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Nick Axford, Delbert S. Elliott and Michael Little

Blueprints for Europe: Evidence-based programmes and how they affect outcomes and risk and protective factors. Nick Axford, Delbert S. Elliott and Michael Little. Standards of evidence. Intervention specificity - is the programme focused, practical and logical? Evaluation quality

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Nick Axford, Delbert S. Elliott and Michael Little

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  1. Blueprints for Europe: Evidence-basedprogrammesand how they affect outcomes and risk and protective factors Nick Axford, Delbert S. Elliott and Michael Little

  2. Standards of evidence • Intervention specificity - is the programme focused, practical and logical? • Evaluation quality - does the evaluation produce valid and reliable findings? • Intervention impact - how much positive change in outcomes can be attributed to the programme? • Dissemination readiness - is the programme ready for implementation in communities and public service systems?

  3. Blueprints ‘Model’ programmes Big Brother Big Sisters Functional Family Therapy Incredible Years Life Skills Training Multidimensional Treatment Foster Care Multisystemic Therapy Nurse Family Partnership Olweus Bullying Prevention PATHS Project TND

  4. Blueprints ‘Promising’ programmes ATLAS BASICS BMRP Fast Track Good Behaviour Game Guiding Good Choices I Can Problem Solve LIFT Orebro Prevention Program Perry Pre-School Preventive Treatment Program Project Northland Raising Healthy Children Strengthening Families 10-14 Strong African American Families SPORT In Shape Steps to Respect Triple P

  5. Outcomes • 5 stages: infancy (0-2), early childhood (3-5), middle childhood (6-11), adolescence (12-17), early adulthood (18-24) • 5 areas (and KDOs) - Positive relationships (e.g. safe from abuse and neglect) - Emotional well-being (e.g. free from depression/anxiety) - Positive behaviour(e.g. does not use illicit substances) - Educational skills/attainment (e.g. school readiness) - Physical health (e.g. healthy gestation and birth)

  6. Outcomes with 5+ programmes • Positive relationships - Positive relationships with positive peers (6-11) - Positive relationships with positive parents (12-17) • Positive behaviour - Absence of enduring negative behaviour (6-11, 12-17) - Does not participate in crime or violence (6-11, 12-17) - Has not tried illicit substances (6-11) - Does not use illicit substances (12-17) - Does not use illicit substances or cigarettes or drink excessive alcohol (18-24) • Educational skills and attainment - At least adequate academic performance (6-11, 12-17)

  7. Outcomes with 0 programmes • Positive relationships - Positive relationships with positive parents (0-2, 18-24) - Positive relationships with positive peers (0-2, 3-5) - Positive relationships with prosocial adults (6-11, 12-17) • Emotional well-being - Free from depression/anxiety (3-5) - Free from suicidal ideation/behaviours (6-11) - Self-regulation (12-17, 18-24) • Positive behaviour - Absence of risky sexual behaviour (6-11) • Educational skills and attainment - At least adequate academic performance (18-24) • Physical health - Freedom from obesity (3-5, 6-11, 12-17) - Freedom from chronic health/developmental impairments (6-11, 18-24)

  8. Outcomes with 1-4 programmes • Positive relationships - Positive relationships with positive parents (3-5, 6-11) - Positive relationships with positive peers (12-17) - Safe from abuse and neglect (3-5, 6-11, 12-17, 18-24) • Emotional well-being - Self-regulation (3-5, 6-11) - Free from depression and anxiety (6-11, 12-17, 18-24) - Free from suicidal ideation and behaviours (6-11, 12-17, 18-24) • Positive behaviour - Absence of enduring negative behaviour (3-5) - Does not participate in crime or violence (18-24) - Absence of risky sexual behaviour (12-17, 18-24) - Absence of teen/unintended pregnancy (12-17, 18-24) • Educational skills and attainment - Ready for school (3-5) - Graduation from High School (18-24) - Entry into stable post-secondary education, training, employment (18-24) • Physical health - A healthy gestation and birth (0-2) - Freedom from chronic health impairments or developmental impairments (3-5, 12-17)

  9. Summary (1) • Outcomes generally well covered: - behaviour, crime, violence - drug/substance misuse • Outcomes needing particular attention: - abuse/neglect - anxiety/depression - physical health (including obesity) - risky sexual behaviour and teen/unintended pregnancy • Developmental stages needing attention: - Infancy (1 programme), early childhood (6), early adulthood (9) - Compares with middle childhood (15) and adolescence (24)

  10. Risk and protective factors • 5 stages: infancy (0-2), early childhood (3-5), middle childhood (6-11), adolescence (12-17), early adulthood (18-24) • 5 areas (and RPFs): - Individual and peer (e.g. hyperactivity / problem-solving) - Family (e.g. family conflict / parent support) - School and work (e.g. repeated a grade / commitment to school) - Community (e.g. community disorganisation / collective efficacy) - Economic (e.g. family poverty / adolescent employment)

  11. ProgrammesxRPFs targeted

  12. RPFs targeted by 10+ programmes

  13. Sample RPFs targeted by 0-1 programmes

  14. Example: PATHS

  15. PATHS cont’d

  16. Example: Multisystemic Therapy

  17. Multisystemic Therapy cont’d

  18. Summary (2) • High variability in extent to which the 72 RPFs are targeted • Over a quarter (20) not targeted by any programme, only 12 targeted by 10 programmes • Focus is mainly on proximal RPFs (especially individual, peer and family) • Striking lack of focus on distal RPFs (community and economic factors) • Programmes are mostly targeting RPFs in middle childhood and adolescence (little in infancy, early childhood or early adulthood) • Most programmes target multiple risk and protective factors, often across domains

  19. Mediation analysis • Mediation analysis conducted in: - 6 out of 10 ‘Model’ programmes - 7 out of 20 ‘Promising’ programmes • Evidence to support theoretical model in all but 2 of 13 where mediation analysis done

  20. Implications • For programme developers: - Useful basis for design - Important gaps in outcomes affected - Attention to other RPFs? • For evaluators: - More research on impact on RPFs - More mediation analyses • In Europe: - Develop programmes that meet Blueprints standards - Test adapted versions of US programmes

  21. Axford, N., Elliott, D. S. and Little, M. (2012) ‘Blueprints for Europe: promoting evidence-based programmes in children’s services’ [Blueprints paraEuropa: PromoviendoProgramasBasados en la Evidencia en los Servicios de Atención a la Infancia], Psychosocial Intervention 21 (2), 205-214. www.psychosocial-intervention.org/ www.colorado.edu/cspv/blueprints/ www.dartington.org.uk

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