PREVENTION RESEARCH BRANCH The Staff: Liz Robertson, Ph.D., Chief Susan David, M.P.H., Deputy Chief Kathy Etz, Ph.D. Eve Reider, Ph.D. Larry Seitz, Ph.D. Liz Cooper, Branch Secretary
RESEARCH OBJECTIVES • Prevent initiation of drug use; • Prevent the progression of drug use among those who use; • Prevent drug-related HIV infection.
Support Extramural Research • Efficacy Studies • Effectiveness Trials • Services Research • Methodology Studies
PREVENTION SCIENCE • Epidemiology • Origins and pathways to drug abuse • Theories • Research evidence that prevention programs do work
WHERE WE ARE • 20 years of research found: • Modifiable risk & protective factors • Points of vulnerability • Some basic prevention principles
Universal – all persons in a particular group Selective – groups at high risk Indicated – individuals at high risk LEVELS OF RISK
THUS, CURRENT FOCI….. • Broadening the components of intervention • More multi-component programs • More selective and indicated level programs
THUS, CURRENT FOCI….. • Early childhood through adulthood • More independent replications • More meta-analyses
THE BOTTOM LINE… • In five years, a 100% increase in grants
FINDINGS ON PROGRAM COMPONENTS • Parents who smoke can lower the risk of smoking among their children by engaging in anti-smoking socialization (Jackson, et al., 1997).
FINDINGS ON PROGRAM COMPONENTS • Intervening as early as grade one to decrease aggression and increase academic success substantially reduces subsequent substance abuse, depression and anti-social behavior (Ialongo, et al., 1999).
FINDINGS ON AUDIENCE • Gender significantly affects drug offers and types of offers (Moon, et al., 2000).
FINDINGS ON AUDIENCE • Programs adapted to address the needs of specific ethnic audiences have greater effects in reducing substance use than universal non-adapted programs (Botvin, et al.,1997).
FINDINGS ON PROGRAM IMPLEMENTATION • Providing accommodations to families helps to attract and retain them in preventive interventions (Spoth, et al., 1999).
FINDINGS ON PROGRAM IMPLEMENTATION • Grouping anti-social youth in interventions can lead to unintended negative effects such as increases in substance use and violence (Dishion et al., 1999).
ROLE OF MODIFIERS MODIFIABLE RISKS INTERVENTION MODERATORS
EARLY CHILDHOOD MODIFIABLE RISKS INTERVENTION • Child social practice • Early education • Parent skill training Inability to share Inappropriate parental expectations Inconsistent discipline
ELEMENTARY SCHOOL AGE MODIFIABLE RISKS INTERVENTION • Organized classroom • Consistently applied rules • Parent/teacher communication School transition Teacher rules & expectations Lack of parental involvement
MIDDLE SCHOOL AGE MODIFIABLE RISKS INTERVENTION Shy/aggressive behavior School failure Problem behavior Poor parental monitoring Social competence Academic skills Prosocial opportunities Parent skills
ADOLESCENCE MODIFIABLE RISKS INTERVENTION • Social & academic skills • Refusal skills • Parent training • Family therapy Anti-social peer Lack of school commitment Family conflict
NEW DIRECTIONS CROSSING THE GREAT DIVIDE
SELECTIVE AND INDICATED POPULATIONS • Clinical populations • Externalizing disorders • Internalizing disorders • Multi-risk children and families
HIV PREVENTION • Primary prevention • Selective populations • Indicated populations
BASIC PREVENTION • Next generation of research: • What works • For whom and • Under what conditions
PREVENTION SERVICES • Existing systems for prevention • Funding sources • Program selection • Cost-benefits/effectiveness • Service availability, access, and delivery
Go Prevention! Go Prevention! Go Prevention! Go Prevention! Go Prevention Go Prevention Go Prevention! Go Prevention Go Prevention! Go Prevention Go Prevention! Go Prevention Go Prevention Go Prevention! GO PREVENTION!