
prosocialinvolvement
Communityrecognition for
prosocialinvolvement
FamilyAttachment
Familyopportunities for
prosocialinvolvement
Familyrecognition for
prosocialinvolvement
Schoolopportunities for
prosocialinvolvement
Schoolrecognition for
prosocialinvolvement
Social skills Belief in themoral order
OverallProtection
Pe
rce
nt
Pro
tect
ed
School 2002 District 2002
Community Family School
Estimated National Value
2002
Survey Participation Rate 2002: 79.7%
Peer-Individual Overall
Nova High School Substance Use & Antisocial Behavior
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Per
centa
ge
School 2002 MTF 2001
Ever Used 30-Day Use
Survey Participation Rate 2002: 79.7%
10th Grade: 2002HeavyUse
Past Year Antisocial Behavior
Nova High School Barriers to Learning 10th Grade
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Pe
rce
nt
At
Ris
k
School 2002 District 2002
Community Family School
Estimated National Value
Survey Participation Rate 2002: 79.7%
2002
Peer-Individual Peer-Individual
Addressing Barriers with Addressing Barriers with Effective ActionEffective Action
Risk Factor Addressed Program Strategy Developmental Period
Favorable Attitudes Toward Drug Use
Classroom Curricula for Social Competence and Competence Promotion
6-14
Community/School Policies
Classroom Curricula for Classroom Curricula for Social and Emotional Social and Emotional
Competence Promotion Competence Promotion Alcohol Misuse Prevention
(Maggs et al., 1998) Bicultural Competence Program
(Schinke et al., 1988)Towards No Drug Use (Dent et al.,
1995) The Valued Youth Partnership
(Cardenas et al., 1992)
Brown and Liao, Fig. 1. Three design phases of a preventive Brown and Liao, Fig. 1. Three design phases of a preventive intervention trial.intervention trial.
Pre-Intervention Assessment No Yes
Pre-Intervention Assessment No Yes
Target Population Pre-Randomized Design Not Located Contacted Or Contacted Ineligible Eligible Selection Bias Refused Consented Intervention Design Randomized Intervention Control Participation Participation Bias No Yes Post-Intervention Design Attrition
Sample / Selected No Yes
Intervention AssignmentIntervention Assignment
RandomizationRandomization Balance, Matching, BlockingBalance, Matching, Blocking Cluster Random Assignment Cluster Random Assignment
What are the Fatal Design What are the Fatal Design Flaws in a Trial?Flaws in a Trial?
Pre-Intervention Assignment:Pre-Intervention Assignment: Intervention:Intervention: Post-Intervention:Post-Intervention:
Pre-Intervention Pre-Intervention Assignment DesignAssignment Design
Extreme Selection BiasExtreme Selection Bias Not a Large Enough Sample is Not a Large Enough Sample is
DrawnDrawn
Intervention DesignIntervention Design
Intervention & Control Subjects Intervention & Control Subjects are differentare different
ContaminationContamination Randomized at Wrong LevelRandomized at Wrong Level Low Intervention DeliveryLow Intervention Delivery Large Drop-outsLarge Drop-outs
Post-Intervention DesignPost-Intervention Design
Large AttritionLarge Attrition Differential AttritionDifferential Attrition Differential Measurement ErrorDifferential Measurement Error
SSDP DesignSSDP Design
• Initiated full intervention and control conditions in 1981 in 8 Seattle elementary schools. • Expanded in 1985 to 18 Seattle elementary schools to add a late intervention condition, a parent training only condition, and additional control students.
• Quasi-experimental study
Full treatment (grades 1-6) = 149 Late treatment (grades 5-6) = 243 Control = 206
Parent training only (grades 5-6) = 210
No significant differences for those lost to attrition No significant differences for those lost to attrition versus those retained with respect to distribution of versus those retained with respect to distribution of participants into the intervention conditions at ages participants into the intervention conditions at ages 18, 21, 24 or 27.18, 21, 24 or 27.
No significant differences between the intervention No significant differences between the intervention and control groups with respect to:and control groups with respect to:• Gender, ethnicity, or childhood povertyGender, ethnicity, or childhood poverty• Mean years living in Seattle by grade 6 Mean years living in Seattle by grade 6 • Mean number of residences lived in from age 5 to 14 Mean number of residences lived in from age 5 to 14 • Proportion of single-parent homes during grade 5 Proportion of single-parent homes during grade 5 • Living in a disorganized neighborhood at age 16Living in a disorganized neighborhood at age 16• Family size, mother’s education, or age at time of survey at Family size, mother’s education, or age at time of survey at
age 21age 21BUT-BUT-More controls than full intervention group born to teen More controls than full intervention group born to teen
mothers.mothers.
Attrition and Internal Validity
2.70
2.75
2.80
2.85
2.90
2.95
3.00
3.05
3.10
13 14 15 16 17 18Age
Leve
l of Sc
hool
Bon
ding Full Treatment
Late TreatmentControl
Effects of SSDP Intervention Effects of SSDP Intervention on School Bonding from Age on School Bonding from Age
13 to 1813 to 18
Hawkins, Guo, Hill, Battin-Pearson & Abbott (2001)
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