1. Prevention, Intervention, and Social Policy
H607: Ethnicity, Context, and Family Dynamics

2. The Plan Levels of prevention/intervention Prevention research cycle
With 2 examples
Issues to consider in prevention research

3. Prevention & Intervention
What is prevention/intervention?
Public Health & Community Psychology
Prevention: avoiding all or part of an etiological chain before it arises
Intervention: stopping, slowing, or reversing a process that is already underway
What is prevention/intervention research?
Identifying links in the causal chain (etiology and process)
Developing a small theory or theory of change
Intervention vs. Treatment

4. Levels of Intervention Categories of Prevention
Tertiary/ Indicated
Secondary/Selected
Primary/Universal

5. Prevention Research Cycle
Cost/Benefits
Analysis
Generative
Research:
Small Theory
Dissemination To
Public
Design Program
to change mediators
Field
Prevention
Trial
Controlled
Prevention Trial

6. Generative Research Base rates, prevalence, and incidence
Sources of the developmental outcome
Characteristics of Individual/family
Characteristics of the environment
Particular combinations of individual and environment
Etiologies
Moderator or risk factors
Mediating processes
Develop a “Small Theory” or “Theory of Change”

7. Develop a “Small Theory:” Advantages
A limited number of important and modifiable processes
Forces the investigator to specify central processes that underlie the developmental outcome
Guides program design and evaluation
Offers guidelines for the design of the intervention
Guides the design of the efficacy trials
With efficacy research, offers guidance for program redesign
Empirical tests of the Small Theory adds to our understanding of basic developmental processes

8. 2 Examples: New Beginnings (NB) & Early Alliance (EA)
Select an Outcome
NB: Conduct Problems, Depression, & other mental health problems
EA: Substance Abuse, Conduct Problems, & School Failure

9. Develop a “Small Theory:” Generative Research
New Beginnings:
Divorce is a risk factor—results in a secondary intervention. WHY?
Why divorce?
Disruption of
Family
Process
Divorce
Stress
Mental
Health
Problems

10. Develop a “Small Theory”
Early Alliance: 2 Levels
Level 1: All children are at some risk
results in a ________ intervention. WHY?
Teacher-
Student
Interactions
School Failure
Conduct Problems
Substance Abuse
Disconnected
from school
Negative
school
experience
Small Theory

11. Develop a “Small Theory”
Early Alliance: 2 Levels
Level 2: Some are aggressive and oppositional already
resulting in a _________ intervention. WHY?
Parenting
Difficulties
Poor
Coping
Strategies
Outcomes
Peer
Difficulties
Small Theory

12. Both Programs target conduct problems:
Different Small Theories
Different Interventions

13. Prevention Research Cycle
Cost/Benefits
Analysis
Generative
Research:
Small Theory
Dissemination To
Public
Design Program
to change mediators
Field
Prevention
Trial
Controlled
Prevention Trial

14. The Programs: New Beginnings
“Selected/Secondary” Program, 12 Weekly Sessions on topics
Topics:
Quality of Mother-Child Relationship
Disciplinary strategies
Negative Divorce Related Events
Contact with Noncustodial Father
Contact with Nonparental Adults

15. The Programs: Early Alliance
Target students:
All 1st & 2nd graders (universal/primary)
Those who are aggressive/oppositional (indicated/tertiary)
Universal/Primary (SEE TABLE 1)
Classroom component
Reading—mentoring
Indicated/Tertiary
Peer Intervention
Family Intervention

16. Prevention Research Cycle
Cost/Benefits
Analysis
Generative
Research:
Small Theory
Dissemination To
Public
Design Program
to change mediators
Field
Prevention
Trial
Controlled
Prevention Trial

17. Controlled Trial Why a controlled trial?
Under the absolute best circumstances does the intervention….
Change mediators
Change outcomes
Are these changes correlated

18. Prevention Research Cycle
Cost/Benefits
Analysis
Generative
Research:
Small Theory
Dissemination To
Public
Design Program
to change mediators
Field
Prevention
Trial
Controlled
Prevention Trial

19. Evaluation!! New Beginnings: Early Alliance
6 years post divorce, compared to control group
Change in outcomes
Few conduct problems & depressive symptoms
Change in mediators
Better communication between parents, better parenting practices, less conflict around visits
Early Alliance
3 years post program, compared to control group
Changes in outcomes
Lower in aggression , higher academic performance
Changes in mediators
Higher in coping competence
Higher engagement in school

20. Issues to Consider Iatrogenic Effects Attrition and Dosage
Unintended Modifications

21. Coming up Next Views on intervention targets and strategies
Program/Policy team project