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January Monthly Newsletter
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In this Issue:
- 2020 Back to the Future, A New Decade in Prevention!
- Additional Resources
- What's Happening Around the Region?
- Epi Corner: Broadening the Lens of Prevention
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The South Southwest Prevention Technology Transfer Center wishes you a prosperous new year and new decade that brings you continued success in your prevention efforts!
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2020 Back to the Future, A New Decade in Prevention!
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As we enter a new decade the science of prevention continues to grow with strong research and evidence that not only validates the current work we are doing but also moves us forward to visualize a future where individuals of every population and age can experience healthy mental, emotional and behavioral (MEB) outcomes.
In a 2009 report,
Preventing Mental, Emotional, and Behavioral Disorders Among Young People,
the National Research Council and Institute of Medicine argued that existing research made the case for support of both prevention and promotion interventions.
A decade later, the 2019 report of National Academies of Sciences, Engineering and Medicine
Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda
shows that growing evidence of the interplay among biological, social, and environmental influences on MEB development, beginning
before a child is even conceived
, has profound implications for the design of interventions to promote healthy MEB development. Researchers have documented evidence for strategies that effectively target risk and protective factors and influence multiple MEB outcomes and can be
implemented universally in health care and education settings
. These findings provide the basis for the development of
policy and program tools
for improving MEB outcomes. Coordinating strategies found to be effective in supporting individuals and families, populations, and multiple generations to address clearly articulated needs is critical to achieving significant benefits relative to the use of ad hoc interventions.
The preventionist of the future can rely upon these and other recommended interventions from the 2019 report that focuses on these areas:
- A lifespan approach, including before conception and extending beyond generations, addressing risk and protective factors at various developmental phases and at the individual, family, community and societal levels.
- A shift from the 2009 report from intervening with the individual child to intervening at the societal and community levels. Health promotion and community wellness approaches have a greater potential to benefit children across populations.
- A public health approach combined with community support emphasizing the role of the county, state, and federal agencies; public education systems; service sectors, businesses; and other local partners is essential in implementing strategies and achieving population-level impacts.
When you have finished reading all 391 pages of the document, take a look at some of these other resources that provide a further look into several of the areas of focus recommended by the report. Especially interesting is the impact of the findings on evaluation and epidemiology found in the Epi Corner, written by Iris Smith at the end of this newsletter.
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Webinar Recording: Fostering Healthy Mental, Emotional, and Behavioral Health in Children and Youth: A National Agenda
Pacific Southwest Prevention Technology Transfer Center
This recorded webinar is an overview of the newly released National Academies of Sciences, Engineering, and Medicine’s consensus report, Fostering Healthy Mental, Emotional, and Behavioral Health in Children and Youth: A National Agenda. During this webinar, several key contributors to the report will highlight updates to the research since the previous report on this topic was released 10 years ago and discuss recommendations for leveraging this substantive research to create a national agenda where children and youth thrive.
Multigenerational Approaches to Fostering Children’s Health and Well-Being
The Opioid Crisis as a Case Study
This publication summarizes the presentation and discussion of a workshop in June 2019 by the Forum for Children's Well-Being to address the need for strategies that affect multiple generations. Comanche Nation in Oklahoma is one of the groups participating in this presentation.
The publication highlights and explains four areas for consideration in future efforts to address children’s health in the wake of the opioid crisis:
1. equity and stigma;
2. relational programming and the power of community;
3. alignment of rules and messages; and
4. attending to economic self-sufficiency with new strategies for trying to reduce poverty.
Promoting Positive Adolescent Behaviors and Outcomes: Thriving in the 21st Century
The National Academies of Sciences, Engineering and Medicine
Board on Children, Youth, and Families
Identifies key program factors that can improve health outcomes related to adolescent behavior and provides evidence-based recommendations toward effective implementation of federal programming initiatives. This study explores normative adolescent development, the current landscape of adolescent risk behavior, core components of effective programs focused on optimal health, and recommendations for research, programs, and policies.
