prevention research 2001 prevention research branch the staff: liz robertson, ph.d., chief liz...
TRANSCRIPT
PREVENTIONPREVENTION
RESEARCH RESEARCH
20012001
PREVENTION PREVENTION RESEARCH BRANCHRESEARCH BRANCH
The Staff:The Staff: Liz Robertson, Ph.D., ChiefLiz Robertson, Ph.D., Chief Susan David, M.P.H., Deputy ChiefSusan David, M.P.H., Deputy Chief Kathy Etz, Ph.D. Kathy Etz, Ph.D. Eve Reider, Ph.D.Eve Reider, Ph.D. Larry Seitz, Ph.D.Larry Seitz, Ph.D. Liz Cooper, Branch SecretaryLiz Cooper, Branch Secretary
RESEARCH RESEARCH OBJECTIVESOBJECTIVES
Prevent initiation of drug use; Prevent initiation of drug use; Prevent the progression of Prevent the progression of
drug use among those who use;drug use among those who use; Prevent drug-related HIV Prevent drug-related HIV
infectioninfection..
Support Extramural ResearchSupport Extramural Research Efficacy StudiesEfficacy Studies Effectiveness TrialsEffectiveness Trials Services Research Services Research Methodology StudiesMethodology Studies
PREVENTION PREVENTION SCIENCESCIENCE
EpidemiologyEpidemiologyOrigins and pathways to drug Origins and pathways to drug
abuseabuseTheoriesTheoriesResearch evidence that Research evidence that
prevention programs do workprevention programs do work
WHERE WE AREWHERE WE ARE
20 years of research 20 years of research foundfound:: Modifiable risk & protective Modifiable risk & protective
factorsfactors Points of vulnerability Points of vulnerability Some basic prevention Some basic prevention
principlesprinciples
RESEARCH EXPANSIONRESEARCH EXPANSION 1996 1996 to 2000to 2000
GRANTS BY COMPONENTSGRANTS BY COMPONENTS
ComponentsComponents % Change % Change 1991-19951991-1995 to to 1996-1996-20002000
Multi-componentMulti-component 180%180%
FamilyFamily 200%200%
SchoolSchool 100%100%
WorkWork 100%100%
ClinicClinic 600%600%
MediaMedia 1000%1000%
GRANTS BY TYPEGRANTS BY TYPE
ComponentsComponents % Change % Change 1991-19951991-1995 to to 1996-1996-20002000
CentersCenters -50%-50%
TrainingTraining 200%200%
MethodologyMethodology -33%-33%
ServicesServices 160%160%
EtiologyEtiology -300%-300%
EpidemiologyEpidemiology -100%-100%
RESEARCH EXPANSIONRESEARCH EXPANSION 1996 to 20001996 to 2000
LEVELS OF RISKLEVELS OF RISK
Universal – all persons in a Universal – all persons in a particular groupparticular group
Selective – groups at high riskSelective – groups at high risk Indicated – individuals at high Indicated – individuals at high
riskrisk
RESEARCH EXPANSIONRESEARCH EXPANSION 1996 1996 to 2001to 2001
GRANTS BY Level of RiskGRANTS BY Level of Risk
ComponentsComponents Change from 1996 - 2001Change from 1996 - 2001
UniversalUniversal 113%113%
SelectiveSelective 375%375%
IndicatedIndicated 225%225%
TieredTiered 100%100%
Special populationsSpecial populations 58%58%
Gender specificGender specific 200%200%
RESEARCH EXPANSIONRESEARCH EXPANSION 1996 1996 to 2000to 2000
SBIR PROGRAMSBIR PROGRAM
FYFY GRANTSGRANTS CONTRACTSCONTRACTS TOTALTOTAL
19961996 77 00 77
19971997 77 00 77
19981998 1111 22 1313
19991999 1111 77 1818
20002000 1313 1010 2323
THUS, CURRENT THUS, CURRENT FOCI…FOCI…
....
Broadening the components of Broadening the components of intervention intervention
More multi-component More multi-component programsprograms
More selective and indicated More selective and indicated level level programsprograms
THUS, CURRENT THUS, CURRENT FOCI…FOCI…
....
Early childhood through Early childhood through adulthoodadulthood
More independent More independent replicationsreplications
More meta-analysesMore meta-analyses
THE BOTTOM LINE…THE BOTTOM LINE…
In five years,In five years,
a a 100%100% increase in increase in grantsgrants
SNAPSHOTS OF SNAPSHOTS OF SELECTED FINDINGSSELECTED FINDINGS
FINDINGS ON PROGRAM FINDINGS ON PROGRAM COMPONENTSCOMPONENTS
Parents who smoke can lower Parents who smoke can lower the risk of smoking among their the risk of smoking among their children by engaging in anti-children by engaging in anti-smoking socialization (Jackson, smoking socialization (Jackson, et al., 1997).et al., 1997).