The Interdependence of Families, Communities, and Children’s Health: Public Investments That Strengthen Families and Communities, and Promote Children’s Healthy Development and Societal Prosperity
National Academy of Medicine
Children’s development is best promoted when, in addition to these direct investments, policies and programs that strengthen families and communities are supported. Children are embedded in families, who are, in turn, embedded in neighborhoods and communities. Consequently, policies or programs that strengthen the ecologies of children—i.e., their families and their communities—also promote children’s healthy development. This document is a review of major federal and state policies targeting social determinants of health, and the evidence regarding their effect, and describes how these policies and programs can strengthen family and community agency or purpose, and therefore can influence children’s development.
Aligning Science, Practice, and Policy to Advance Health Equity
This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.
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What's Happening Around the Region?
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Decolonizing Data: Restoring Culture and Rebuilding Beauty
Abigail Echo-Hawk, Chief Research Officer at the Seattle Indian Health Board will share techniques that tribal programs that can be used to collect and use data that focuses on the needs of indigenous communities. This event will be made available via live stream for participants who cannot attend in person.
Date:
Thursday, January 23, 2020
Time:
1:30 PM to 3:30 PM CST
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Self-guided Learning Courses
- Introduction to Substance Abuse Prevention: Understanding the Basics
- Marijuana
- E-Cigarettes and Vaping
- Early Childhood Development: Toxic Stress and Adverse Childhood Experiences
- Prevention in Action Series: Teaching the SAPST at a University
- Minecraft, not Ms. Pac-Man: Transforming Prevention Presentations for Today's Audience
- Evaluation
- Social Media and Use of Technology
- “Talk. They Hear You.” Campaign
Online Courses
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2020 PFS Academy: Save These Dates
Time:
Each webinar will begin 8:00 PT/9:00 MT/10:00 CT/11:00 ET
SAMHSA’s Strategic Prevention Framework (SPF) provides practitioners with comprehensive guidance to more effectively address substance abuse and related behavioral health problems in their communities. This seven-part webinar series will explore this five-step, data-driven process to identify genuine prevention needs, build capacity and plans to address those needs, implement effective programs and strategies, and evaluate and continually improve prevention efforts. At each step of the SPF and in separate sessions, practitioners will learn to incorporate the guiding principles of cultural competence and sustainability to help support the implementation of SAMHSA’s Strategic Prevention Framework (SPF). Specifically:
- February 25, Part 1: Assessment, will introduce the SPF and explore how to identify the needs of the community using data.
- March 24, Part 2: Capacity Building, will guide participants through the process of improving community readiness and increasing the resources available to address prevention efforts.
- April 21, Part 3: Planning, will prepare participants to plan to address identified needs.
- May 19, Part 4: Implementation, will provide participants with the tools needed to implement prevention programs, policies, and practices with fidelity and effectiveness.
- June 23, Part 5: Evaluation, will offer helpful guides for the collection and analysis of prevention strategies and teach participants how to modify programming for future enhanced results.
- July 21, Part 6: Sustainability, will provide participants with the elements of a sustainable prevention program and how to integrate sustainability into each step of the SPF.
- August 25, Part 7: Cultural Competency, will prepare participants to demonstrate cultural competence at the individual, organizational and system level at each step of the SPF.
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Epi Corner
Iris Smith, Ph.D., M.P.H.
South Southwest Prevention Technology Transfer Center
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Broadening the Lens of Prevention
The recently published Consensus Study Report by the National Academies of Sciences (NAS), Engineering and Medicine,
Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth
(2019),
[1]
urges us as prevention practitioners, researchers and policy makers to broaden the lens through which we view prevention. The report provides a comprehensive overview of the complex interaction of biological, social and environmental factors that influence mental, emotional and behavioral development across the lifespan. There is a growing body of research that demonstrates there is a dynamic interaction among genetic, biological social and environmental influences from preconception to adulthood. It is important to view prevention from this broader lens that extends beyond the individual. The report emphasizes the importance of facilitating positive outcomes at the
community
as well as the individual and group level. The authors of the report recognize that coordinated data collection, analysis and synthesis at the individual, community, state, and national levels are key elements of an effective prevention system capable of achieving positive and sustainable outcomes that can be replicated across communities.
The selection of evidence-based interventions has been encouraged during the past decade and is now widely accepted by the practice community. However, the scaling up of individual programs to community or state-wide strategies remains a challenge. One of the reasons for this is that most evaluation data is based on efficacy studies- i.e. the program has been successful in a specific context with a specific population under controlled circumstances. At the program level, effort is often directed toward selecting and adapting programs to fit a specific community context. The NAS report recommends moving beyond reliance primarily upon randomized control trials to the use of real world clinical trials; comparative effectiveness studies, hybrid designs that blend components of efficacy and effectiveness trials. Outcome measurement should include health policy outcomes; pre/post observations and other quasi-experimental methods as well as quality improvement research. Learning collaboratives that allow for testing and sharing of ideas and resources at multiple sites in the design and implementation of interventions can also enhance understanding of what is working and what is not (NAS, 2019; pg. 38).
It is also critical that we identify the core elements of effective strategies that must be present in order for the program to be successful in any context. Factors such as recruitment and retention rates, the minimum “dose” required as well as the support and infrastructure required to ensure success are important to document. The synthesis of data across programs and in varied contexts can inform dissemination efforts.
At the community level it is important to understand mediators at both the individual level and in the larger social environments. At the individual level exposure to adverse childhood experiences such as parental abuse or neglect, substance use, mental illness are potential mediators. At the community level, factors such as poverty, access to health services (physical and mental) crime, violence, drug use and trafficking attenuate individual risk factors and may influence program outcomes. Identifying and tracking trends in these types of community level indicators can assist practitioners in interpreting and synthesizing outcomes at the individual, system and community level. The NAS report proposes an integrated theory of change that requires the coordination between multiple sectors of the community (The theory of change can be viewed in the original document)
[2]
.
Intervention and community level outcome monitoring of child and youth well-being is a community-wide assessment process, requiring collaboration among diverse community partners. Successful community monitoring systems include the following features
[3]
:
- Provides the community with accurate estimates of well-being for the entire population of children and adolescents in the community.
- Identifies core indicators of well-being identified through research studies
- Includes indicators with both measures of youth functioning and measures of the factors that influence development.
- Generates information for decision makers and community members so that it can be easily understood and readily used for answering specific questions.
- Provides timely data about trends in well-being and risk and protective factors that predict youth outcomes.
- Utilizes available data including both survey and archival data.
- Encourages widespread participation of community members in the design, maintenance, and use of the system.
- Guides priority setting and decision-making regarding choice of programs, policies, and practices to improve youth well-being.
Epidemiology and evaluation have important roles to play in illuminating the myriad factors that influence healthy physical and emotional development of children and youth as well as increasing our understanding of
what
works for
whom
and under
what circumstances
. While assessment of individual risk and protective factors remain important, effective prevention
systems
also require assessment and understanding of community level factors that promote healthy development across the lifespan.
Helpful Resources
- Kids Count: online database that profiles well-being in each state
- Society for Prevention Research: dedicated to advancing scientific investigation on the etiology and prevention of social, physical and mental health, and academic problems and on the translation of that information to promote health and well-being. The multi-disciplinary membership of SPR is international and includes scientists, practitioners, advocates, administrators, and policy makers who value the conduct and dissemination of prevention science worldwide.
[1] National Academies of Sciences, Engineering and Medicine (2019).
Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda.
Washington, DC. The National Academies Pres, doi:
https://doi.org/10.1722625201
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