FINDINGS ON PROGRAM FINDINGS ON PROGRAM COMPONENTSCOMPONENTS
Intervening as early as grade Intervening as early as grade one to decrease aggression and one to decrease aggression and increase academic success increase academic success substantially reduces substantially reduces subsequent substance abuse, subsequent substance abuse, depression and anti-social depression and anti-social behavior (Ialongo, et al., 1999).behavior (Ialongo, et al., 1999).
FINDINGS ON AUDIENCEFINDINGS ON AUDIENCE
Gender significantly affects Gender significantly affects drug offers and types of offers drug offers and types of offers (Moon, et al., 2000).(Moon, et al., 2000).
FINDINGS ON AUDIENCEFINDINGS ON AUDIENCE
Programs adapted to address Programs adapted to address the needs of specific ethnic the needs of specific ethnic audiences have greater effects audiences have greater effects in reducing substance use than in reducing substance use than universal non-adapted universal non-adapted programs (Botvin, et al.,1997).programs (Botvin, et al.,1997).
FINDINGS ON PROGRAM FINDINGS ON PROGRAM IMPLEMENTATIONIMPLEMENTATION
Providing accommodations Providing accommodations to families helps to attract to families helps to attract and retain them in and retain them in preventive interventions preventive interventions (Spoth, et al., 1999).(Spoth, et al., 1999).
FINDINGS ON PROGRAM FINDINGS ON PROGRAM IMPLEMENTATIONIMPLEMENTATION
Grouping anti-social youth in Grouping anti-social youth in interventions can lead to interventions can lead to unintended negative effects unintended negative effects such as increases in substance such as increases in substance use and violence (Dishion et al., use and violence (Dishion et al., 1999).1999).
Family
Surrounding Context
Cultural, Economic and Political Factors
School
Peers
Time
ROLE OF MODIFIERS ROLE OF MODIFIERS
MODERATORS
MODIFIABLE RISKS INTERVENTIO
N
EARLY CHILDHOODEARLY CHILDHOOD
MODIFIABLE RISKS
INTERVENTION
Inability to Inability to shareshareInappropriate Inappropriate
parental parental expectationsexpectationsInconsistent Inconsistent disciplinediscipline
Child social Child social practicepracticeEarly Early educationeducationParent skill Parent skill trainingtraining
ELEMENTARY SCHOOL ELEMENTARY SCHOOL AGEAGE
MODIFIABLE RISKS
INTERVENTION
School School transitiontransitionTeacher rules &Teacher rules &
expectationsexpectationsLack of parental Lack of parental
involvementinvolvement
Organized Organized classroom classroom Consistently Consistently applied rulesapplied rulesParent/teacher Parent/teacher communicationcommunication
MIDDLE SCHOOL AGEMIDDLE SCHOOL AGE
MODIFIABLE RISKS
INTERVENTION
Shy/Shy/aggressive aggressive behaviorbehaviorSchoolSchoolfailurefailureProblem Problem behaviorbehaviorPoor parental Poor parental
monitoringmonitoring
Social Social competencecompetenceAcademic skillsAcademic skillsProsocial Prosocial opportunitiesopportunitiesParent skillsParent skills
ADOLESCENCEADOLESCENCE
MODIFIABLE RISKS
INTERVENTION
Anti-social Anti-social peerpeerLack of school Lack of school
commitmentcommitmentFamily Family conflictconflict
Social & Social & academic skillsacademic skillsRefusal skillsRefusal skillsParent trainingParent trainingFamily therapyFamily therapy
NEW DIRECTIONSNEW DIRECTIONS
CROSSING THE GREAT DIVIDE
SELECTIVE AND SELECTIVE AND INDICATED POPULATIONSINDICATED POPULATIONS
Clinical populationsClinical populationsExternalizing disordersExternalizing disorders Internalizing disordersInternalizing disorders
Multi-risk children and Multi-risk children and familiesfamilies
HIV PREVENTIONHIV PREVENTION
Primary prevention Primary prevention Selective populationsSelective populations Indicated populationsIndicated populations
BASIC PREVENTIONBASIC PREVENTION
Next generation of Next generation of research:research: What worksWhat works For whom and For whom and Under what conditionsUnder what conditions
PREVENTION PREVENTION SERVICESSERVICES
Existing systems for preventionExisting systems for prevention Funding sourcesFunding sources Program selectionProgram selection Cost-benefits/effectiveness Cost-benefits/effectiveness Service availability, access, and Service availability, access, and
deliverydelivery
Prevention!
Go Prevention!
GO PREVENTION!
GoGo Prevention!
Go Prevention!
Go Prevention
Go Prevention
Go Prevention
Go PreventionGo Prevention
Go Prevention!
Go Prevention!
Go Prevention!
Go Prevention
Go Prevention!